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Coordinator, Risk ManagementNext Steps... Apply Now
Job Location: Unity
Department: Quality And Patient Safety
Position Status: Regular Full-Time
Avg Hrs/Wk: 40
Pay Range: USD $37.79/Hr. - USD $56.31/Hr.
FLSA Status: Exempt
Work_Days: Mon-Fri, no weekends
Shift Start Time: 8am
Shift End Time: 5pm
Coordinator, Risk Management
This role supports Legacy Health's clinical risk management and patient safety activities. The primary responsibilities are to provide expertise in identifying, mitigating and controlling losses related to patient and visitor injury, to maintain compliance with specified regulatory requirements including mandatory and voluntary patient safety reporting, and the control of related charges, and to promote patient safety. Related activities include partnering with clinical personnel in managing adverse outcomes, investigating incidents, recognizing, investigating and reporting potentially compensable events, and providing education, support and consultation to clinical personnel regarding clinical risk management issues and practices. Additional activities include facilitating root cause analyses, surveillance for and reporting events in compliance with LH policy and regulatory agency requirements, support of the investigation of patient grievances, and real time risk management consultation. Clinical experience is required.
GENERAL ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS
- Partners with clinical personnel and leadership to manage, investigate adverse outcomes including those related to medical error
- Conducts or supports the investigation of and response to patient grievances, in accordance with LH and regulatory requirements
- Provides real time risk management consultation for LH employees and leaders and responds to professional and general liability questions posed by physicians, nurses, and other LH employees.
- Supports the process of disclosure for medical errors
- Facilitates root cause analysis investigation and the development of appropriate and effective improvement plans
- Coordinates efforts to seek resolution to adverse outcomes as appropriate
- Seeks to learn about, investigate and assesses liability and probability of legal action for notification of insurance carriers to assure coverage.
- Reports to Manager cases that need consideration for reporting to the professional and general insurance programs including the self-insurance program and excess carriers.
- Reports to administration those incidents with claims potential; reports to higher authority any serious event involving actual or potential injury to patients, or visitors.
- Recognizes, investigates, and prepares the reports for those cases that meet criteria for patient safety reporting to patient safety agencies and regulatory bodies
- Recognizes, investigates and works collaboratively with Patient Business Services to identify charges related to adverse events that should not be billed.
- Coordinates review and response to complaints and quality of care concerns posed by health plans.
- Supports and uses systems for risk identification, investigation, and risk reduction; maintains a network of informational sources and experts; performs risk assessments of patient care practices and areas to access loss potential.
- Maintains confidential risk management files and related data in a manner that supports compliance with LH policies, regulatory and governmental agencies, promotion of patient safety and effective claims investigation and management.
- Works at the direction of the Manager of Risk Management and Patient Safety, the claims manager and legal counsel to support the investigation, processing, and defense of claims against Legacy Health.
- Recognizes, investigates, and prepares cases of general liability for referral to the claims process
- Recommends ways to minimize risks through system changes and revisions to new or existing policies and procedures. Participates on select committees related to provision of patient care and directed towards promoting risk management and patient safety.
- Maintains awareness of legislative and regulatory activities related to health care risk management
- Provides in-service training to Legacy Health physicians, nurses and others regarding their role in reducing liability exposures.
- Reviews collated data to identify trends regarding incidents, and recommends corrective action to management
- May support medical staff peer review
- Will have on-call responsibility
- Other duties as assigned by the Manager, Risk Management and Patient Safety
Bachelor's degree required.
Three to five years of experience in healthcare including behavioral health risk management or related field required.
Three to five years of experience in a clinical role or clinical management preferred
Licensed Health Care Professional preferred.
Requires knowledge of and remains current in: healthcare risk management; healthcare standards of practice; LH policies and procedures; professional and general liability and liability insurance; and specified regulatory requirements for management of grievances and adverse events. Maintains and demonstrates skills in investigation, witness interviewing techniques, negotiation and conflict resolution. Manages critical situations in a professional, objective and effective manner. Able to make independent, real time decisions within the clinical risk management and patient safety scope of responsibility. Communicates effectively both orally and in written form. Able to engender trust among internal customers. Provides excellent customer service for internal and external customers. Works independently and establishes and reevaluates priorities daily. Meets deadlines. Keyboard skills and ability to navigate electronic systems applicable to job functions. Excellent public speaking skills and ability and willingness to train others about risk management.
LEGACY'S VALUES IN ACTION:
Follows guidelines set forth in Legacy's Values in Action.
Equal Opportunity Employer/Vet/Disabled