Job SummaryThe RN - Clinical Risk Manager ("CRM") is responsible for identifying, assessing, and mitigating risks across the MVHS system while enhancing patient safety and quality of care. This position will administer MVHS's risk management program on a day-to-day basis, documenting, managing and analyzing risk management data, conducting proactive risk assessments, delivering targeted risk management education, and providing risk management consultation to ensure compliance with regulatory standards, promoting a culture of safety, throughout the organization. Responsible for management of pending insurance claims and partnering with brokers and insurers.
Core Job Responsibilities- Coordinates MVHS's clinical risk management program to meet the system's needs in a manner that fulfills our mission and strategic goals while complying with regulations, laws and accreditation standards.
- Follows a comprehensive enterprise risk management approach in risk identification, analysis, evaluation, mitigation and monitoring.
- Reviews and analyzes occurrence reports related to risk management, quality of care, regulatory issues, and insurance concerns.
- Participates in Root Cause Analysis investigations and coordinates with departments and clinical chairpersons for peer reviews.
- Prepares incident summary reports and provides all necessary documentation for investigations and resolutions. Submits reports to appropriate regulatory authorities as required.
- Monitors the risk management information system database for patient harm events or unanticipated outcomes and investigates accordingly.
- Participates in the peer review process and ensures safety solutions are implemented.
- Collaborates with on-site investigators and participates in risk management assessments.
- Serves as a resource person and presents risk management issues for discussion and evaluation.
- Identifies organizational risks through trend analysis. Prepares and presents reports to be presented to leadership regarding findings. Advises on the risk of current or future activities conducted throughout the system.
- Collaborates with other areas including Quality/Performance Improvement to establish quality and safety goals; participates on quality of care and patient safety committees.
- Reviews and/or drafts administrative policy and procedures that fall within the risk management domain.
- Provide guidance and advice regarding clinical risk management issues, policies, procedures and practices across MVHS system.
- Delivers educational programs to raise staff awareness of risk exposure and professional liability.
- Responds to inquiries regarding reports and professional liability matters in collaboration with legal department.
- Keeps current with regulatory requirements related to risk management.
- Manages insurance claims in coordination with other members of the legal/compliance department
- Maintains strong relationships with brokers, underwriters, and third party consultants as required.
- Works collaboratively with Compliance department to implement a comprehensive internal audit plan focused on high risk areas.
- Collaborate with leadership and cross functional teams to embed risk awareness into strategic planning.
- Serves as a member on various system risk/patient safety/quality committees to offer input and provide consultation on risk identification and reduction strategies.
- Partners with legal counsel to provide clinical knowledge an assistance throughout the litigation process to achieve resolution of incidents, claims and litigation matters.
- Is available to field inquiries from our staff outside of normal business hours.
- Performs related duties as directed.
Education/Experience RequirementsREQUIRED:- Bachelor's degree in a related field.
- At least 5 years of experience that may include a combination of risk management, clinical, quality and/or legal work.
- Leadership, critical thinking and analytical skills.
- Outstanding written, verbal, presentation and interpersonal communication skills.
PREFERRED:
- Master's degree in a related area.
- Paralegal, claim management or equivalent legal/risk experience.
Licensure/Certification RequirementsREQUIRED:- Current NYS RN or allied health professional licensure.
PREFERRED:
Job DetailsReq Id 96387
Department LEGAL AND COMPLIANCE
Shift Days
Shift Hours Worked 8.50
FTE 1
Work Schedule SALARIED GENERAL
Employee Status A1 - Full-Time
Union Non-Union
Pay Range $74k - $118k/Annually
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