Job DescriptionThe Risk Management Program Manager will participate in creating an atmosphere that supports and encourages high performance, teamwork and continued dedication toward improved Risk Management throughout UPH. This position will focus on creation and execution of action for key, complex projects within and supporting the Risk Management team. Serves as a resource, liaison and representative of UPH, expanding the capabilities of clinicians, managers, and administrators by providing them with resources to accomplish specific objectives aimed at decreasing risk across the health system, improving patient care processes and protecting the assets of the organization.
Responsible for supporting and assisting Associate General Counsel, Director Enterprise Risk Management and Risk Managers to oversee projects and initiatives to ensure timelines and high-quality outcomes are achieved.
Responsibilities:Risk Management Advisor
- Serves as a risk management advisor and expert; provide justification for decisions using data combined with a deep understanding and knowledge of risk management at UnityPoint.
- Consult, advise, and lead multiple health system diverse strategic, initiatives, including defining the scope and work plan, managing execution across deliverable design and development, coordinating resources, and aligning with key stakeholders.
- Assist in the development, implementation, and maintenance of structures and processes which support risk management and patient safety.
- Provide guidance on risk mitigation strategies, contract formation and contract management.
- Facilitate the collection, storage, and analysis of loss control, improvement, and safety data.
- Report on KPIs, KRIs and other loss control/claims data to UPH leadership on a regular basis.
- Investigate and develop risk reduction/loss control strategies from claims data.
- Assist in the development of policies, procedures, systems and works flows that enhance the overall Risk Management Program throughout UPH Health System as appropriate.
- Initiate planning and development of risk management and loss prevention education for all departments & care providers.
- Provide risk management consultation and advice to executives, physicians, care providers and employees and maintains knowledge of current healthcare-related risk management trends and issues.
- Coordinate and/or conduct annual Risk Assessments in high-risk areas or process and implements actions plans from findings.
- Collaborate with UPH Legal, the Third-Party Administrator, commercial insurance carriers and defense counsel in supporting the litigation process.
- Complete and report potential liability issues and claims internally as well as to UPH, the Third-Party Administrator, and any other commercial insurers as indicated using claim reporting guidelines established by UPH legal and any commercial insurer as directed.
- Collaborate with claimants, legal, senior leadership and other colleagues to evaluate and when indicated, negotiate asserted claims to resolution.
- Lead and organize disclosure teams for adverse outcomes when appropriate for disclosure.
- Review and make recommendations to continuously improve, expand and create efficiencies in current programs and practices.
- Serves as member of Critical Events Committee (CEC), safety, mortality/morbidity, and other committees that would benefit from risk management representation.
- Complete medical record reviews, compares current practice against best practice guidelines and provides recommendations to reduce risk and improve patient care processes.
- Support Patient Relations with Complaint and Grievance responses specific to harm (and potential for liability).
- Investigate potential compensable events as directed by Director or UPH Legal, which may include interviews of medical staff, employees, visitors, and patients, and assesses potential liability.
- Identify potential loss conditions and practices and evaluate their significance. Reports findings and devises remedial action plans.
- Perform other duties as required or assigned.
QUALIFICATIONS:- Bachelor's degree in nursing, health-related field or risk management.
- Five years of progressive risk management experience required.
- Experience applying modern improvement methodology to lead change required.
- Experience in the concepts and applications of continuous improvement including ability to manipulate data, trend and analyze data
- Prior Healthcare Risk Management experience is strong preferred.
- Valid driver's license when driving any vehicle for work-related reasons.
- Certified Professional in Healthcare Risk Management (CPHRM), Associate in Risk Management (ARM), or Certified Professional in Patient Safety (CPPS).
- Writes, reads, comprehends and speaks fluent English.
- Demonstrated excellence in judgment, temperament, confidentiality, collaboration, education, written and verbal communication skills, facilitation, and crisis management teaching and interpersonal skills.
- Must be familiar with general clinical aspects of patient care.
- Flexibility, tolerance, and demonstrated ability to prioritize multiple tasks with attention to detail essential.
- Demonstrated ability to interact with a wide diversity of people and situations while maintaining a customer focus.
- Ability to adapt to stressful situations quickly and effectively.
- Must have accurate word processing/computer skills.
- Must have excellent verbal/written communication skills, analytical skills, and must exhibit good judgement.
- Must have knowledge and good understanding of hospital policies and procedures related to patient care and safety
- Proficient use of software applications including but not limited to Microsoft Word, PowerPoint, Excel and Outlook
