Risk Manager

Virtual - Arizona (flexible 40 hours per week; will require traveling from site to site and working one day remotely for document preparation/claim file management).

About the role

Incumbent will primarily provide either risk event management or compliance assessment analysis. Develops, coordinates, and administers the activities of the Risk Management (RM) Department which encompasses all areas of potential liability exposure to the corporation, including aspects of patient care that impact the quality of services delivered and exposure to risks generated.

Emphasis is placed on error prevention, reporting process, data collection, analysis, reporting tools, and risk identification utilizing root cause analysis. Supports Scottsdale Captive Insurance Company by leading the investigation process, carefully documenting information gathered and action taken. Under the direction of legal counsel, may serve in the defense of any claims.

Responsibilities

• Investigates incidents, grievances, complaints, and claims at the direction of the General Counsel by analyzing appropriate documents to determine standard of care and general liability issues. Interviews staff, physicians, and other witnesses; prepares a summary of findings for Counsel.
• Manages accurate and detailed case files related to incidents and investigations. Performs additional research as required.
• May lead other high-level investigations requiring special skills and protection of confidential information, providing findings to leadership.
• Analyzes investigative results to establish an assessment of liability and recommends the disposition of claims and other liability situations.
• Collaborates with internal and external legal experts in the defense of claims against the system, including researching medical facts or cases, assisting outside counsel in preparing witnesses for depositions/trials, and participating in depositions.
• Represents HonorHealth at settlement conferences, trials, and other legal proceedings.
• Organizes and facilitates meetings with patients, families, attorneys, and interested parties to resolve disputes and/or negotiate settlements within administrative authority.
• Provides consultative services to staff members, physicians, and leadership regarding medical-legal issues.
• May provide ongoing advice and resources to management for compliance issues, process monitoring, and improvement, working with management to implement these improvements.
• Facilitates, consults, advises, and educates the organization in defining specific risk exposures to minimize the frequency and reduce the severity of actual and potential patient safety hazards based on current research findings and evidence-based practice.
• May assist in the development of compliance training materials and performance of ongoing compliance training throughout the facilities and research operation, including computer-based training.
• Remains current with ASHRM, JCH, CMS, and other regulatory requirements to minimize loss exposure and claims.
• Participates in multiple committees, task forces, and process improvement teams within the system. Recommends policy and procedure development and revisions.
• May manage or assist with management of members of the Risk Department for risk event management in closure of events and completion of worklists. Conducts system analysis and disseminates information as appropriate throughout the organization.
• May manage the MIDAS Risk event database, including directing data entry, monitoring database integrity, formulating reports, and training system users.
• Interacts and works collaboratively with all areas of the HonorHealth organization to integrate, coordinate, and manage reporting of risk event data within MIDAS Risk Management.
• Works with all levels of end users to understand their needs. Collaborates with MIDAS Specialist to write reports and assure completeness and accuracy before submitting to requestor.
• Tests MIDAS+ system upgrades and facilitates any identified changes in process as it relates to Risk events. Participates in the development of RDE Risk template use and dictionaries.
• Monitors and directs other department managers that use MIDAS Risk event data to ensure appropriate standards and processes are developed, monitored, and maintained to support the integrity of the Risk data.
• Identifies and resolves data integrity issues. Evaluates changes in data and the impact on data integrity with changes to data definitions and existing data as needed.
• Manages and facilitates ongoing training for new and existing Risk MIDAS+ users. Determines user security access for Risk event managers. Responds to user questions on system usage in the risk event module.
• May perform risk assessments of high-risk areas to evaluate potential for loss.
• May develop, in collaboration with various system stakeholders, risk reporting tools to track the effectiveness of programs, initiatives, and evidence-based practices for use in divisional planning.
• May collaborate with Quality Enhancement Services for sentinel event investigations and participates in root cause analysis teams for monitoring the effectiveness of continuing quality improvement as identified in the action plan.
• Serves as Risk Management Department liaison to Quality Enhancement Department to provide risk perspectives, strategies, and recommendations.
• May manage files for the system for Product Recalls and Safety Alerts. Investigates and provides required reporting, follow-up, and file maintenance for all Safe Medical Device Act reporting to the FDA within the system.

Requirements

• Bachelor’s degree in business or clinical area (required). Master’s degree in business or clinical area (preferred).
• 7 years of RN or clinical professional experience, with 5 years of risk management, patient relations, quality, or safety experience within the past 7 years (required).
• 5 years of RN or clinical professional experience, with 3 years of risk management, patient relations, quality, or safety experience within the past 5 years (required).
• State licensure and/or compact state licensure as an RN or other professional clinical licensure (required).
• CPHRM or ARM certification (preferred).