The Manager of Risk Management reports to the Director, Patient Safety. They are responsible for mitigating risks to patients, employees and the facility. Strong customer service as well as patient advocacy skills as the candidate is responsible for the hospital’s grievance process. The Risk Manager must also utilize data to identify trends and process improvements. Develops proactive loss control techniques and recommendations, and communicates to employees and medical staff through written documents and in-service programs.
- Assists in the establishment and effectiveness of a vigorous loss prevention program. This includes but is not limited to the daily review of the facility’s incident reporting system, investigating, analyzing, and reporting patient safety incidents, medical errors, and potential risks to patients, hospital staff, and the facility. Coordinates disclosure of serious events to patients and/or families in accordance with organizational policy and regulations.
- Assists the Director Patient Safety with defense legal counsel coordination of investigations, processing and defense claims against the facility; records, collects, documents, maintains and providing defense attorneys any requested information as well as other documents as requested.
- Maintains the claims management system, effective lines of communication with the hospital CEO, the Director of Corporate Claims, legal counsels, Administration and Department Directors/Nurse Managers, and others as necessary; assisting in adjusting and settling claims with corporate guidelines; and working with hospital legal counsel in developing a satisfactory defense.
- Develops responses to patients, their families, and employees following the investigating of potentially compensable events and asserted legal actions. Ensures that responses are compliant with regulatory timeframes. Also ensures that departmental benchmarks (turnaround times) for facility responses are met.
- Acts as a resource for patient and families as well as departmental customers.
- Coordinates annual and ongoing patient safety education, i.e. falls prevention, etc. to hospital staff as needed.
- Improves patient quality of care by analyzing claims, reviews policies and procedures, Responsible for researching topics on Risk Management, and reports any quality of care issues up the chain of command.
- Serves as a source of information on medical/legal issues as they arise throughout the facility.
- Demonstrates knowledge or hospital and departmental policies and procedures, and interprets these to patients, families, and hospital staff when necessary.
- Demonstrates knowledge of guidelines and standards of various regulatory agencies to assist in mandatory compliance and accreditation.
- Keeps abreast of pertinent legislations, statutes and trends concerning areas of claims/risk management responsibilities.
- Include patient safety in new hire orientation presentation (e.g. regulatory requirements, reporting expectations, safety culture, etc.)
- Work with security on procedures to reduce the frequency and/or minimize the severity of property loss or assets.
- Manage non-HCI cases: accept/process subpoenas, visitor events, property loss or theft, etc.
- Either graduate of accredited nursing school or degree in health service or related field
- Master’s degree preferred at hire, but required within 3 years of hire
- Minimum of five (5) years’ experience required in an acute care hospital setting
- If RN, current Nevada RN license required
- Certified Professional in Health Care Risk Management (CPHRM) within 1st year of hire
- IHI Basic Quality Certification, Institute for Healthcare Improvement within 1st year of hire.
- ASHRM – American Society for Healthcare Risk Management
- AHA – American Hospital Association
- Proven risk management experience
- Claims adjustment/insurance/legal experience preferred
- Data analysis and interpretation skills preferred
- Must be able to articulate data findings to hospital staff