PeaceHealth is seeking a Clinical Risk Manager
Administers the risk management activities in assigned Network inpatient and outpatient facilities. Responsible for identifying, assessing and recommending actions for actual and potential exposures to the organization with a goal of improved patient safety and protection of the organization’s assets. Ensures adherence to government regulations and accrediting body standards and implements policies and procedures necessary to support risk structures and processes. Facilitates network, community, or PHMG leadership in the design, development, implementation, and monitoring of the risk management program, including effective systems which promote and support patient, caregiver and visitor safety, medical malpractice prevention and the health of the organization, and that align with PeaceHealth mission and values.
- Coordinates and administers risk identification, investigation and reduction, monitors risk functions and performs risk surveys to assess loss potential. Supports, and ensures the implementation of the System risk management strategies. Works in collaboration with the Patient Safety Consultant to improve patient safety. Will rotate on call coverage using a team approach.
- Performs investigations and responds to incidents/events, potential claims, and grievances presented against caregivers, physicians and the organization for liability and damages. Records and collects documents and evidence and maintains work product in accordance with legal requirements and sets up claim. Ensures collaboration and mitigation of risk to the organization’s insurance coverage against liability and casualty loss.
- Interacts with patients and their families when patient grievances arise. Conducts a review of the concern and responds in writing to the patient. Supports the work of the Complaint/Grievance Management program in accordance with CMS requirements.
- Collaborates with patient safety, medical and departmental caregivers to ensure timely risk management review and management of serious patient events and medical errors. Facilitates and/or co-facilitates the review of variances rising to a Sentinel Event, State and/or Federal regulatory reporting and directs the communication of unanticipated events to patients and potential compensable events. Provides clinical risk management guidance in safety stops including disclosure of unanticipated events.
- Analyzes variance data trends and reports findings related to risk strategies. Contributes to the development of mitigation and intervention strategies. Regularly provides leadership with progress reports and data (including recommendations) related to risk management.
- Serves as risk management representative to the Facility Quality and or Patient Safety Committee (including falls task force/team), Ethics Committee, Environment of Care, Grievance Committee and other assigned committees.
- Investigates alleged EMTALA violations. Ensures that applicable regulatory and accreditation requirements are met in a proactive manner. Participates in development of processes/systems designed to share and recognize performance improvements and compliance across the organization to mitigate risks to patient and caregiver safety/risks to the organization.
- Facilitates teams related to system-wide approaches for risk mitigation. Supports skills and competency development in risk management for community-based resources. With system team, designs training curriculum, develop program content and provide education to leadership teams, quality leaders, supervisors and staff.
- Develops and communicates with senior management on appropriate responses to risk events and medical care complaints in accordance with legal requirements.
- Serves as a liaison and problem solver to provide guidance for enterprise risk prevention for new clinical services, programs and equipment. Facilitates or co-facilitates FMEA study with Patient Safety caregivers and RCA meetings for Serious Reportable events in collaboration with the patient safety consultant.
- Bachelor’s Degree in Healthcare, Nursing, Business or Computer Science required or a combination of education and experience that provides the caregiver with the requisite knowledge, skills and abilities to perform the job will be considered.
- Minimum of three years of clinical risk management experience required.
- Certified Professional in Healthcare Risk Management (CPHRM) certification required within eighteen months of employment.
- Advanced knowledge of state, federal, and accreditation requirements including but not limited to: CMS Conditions of Participation for acute care and critical access hospitals,
- General knowledge in other regulatory areas such as, OSHA, EMTALA, and HIPPA.
- State healthcare rules and statutes, and state licensing requirements preferred.
- Experience and knowledge in use of administrative and quality data, with statistical validity preferred.
- Able to work flexible hours
- Participation in on-call coverage required.
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For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state, or federal laws.