Clinical Risk Manager

About the role

The Clinical Risk Manager is responsible for the review, investigation and prioritization of reported clinical and organizational events in order to decrease the frequency and severity of patient safety events and works closely with Claims Management to identify potential/actual professional and general liability claims. Collaborates with Performance Improvement team and Operational Leaders to identify key quality and patient safety trends. Actively engages leaders in evidence-based practice for cause analysis and high reliability strategies to prevent and mitigate patient safety events.

Responsibilities

• Patient Safety/Risk Management:
  • Review electronically reported events for inpatient units and procedural areas.
  • Identify and assess potential risks and liabilities of reported events.
  • Work with interdisciplinary teams to identify and implement risk mitigation strategies, leaders in associated departments/units to assure swift resolution, identification of key learning elements/strategies and assuring timely action/communication is planned and initiated.
  • Ensure involved department(s) event follow-up is timely and appropriate.
  • Provide patient safety/risk management support for assigned areas including noted trends and education.
  • Collaborate with identify key quality and patient safety issues that require broader system review and intervention.
  • Partner with organizational leaders and frontline staff to improve safety culture and processes.
  • Educate all levels on the importance of early notification of patient safety events.
  • Analyze experiential data and report trends to leadership.
  • Serve as an advisor to physicians and Administration on issues related to disclosure, documentation, and management of untoward outcomes.
  • Coordinate communication of preventable untoward outcomes to key corporate individuals as per protocol.
  • Manage in collaboration with physician leadership as part of the peer review process.
  • Collaborating with clinical and administrative teams to conduct risk assessments.
  • Promoting patient safety and error prevention through evidence-based practices.
• Claims Investigation:
  • Investigate occurrences to identify Potential Compensable Events (PCEs) and work with Claims Management team to discuss and determine liability and causation.
  • Work with the Claims Management team to process Notices of Claim (NOCs) for submission to Third Party Administrator (TPA) in a timely manner.
  • Attend monthly Risk/Claims Management meetings to discuss assigned PCEs and NOCs.
  • Identify potential insurance claims, including tracking, reporting, and coordinating resolution with the Legal and Insurance attorneys/team.
  • Develop and implement risk mitigation strategies and programs to reduce the hospital's exposure to liability and financial risks.
  • Liaise with insurance providers and legal counsel as needed.
• Other:
  • Address and assist the Compliance team with the mitigation of mitigating compliance issues as necessary.
  • Analyze data related to risk management, incidents, and claims to identify trends and areas for improvement.
  • Use data to inform risk reduction strategies.
  • Provide training and education to clinical, non-clinical, and administrative staff on risk management, patient safety, and legal considerations.
  • Foster a culture of risk awareness and safety.
  • Develop and maintain effective emergency preparedness plans and responding plans to ensure the hospital's readiness for unforeseen events.
  • Takes call 24/7 on a rotating basis.

Requirements

• Bachelor's Degree in Health Administration Required OR Bachelor's Degree in Nursing Required.
• 5+ Years Clinical experience AND 2 Years Patient safety/risk management experience as a specialty or associated with Clinical Leadership responsibilities.
• Experience with Epic and RL Solutions preferred.
• Strong communication skills - written and verbal.
• Ability to interact with all levels of the organization confidently and professionally.
• Ability to partner with a wide range of team members, physicians and clinicians.
• Conflict resolution and mediation skills.
• Be flexible and adaptable to changing situations and priorities.
• Strong investigative and analytical skills.
• Multi-tasking capacity.

Qualifications

• Registered Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR) Preferred.

Skills

• Strong communication skills - written and verbal.
• Ability to interact with all levels of the organization confidently and professionally.
• Ability to partner with a wide range of team members, physicians and clinicians.
• Conflict resolution and mediation skills.
• Be flexible and adaptable to changing situations and priorities.
• Strong investigative and analytical skills.
• Multitasking capacity.

Benefits

• Premium pay for eligible employees.
• Career Pathways to Promote Professional Growth and Development.
• Variety of Medical, Dental, and Vision options.
• Tuition Reimbursement.
• Free Parking at designated locations.
• Wellness Program Savings Plan.
• Health Savings Account Options.
• Retail Options with Company Match.
• Paid Time Off.
• Community Involvement Opportunities.