Risk Manager

About the role

The Risk Manager is responsible for the review and evaluation of events entered into the Atlantic Health reporting system, and to identify potential claims, lawsuits, and reportability under the Patient Safety Act. Refers events to Peer Review, Quality & Outcomes Management and other committees to address as appropriate. Manages the resolution process related to complaint/grievances. Provides education to nursing, medical residency staff and all ancillary departments as needed. Manages translation services.

Responsibilities

• Organizes and moderates Root Cause Analysis and assists with the development of corrective action plans.
• Captures and documents facts and reviews medical records/documentation.
• Responds to significant events; review facts; review medical record/documentation; preserve any evidence; conduct staff interviews.
• Provides recommendations for staff re: investigation/handling of events to appropriate management, administrators.
• Develops educational programs as appropriate or needed based on event findings and trends.
• Evaluates event for severity, frequency and probability of financial loss.
• Reports as appropriate to administration and committees.
• Submits initial notification of SPE to DHSS.
• Coordinates case presentations to Preventable Events Review Committee.
• Addresses clinical queries by reviewing applicable policies and aligning responses with identified clinical needs.
• Serves as a resource for all inquiries, fostering ongoing open communication and engagement.
• Delivers targeted education and in-service training to nursing, medical, and residency staff, as requested or informed by needs identified through case review and event reporting trends.
• Triage events, escalate, investigates and refers as appropriate, close events.
• Acknowledges clinical staff for Good Catches.
• Facilitates, prepares and submits material to agency and respond to deficiencies.
• Coordinating and facilitating investigations (DHSS), (FDA), (CMS).
• Facilitate, prepare and submit material to agency and respond to deficiencies.
• Coordinate voluntary and required reporting to the FDA.
• Proactively manage difficult patients and family members of complex care cases to mitigate complaints.
• Manage the response process as well as the electronic documentation of all clinical complaints/grievances in the database.
• Track and trend patterns of complaints/grievances and reports to leadership.
• Ensure compliance with DOH/CMS regulations regarding clinical patient complaints/grievances.
• Manage and arrange language translation services for patients and families while ensuring compliance with regulations.
• Provide training to teams on language translation services as needed.

Qualifications

• Bachelor's degree in Healthcare or related field preferred.
• Minimum 7 years of Risk Management experience preferred.
• Minimum 3 years in Healthcare work experience required.
• Must pass a Level II Background Check.
• Required Licenses, Certifications Or Registrations: RN or other clinical professional license, CPHRM within two years of hire.

Skills

• Strong analytical and problem-solving skills.
• Excellent communication and interpersonal skills.
• Ability to manage multiple tasks and prioritize effectively.
• Knowledge of healthcare regulations and standards.
• Proficiency in Microsoft Office Suite.

Benefits

Atlantic Health offers a competitive and comprehensive Total Rewards package that supports the health, financial security, and well-being of all team members. Offerings vary based on role level (Team Member, Director, Executive). Below is a general summary, with role-specific enhancements highlighted:

• Medical, Dental, Vision, Prescription Coverage (22.5 hours per week or above for full-time and part-time team members)
• Life & AD&D Insurance
• Short-Term and Long-Term Disability (with options to supplement)
• 403(b) Retirement Plan: Employer match, additional non-elective contribution
• PTO & Paid Sick Leave
• Tuition Assistance, Advancement & Academic Advising
• Parental, Adoption, Surrogacy Leave
• Backup and On-Site Childcare
• Well-Being Rewards Employee Assistance Program (EAP)
• Fertility Benefits, Healthy Pregnancy Program
• Flexible Spending & Commuter Accounts
• Pet, Home & Auto, Identity Theft and Legal Insurance

Pay

Final compensation and benefit eligibility may vary by role and employment status and will be confirmed at the time of offer.

Schedule

Hours and schedule details will be provided upon hire.