Risk Manager - Aurora St. Lukes

Major Responsibilities

• Utilizes a proactive risk management approach that relates to an enterprise scope of practice
• Establishes relationships with site executive and medical staff leadership to identify and facilitate development and resolution of system and site risk identification and reduction measures
• Oversees the development of site risk management programs, ensuring standard assessment and measures
• Supports appropriate risk management coverage within site
• Addresses health outcomes, risk identification, loss prevention, and claims management to improve the quality of patient care; prevent, mitigate and/or reduce risk of potential and actual financial, physical and reputational loss at assigned sites
• Participates in site health outcomes goals and strategic plan development, implementation and measurement including provision of data and recommendation within the site
• Participates in site level safety huddles; participate in weekly risk huddles
• Identifies, in conjunction with site and other departments, high risk areas requiring proactive risk assessments
• Captures, analyzes, and develops improvement actions based on claims loss runs
• Submits site and physician exposure data for the annual insurance renewal
• Maintains site adverse event reporting, investigation, and resolution process
• Reviews and tracks reported events
• Maintains and improves process to identify significant events and notify appropriate system and site executives, claims, patient safety, legal, compliance, safety/security, and media relations
• Facilitates patient disclosure meetings
• Tracks, trend, analyzes data to mitigate, reduce or eliminate harm and/or liability issues
• Works with public safety/security to identify, mitigate and prevent safety issues and exposure for the organization, including teammates and visitors
• Acts as the site risk expert and resource for medical/legal inquiries of physicians, nurses, administrators, and others regarding emergent patient care issues and loss control, in conjunction with Legal Counsel; for policy and procedure development, including event reporting, consent, and disclosure policies; for applicable contract review
• Works with site, and if needed other sites, to address patient complaints and grievances
• Ensures regulatory compliance and appropriate responses
• Ensures referral, review and response of patient complaints with significant quality or service concerns
• Involves language services and civil rights departments as needed
• Tracks and trend complaints and grievances, identifying risk or liability issues
• Works collaboratively with Legal and Compliance on site issues, contracts, regulatory and accreditation issues, operational and policy issues, governmental, litigation and other relevant issues
• Keeps management informed of site-based issues; coordinate communication to site from system

Licensure, Registration, and/or Certification Required

• Certified Professional in Patient Safety (CPPS) designation issued by the Certification Board for Professionals in Patient Safety (CBPPS) needs to be obtained within 1 year, or
• Certified Professional in Health Care Risk Management designation issued by the American Hospital Association (AHA) needs to be obtained within 1 year.

Education Required

• Bachelor's Degree in Health Care Administration or related field.

Experience Required

• Typically requires 7 years of experience in in system healthcare setting, experience with risk management, patient safety and quality.

Preferred

• Clinical experience
• Medical records review using Epic
• Origami system experience

Knowledge, Skills & Abilities Required

• Proficient in Microsoft Office (Excel, Word, PowerPoint, Access) or similar products
• Ability to guide and mentor physicians, including disruptive behavior and in situations where failure to follow policy is not an option
• Strong decision-making and critical thinking skills
• Significant successful high-level interaction with medical staff
• Strong skills in successfully managing multiple units
• Strong skills in diplomacy and conflict resolution at various levels within the organization
• Strong aptitude in human resource management
• Ability to handle multiple demands simultaneously
• Excellent communication skills (oral and written, group and one-on-one)
• Extensive knowledge of statistical methods, data analysis and presentation

Physical Requirements and Working Conditions

• Frequently lifts up to 10 lbs. and occasionally lifts over 100 lbs. with assistance
• Must be able to sit 50% of the workday and stand 35%
• Must have clear speech, hearing and vision
• Will be exposed to mechanical, electrical and chemical hazards
• Must wear protective clothing (i.e., lead aprons, isolation gowns, protective eyewear, etc.) as needed
• Operates all equipment necessary to perform the job