EWARD HEALTH CARE SYSTEM POSITION DESCRIPTION
POSITION: Risk Manager GRADE:
REPORTS DIRECTLY TO: Director of Quality & Safety
REPORTS INDIRECTLY TO: Chief Medical Officer, Corporate Risk Management and Patient Safety
The risk manager is responsible for coordinating all aspects of the risk management program, including the identification, evaluation and treatment of risk in the organization. The risk manager develops and manages a systematic process to identify, assess, and treat actual and potential exposures to loss.
Assists the Director of Quality and Safety and Manager of Accreditation/Regulatory Readiness and Patient Safety with the implementation of the System-wide Quality and Safety Plan consistent with board approved plans and regulatory and standard setting agencies.
- Collaborates with the following staff, by job category:
- Chief Medical Officer
- Chief Nursing Officer
- Patient Care Directors
- Physician Leaders
- Case Managers
- Patient Care Assessment Coordinator
- Director, Care Management Systems
- Infection Control Nurse Epidemiologist
- Serves in a consultative role to the following:
- Q & S Task Forces
- Directors of Support Services
- Medical Staff Service Committees
- Serves on Hospital committees as directed including but not limited to:
- Quality and Safety Committee
- Grievance Committee
- Patient Safety Triage Team
- Patient Care Assessment Committee
- Supervised and/or reportable to the following, by job category:
- Director of Quality and Safety
- Oversees activities of the Patent Advocate and Human Rights Officer to ensure compliance with reporting obligations as defined by regulating bodies
- Under the general supervision of the Director of Quality and Safety as well as the System Risk Management/Patient Safety/ CMO with latitude for independent initiative and judgment consistent with elements of the Quality and Safety Program
- Manager is responsible for assisting with the day to day implementations of the system’s approved Q & S Plan
- Oversees the activities of the Patient Advocate/Human Rights Officer
- Manages a risk identification process for the organization’s operations, departments, and services. Educates and assists other managers in assessing their areas of responsibility for exposures to loss and unsafe processes and conditions.
- Maintains a risk management information system. Collects, evaluates, and reports on events, incidents, and claims. Performs statistical analysis and trending of events and claims to pinpoint high risk areas for management attention.
- Reviews and analyzes incident reports, rates by severity and conducts all follow-up as identified from review. Completes trending analysis to identify top priority areas for improvement
- Investigates all serious events. Assists with communication and documentation of errors or serious events in accordance with legal requirements and/or accreditation standards.
- Develops and maintains positive working relationships with providers, management, and staff to promote open communication and accurate flow of information.
- Coordinates risk and safety management orientation and continuing education programs for providers, management, and staff to enhance awareness of their role in patient safety, risk reduction, and event reporting.
- Chairs the patient safety triage team/grievance committee(s) and serves on other patient care and safety related committees as member, or ex officio, as needed to communicate findings, recommendations, actions, and results.
- Acts as liaison to outside agencies such as local, state, federal, or voluntary accrediting agencies.
- Prepares reports of events as required by law or in accordance with voluntary participation.
- Coordinates internal surveys and inspections, monitors reports, and coordinates corrective actions or recommended improvements with management and staff.
- Remains knowledgeable about and promotes compliance with professional standards and guidelines. Implements changes to ensure consistency with regulatory requirements.
- Works with general counsel to coordinate the investigation, processing, settlement, and defense of claims and suits against the organization. Notifies insurance carriers of potential and actual claims. Coordinates the release of information in response to subpoenas, court orders, attorney requests, etc.
- Reviews patient complaints which may result in legal action. Works with patient advocate to offer solutions to patient grievances. Works with billing and compliance officer in deciding on appropriateness of billing waivers/write offs.
- Assists departments with the integration of quality, regulatory, infection control and risk management activities
- Supports process of root cause analysis in the event of a sentinel or near miss event. Coordinates review of medical information, debriefs all individuals as identified, performs cause and effect analysis and coordinates expert panel review, root solution and follow-up for all incidents identified
- Supports FMEA analysis when high volume, high risk opportunities as discovered through incident report analysis. Organizes team, creates process maps, creates failure modes analysis, identifies prevention and/or corrective action strategies and implants as identified
- Understanding and implementation of programs related to national and local patient safety initiatives
- Acts as liaison to statewide and national collaborative for quality and safety initiatives
- Available on beeper/phone at all times during scheduled working hours
- Performs all other job- related duties as requested by the Director of Quality and Safety
- Duties as assigned by Director of Q & S
- Shall be accountable for the on-going integration of the System Quality and Safety Plan
- Shall be accountable for abiding by all relevant departmental/hospital policies and procedures
- Shall be accountable for maintaining the confidentiality and security of all hospital related, medical staff related and patient related data and information
- Shall be accountable for the timely and complete review and investigation of all incidents and grievances reported into the department.
- Two to five years experience within a hospital risk management with a focus on patient safety, risk management or quality improvement. Experience and/or demonstrated understanding of root cause analysis and FMEA analysis.
- RN preferred or other Clinical background to provide for appropriate investigation of clinical events
- BS required, MS or JD preferred
- Strong organizational skills
- Strong interpersonal skills, ability to work across disciplines
- Ability to analyze data, formulate meaningful information
- Ability to work with highly sensitive and confidential information with appropriate discretion
- Able to communicate verbally and in writing in the English language
- Training in patient safety or risk management and quality/performance
- Improvement methodology, concepts, education and implementation
- Membership and active participation in professional organization(s)
- Certified Professional in Healthcare Risk Management (CPHRM), preferred
- State licensed when indicated
Equal Opportunity Employer Minorities/Women/Veterans/Disabled