Risk Program Manager

Position Summary

The Risk Program Manager collaborates with senior leaders and key stakeholders or experts, (e.g., Clinical Operations, Patient Safety, Supply Chain, Legal, and Regulatory Services), throughout Phoenix Children's to develop system-wide responses to risk issues that impact specific groups or the entire organization with policies/procedures, guidelines, tools, forms, and education/training. In addition, this position serves as a liaison between patients, families, and all hospital departments, facilitating conflict management and complaint resolution to achieve optimal communication between patients and healthcare team.

Position Duties

• I. Develops risk mitigation strategies based on analysis of relevant data (e.g. claims, complaints/grievances, Serious Reportable Events, and risk assessments).

  Investigates and analyzes potential and actual professional liability exposures in the organization; evaluate the extent and elements of exposure and recommend appropriate actions for risk mitigation

  Works in conjunction with the Quality Management and operational leaders in the investigation of potential or actual events/concerns.

  Participates in root cause analysis (RCA), Failure Mode and Effects Analysis (FMEA), or risk mitigation and investigation strategies.

  Supports the Risk Management and Quality Management teams in error prevention efforts by investigating and analyzing events and trends, and communicates findings to appropriate departments/staff.

  Develops processes and benchmarks to monitor the effectiveness of risk mitigation strategies.

  Collaborates with Risk Management and Quality Management staff in developing periodic in-services, teleconferences, face-to-face meetings and work groups regarding health care risk management and related topics.

  Performs risk assessments and audits in various clinical settings and coordinates development of clinical loss prevention plans for Phoenix Children's based on event or claims analysis.

  Absorbs an active role in on-boarding newly acquired practices and mitigating potential liabilities using risk assessment tools.

  Assists Quality Management in gathering information requested by regulatory agencies, in regards to complaints/grievances, and event investigations.

  Assists Quality Management in the identification of policies/procedures, and other information that identifies and supports organizational efforts in response to regulatory investigations.

• II. Investigate and analyze potential and actual professional liability exposures in the organization; evaluate the extent and elements of exposure and recommend appropriate actions for risk mitigation.

  Ensures the quality of legal services for HPL lawsuits and the efficient use of funds allocated for legal expenses by directing the activities of outside defense counsel, performing internal audits of defense legal services and continually evaluating strategic alternatives and opportunities for early mediation/resolution of claims and litigation.

  Serves as a liaison between Counsel, other business units and external contacts to coordinate and expedite legal matters to ensure discovery and other related documents are prepared and executed accurately and in a timely manner.

  Collaborates in the completion of notifications and financial recommendations needed for compliance with tracking and insurer requirements, including excess insurance carrier notifications, reserve recommendations, and any federal, state, or entity reporting requirements (including SMDA, MMSEA Section 111, DataBank, etc.) as necessary.

  Provides oversight and maintains the accuracy and integrity of documentation in the Risk Management System (RMIS).

  Ensures that the claims/litigation files and other documentation are organized, clear, concise, and timely updated.

  Works with clinical leaders to manage complex or unresolved complaints and grievances.

  Researches medical records, policies and procedures to gather information required for the resolution of complaints/grievances.

  Supports operational leaders in implementing and sustaining patient experience improvement initiatives.

  Is a key partner is supporting the culture of patient and family centered care.

  Initiates rounding on patients and staff and prioritizes focused re-visits to improve the patient and family experience.

  Works with clinical leaders to ensure a written response to grievances in accordance with applicable policies and regulations.

• IV. Provides on-call assistance for emergent/urgent risk management issues.

  Performs miscellaneous job related duties as requested.

Position Qualifications

• Education

  Do you meet this requirement or have the ability to obtain it within the timeframe listed in the requirement?

  Bachelor of Science in Nursing (BSN) or a related field.

  Required Yes No

• Experience

  Do you meet this requirement or have the ability to obtain it within the timeframe listed in the requirement?

  Three(3) or more years of experience in one (1) or more of the following fields: Registered Nurse, Respiratory Therapist, or other clinical professional field,

  Required Yes No

• Experience

  Do you meet this requirement or have the ability to obtain it within the timeframe listed in the requirement?

  Three(3) or more years of experience in Risk Management, Quality Improvement, or other loss prevention techniques and operations.

  Required Yes No

• Skills

  Possess project management skills as well as strong verbal and written communication skills.

  Ability to effectively listen, present, discuss, report, and explain trends and patterns.

  Must possess high level of interpersonal diplomacy, finesse and negotiation ability to influence a wide variety of stakeholders, many of whom have responsibilities and interest that are distinct form those of Risk Management.

  Possess a comprehensive knowledge of healthcare Risk Management and loss prevention techniques and operations.

  Preferred Yes No

• Special Skills

  Requires significant use of personal computer, phone and general office equipment and databases.

  Required Yes No

• Physical Requirements & Occupational Exposure/Risk Potential

  Physical Requirement - Climbing - Frequently

  Physical Requirement - Feeling (sensing textures and temperatures) - Frequently

  Physical Requirement - Fine Motor Skills (pinching, gripping, etc) - Frequently

  Physical Requirement - Hearing - Constantly

  Physical Requirement - Pushing/pulling - Occasionally

  Physical Requirement - Reaching - Frequently

  Physical Requirement - Sitting - Constantly

  Physical Requirement - Standing - Constantly

  Physical Requirement - Stooping/crouching/kneeling/crawling - Frequently

  Physical Requirement - Talking - Constantly

  Physical Requirement - Tasting/smelling - Occasionally

  Physical Requirement - Walking - Constantly

  Physical Requirement - Near Vision - Constantly

  Physical Requirement - Far Vision - Constantly

  Physical Requirement - Color Discrimination - Occasionally

  Physical Requirement - Use of keyboard, mouse and/or computer equipment - Constantly

  Occupational Exposure/Risk Potential - Inside office environment

  Occupational Exposure/Risk Potential - Outdoor weather conditions

  Occupational Exposure/Risk Potential - Extreme temperatures

  Occupational Exposure/Risk Potential - Confined areas

  Occupational Exposure/Risk Potential - High places

  Occupational Exposure/Risk Potential - Extreme noise levels

  Occupational Exposure/Risk Potential - Airborne communicable diseases

  Occupational Exposure/Risk Potential - Bloodborne pathogens or bodily fluid

  Occupational Exposure/Risk Potential - Fumes or airborne particles

  Occupational Exposure/Risk Potential - Hazardous materials exposure

  Occupational Exposure/Risk Potential - Radiation exposure

  Occupational Exposure/Risk Potential - Toxic or caustic chemicals

  Applicable