Clinical Risk Manager

Responsibilities

• Participate in day-to-day risk management operations, including risk mitigation, investigations, and responding to safety events.
• Develops, coordinates, and administers facility-wide systems for risk identification, investigation, and risk reduction.
• Reviews collected data to identify trends regarding accidents or occurrences, and recommends corrective action to management, if appropriate.
• Informs leaders of events/incidents, issues, findings, and risk management recommendations; provides feedback to leaders at all levels in the effort to eliminate risks.
• Proactive analysis of patient safety and medical errors processes.
• Prepares reports for leaders regarding trends/patterns and findings.
• Exercise professional judgment and critical thinking to facilitate focused investigation and root cause analysis and the development of appropriate corrective action plans.
• Leads investigations for adverse events and sentinel events. This includes leading root cause analysis and making recommendations for improvement.
• Prepares risk management and patient safety reports to be submitted to the senior leadership, board, and other appropriate committees.
• Active participation in patient safety activities by providing data to support priorities, clinical risk management expertise, and participating in patient safety projects.
• Serves as a resource, internal consultant, and educator for patient safety/risk management issues.
• Complies with various codes, laws, rules and regulations concerning patient care, including those mandated by state and federal agencies, incident reporting, also includes investigative activities with federal, state and local enforcement authorities.
• Designs and implements risk management surveys and studies; conducts surveys studies, and special projects to assist in long-term planning and changes to facility polices and systems that reduce risk and losses.
• Responsible for identifying and communicating regulatory requirements related to risk management.
• Facilitates and assists with disclosure of medical errors and supports providers through the process.
• Assists in resolving treatment issues, including patient decisions made against medical advice (AMA), refusals of treatment, and consent issues.
• Provides assistance to departments in complying with Joint Commission or other accrediting agencies regarding risk management related standards.
• Recommends appropriate revisions to new or existing policies and procedures to reduce the frequency of future occurrences; recommends ways to minimize risk through system changes; reviews and revises facility policies as appropriate to maintain adherence to current standards and requirements.
• Maintains awareness of legislative activities that may affect risk management programs.
• Organizes and manages facility-wide educational programs on healthcare risk management and related subjects for healthcare practitioners.
• Plans, develops, and presents educational material to administration, the medical staff, nursing personnel, and other department personnel on topics related to risk management as they affect personnel.
• Maintains a risk management education calendar
• Manages/facilities any of the following activities as assigned: Nursing peer review Ancillary peer review Physician quality review Resident quality review
• Collaborates with security and local police on procedures to reduce the frequency and/or minimize the severity of property loss or assets.
• Collaborates with the claims and insurance team regarding actual or potential injury to patients, visitors, and employees; collects information necessary to prepare for the defense of claims.

Qualifications

• Bachelor Degree Nursing from an accredited college or university.
• 5 or more years of experience as a nurse in a healthcare setting.
• 2 or more years of management experience or leadership role in a healthcare setting.
• 2 or more years of experience in one or more of the following areas: risk management, quality improvement, health information management, healthcare administration, business administration, legal support, or insurance claims investigation, and settlement.