Risk Manager

Job Description Evaluate events for severity, frequency and probability of financial loss Report as appropriate to administration and committees Respond to significant events; review facts; review medical record/documentation; preserve any evidence; conduct staff interviews Provide recommendations for staff regarding investigation/handling of events to appropriate management, administrators Refer to Peer Review, Care Review, and Quality & Outcomes Management Committees to address as appropriate Develop educational programs as appropriate or needed based on event findings and trends Review events and identify potential claims/lawsuits Prepare potential files, documenting factual investigation of event Communicate findings to the legal team as appropriate for case preparation Review incidents and determine reportability as a Serious Preventable Event under the Patient Safety Act Conduct initial team huddle and determine next steps along with Executive Sponsorship Submit initial notification of SPE to DHSS Organize and moderate Root Cause Analysis meeting with health care providers involved to identify causal and contributing factors to the event, and assist with development of a corrective action plan Coordinate case presentations to Preventable Events Review Committee Advise site nursing staff, medical staff and administration on legal issues, billing, insurance, risk management, corporate compliance, EMTALA, HIPAA and other regulatory concerns following the review of regulations and standards Address clinical queries by reviewing applicable policies and aligning responses with identified clinical needs Serve as a resource for all inquiries, fostering ongoing open communication and engagement Deliver targeted education and in-service training to nursing, medical, and residency staff, as requested or informed by needs identified through case review and event reporting trends Topics include litigation process, documentation, event management, hospital policies, protocols Triage events, elevate, investigate and refer as appropriate, close events Acknowledge clinical staff for Good Catches Provide training to nursing staff, medical staff, and residency staff on use of program Coordinate and facilitate investigations (DHSS)(FDA) (CMS) Facilitate, prepare and submit material to agency and respond to deficiencies Coordinate voluntary and required reporting to the FDA Proactive management of difficult patients and family members of complex care cases to mitigate complaints Liaison between patient/family and nursing/physician teams to resolve concerns Manage the response process as well as the electronic documentation of all clinical complaints/grievances in the database Track and trend patterns of complaints/grievances and report to leadership Ensure compliance with DOH/CMS regulations regarding clinical patient complaints/grievances Manage and arrange language translation services for patients and families while ensuring compliance with regulations Provide training to teams on language translation services as needed Required Qualifications Bachelor's degree in Healthcare or related field preferred Minimum 7 years of Risk Management experience preferred Minimum 3 years in Healthcare work experience required Must pass a Level II Background Check Required Licenses, Certifications Or Registrations RN or other clinical professional license CPHRM within two years of hire EEO Statement Atlantic Health, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran status. #J-18808-Ljbffr