Job Summary:

Is responsible for facilitating and implementing existing risk management program to be consistent with the established philosophies and procedures of the organization. Provides day-to-day technical leadership while performing escalated or complex duties; responding to risk-related issues and complaints involving the organization and its affiliates; manages and analyzes risk management information data; conducts risk management in-services and education; collaborates with appropriate departments in activities that aim to prevent, mitigate and reduce risk; coordinates communication, disclosure, and early resolution after a safety event; collaborates and supports Claims team in managing the organization's insurance program; interfaces with internal and external legal defense counsel; and complies with risk management standards for purposes of accreditation, regulatory, and statutory compliance with the objective of promoting and enhancing patient and employee safety, evidence based and safe care, and minimizing losses to protect the assets and reputation of the organization. Supports subject matter experts in review and development of policies and procedures related to nursing, clinical practice and risk management and is a resource to Risk teams.

Job Requirements:

Education and Work Experience:

• Bachelor's Degree or equivalent combination of education/related experience: Required
• Two year's leadership experience: Required
• Three years' experience in healthcare or general risk management: Required
• Three years' nursing experience: Required

Licenses/Certifications:

• Certified Professional in Healthcare Risk Management (CPHRM): Required within two years of hire
• Registered Nurse (RN) license in the state of practice: Required

Essential Functions:

• Reviews events and complaints that pose organizational risk and assists in appropriate responses. Participates in patient safety event review meetings and completes necessary follow up. Initiates review of events with high harm and potentially compensable events (PCEs).
• Participates in activities designed to reduce risk exposure and improve safe patient care (e.g. Cause Analysis, Failure Mode Effects Analysis (FMEA) and performance improvement teams). Contributes and participates in risk assessments as needed to proactively identify and evaluate areas of risk. Acts as a liaison and resource to assess risk exposures in specific clinical and other situations (e.g. Facilities, Safety, Nursing, Pharmacy, Security, and Patient Relations). Works with Safety, Procurement, and Clinical Engineering and Clinical Operations to identify medical device and equipment failures for purposes of improving organizational risk, patient safety and for reporting to the Food and Drug Administration (FDA). Participates as member of various organizational councils/committees to provide risk management perspective and input for purposes of reducing organizational risk and promoting safety activities.
• Contributes to the investigations and analysis of potential and actual general and professional liability claims filed against Adventist Health facilities, employees, and medical staff in conjunction with Claims team, and Legal department. Utilizes clinical expertise to review related clinical information (e.g. medical record, relevant medical literature); participates in interviews with individuals involved; named parties, and/or other clinical experts. Participates in all aspects of claims process which includes but is not limited to: coordination of depositions; response to interrogatories; requests for production of evidence; ensuring documentation and data management. Ensures timely and accurate response to inquiries for claims history and coverage information. Monitors evidence preservation (e.g. surveillance video, equipment, etc, and/or litigation holds). Attends trial as site representative as directed by internal and external legal counsels. Recommends payment for replacement of lost property after claims evaluation. In collaboration with Claims team and internal and external legal counsels, negotiates settlement of small claims within administrative authority and advises billing department of appropriate action for unpaid accounts involved in litigation . Safeguards documents obtained or developed for cause analysis to ensure documents/proceedings are protected from discovery
• Collaborates with Director of Risk Management in developing risk management program, policies and procedures and enhances existing risk management programs, policies, and procedures consistent with established organizational philosophies and values. Supports the periodic review and monitoring of risk management programs and solutions. Maintains a network of informational sources and experts, performs risk surveys, inspects patient care areas and reviews facilities to assess loss potential.
• Partners with various departments to analyze data (e.g. complaints, grievances, claims, lawsuits) to identify priority topics and audiences for targeted training and education. Utilizes external data (local, state, national) to identify high-risk topic areas and focus groups for targeted education. Offers risk educational program on a regular basis and as requested including organization-wide presentations as well as specialty specific.
• Performs other job-related duties as assigned.

Organizational Requirements:

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.