The risk manager is responsible for coordinating all aspects of the risk management program including the identification, evaluation and treatment of risk in the organization. The risk manager develops and manages a systematic process to identify, assess, and treat actual and potential exposures to loss. Assists the Director of Quality with the implementation of the System-wide Quality and Safety Plan consistent with board approved plans and regulatory and standard setting agencies.
- Manages a risk identification process for the organization's operations, departments, and services.
- Educates and assists other managers in assessing their areas of responsibility for exposures to loss and unsafe processes and conditions.
- Maintains a risk management information system.
- Collects, evaluates, and reports on events, incidents, and claims.
- Performs statistical analysis and trending of events and claims to pinpoint high risk areas for management attention.
- Reviews and analyzes incident reports, rates by severity and conducts all follow-up as identified from review.
- Completes trending analysis to identify top priority areas for improvement.
- Investigates all serious events. Assists with communication and documentation of errors or serious events in accordance with legal requirements and/or accreditation standards.
- Develops and maintains positive working relationships with providers, management, and staff to promote open communication and accurate flow of information.
- Coordinates risk and safety management orientation and continuing education programs for providers, management, and staff to enhance awareness of their role in patient safety, risk reduction, and event reporting.
- Chairs the patient safety triage team and serves on other patient care and safety related committees as member, or as needed to communicate findings, recommendations, actions, and results.
- Acts as liaison to outside agencies such as local, state, federal, or voluntary accrediting agencies.
- Prepares reports of events as required by law or in accordance with voluntary participation.
- Coordinates internal surveys and inspections, monitors reports, and coordinates corrective actions or recommended improvements with management and staff.
- Remains knowledgeable about and promotes compliance with professional standards and guidelines.
- Implements changes to ensure consistency with regulatory requirements.
- Works with general counsel to coordinate the investigation, processing, settlement, and defense of claims and suits against the organization.
- Notifies insurance carriers of potential and actual claims.
- Coordinates the release of information in response to subpoenas, court orders, attorney requests, etc.
- Reviews patient complaints which may result in legal action.
- Works with patient advocate to offer solutions to patient grievances.
- Works with billing and compliance officer in deciding on appropriateness of billing waivers/write offs.
- Assists departments with the integration of quality, regulatory, infection control and risk management activities
- Supports process of root cause analysis in the event of a sentinel or near miss event.
- Coordinates review of medical information, debriefs all individuals as identified, performs cause and effect analysis and coordinates expert panel review, root solution and follow-up for all incidents identified
- Supports FMEA analysis when high volume, high risk opportunities as discovered through incident report analysis.
- Organizes team, creates process maps, creates failure modes analysis, identifies prevention and/or corrective action strategies and implants as identified
- Assists Director with appropriate reporting of risk events to regulatory agencies and insurance carrier
- Understanding and implementation of programs related to national and local patient safety initiatives
- Acts as liaison to statewide and national collaborative for quality and safety initiatives
- Available on beeper/phone at all times during scheduled working hours
- Performs all other job related duties as requested by the Director of Quality.
- Accountable for the on-going integration of the System Quality and Safety Plan.
- Abide by all relevant departmental/hospital policies and procedures.
- Maintain the confidentiality and security of all hospital related, medical staff related and patient related data and information.
- Timely and complete review and investigation of all incidents and grievances reported into the department.
- Under the general supervision of the Director of Quality as well as the Vice President of Medical Affairs with latitude for independent initiative and judgment, the Quality and Safety program.
- Responsible for assisting with the day to day implementation of the system's approved Quality and Safety Plan.
- Oversees activities of the Patient Advocate and Human Rights Officer to ensure compliance with reporting obligations as defined by regulating bodies.
- Two to five years experience within a hospital risk management with a focus on patient safety, risk management or quality improvement.
- Experience and/or demonstrated understanding of root cause analysis and FMEA analysis.