Risk Program Specialist

: Job Locations: US-CA-Oceanside Overview:

Tri-City Medical Center has served San Diego County's coastal communities of Carlsbad, Oceanside and Vista, as well as the surrounding region for more than 60 years and is one of the largest employers in North San Diego County. Tri-City is administered by the Tri-City Healthcare District, a California Hospital District. As a full-service acute care public hospital with over 500 physicians practicing in over 60 specialties, Tri-City is vital to the well-being of our community and serves as a healthcare safety net for many of our citizens. The hospital has received a Gold Seal of Approval® from the Joint Commission showcasing a commitment to safe and effective patient care for the residents of the community.

Tri-City Medical Center prides itself on being the home to leading orthopedic, spine and cardiovascular health services while also specializing in world-class robotic surgery, cancer and emergency care. Tri-City's Emergency Department is there for your loved ones in their time of need and is highly regarded for our heart attack and stroke treatment programs. When minutes matter Tri-City is your source for quality compassionate care close to home. Tri-City partners with over 90 local non-profit and community organizations as part of our COASTAL Commitment initiative. Together we are helping tackle some of our communities' pressing health and social needs.

Position Summary:

This position is responsible for the relationship between patients, families, and hospital departments to ensure patients receive a high level of care. In coordination with the Quality Assurance/Performance Improvement and Clinical Quality Committees, this position identifies potential risks and weaknesses to mitigate errors, accidents and losses and develops strategies to improve them. The individual must consistently support the mission, vision and values of the Medical Center, and acts as a role model relative to the Medical Center's Service Standards. This position reports to the General Counsel.

Major Position Responsibilities:

The position characteristics reflect the most important duties, responsibilities and competencies considered necessary to perform the essential functions of the job in a fully competent manner and other duties that may arise. They should not be considered as a detailed description of all the work requirements of the position. The characteristics of the position and standards of performance may be changed by TCMC with or without prior notice based on the needs of the organization.

• Maintains a safe, clean working environment, including unit based safety and infection control requirements.
• Patient Relations
  • Oversees the relationship between patients, families, and hospital departments to ensure patients receive a high level of care.
  • Investigates patient complaints. Serves as a liaison between patient's families and medical center to see timely resolution and work to achieve maximum satisfaction levels.
  • Develops plans for case review, conducts and coordinates investigations and multi-disciplinary reviews recommending solutions.
• Quality and Risk
  • Responsible for investigating potential risks and weaknesses to mitigate errors, accidents and losses and develops strategies to improve.
  • Responsible for data management and incident reporting analysis within incident tracking database.
  • Responsible for handling in house patient complaints.
  • Responsible for handling Grievances.
• Education
  • Develops and implements educational programs for employees and medical staff based on analysis of risk assessments, historical and concurrent occurrence and claims data and national trends.
• Additional Responsibilities
  • Works collaboratively with the Patient Safety Officer for reporting of suspected violations of all relevant laws and regulations including Joint Commission, Department of Public Health, Medicare Conditions of Participation, and District's Policies and Bylaws. Proactively communicates with staff and regulatory bodies to prevent deficiencies and draft plans of correction in coordination with Regulatory Department.
  • Elevates material non-compliance and concerns to General Counsel or designee.

Qualifications:

• Minimum one (1) year experience in quality and/or risk management, required.
• Legal experience, preferred.
• Various knowledge and understanding of the healthcare industry, California laws regulating hospitals and health systems, such as California Tort Claims Act, Joint Commission, Title 22, and experience dealing with such in matters related to quality, risk and the patient complaint process, required.
• Intermediate computer skills, required.
• Experience to gather and analyze data & manage databases, required. Experience with RL Solutions or other incident reporting databases, preferred.
• Able to multi-task in an organized efficient manner and high degree of flexibility, required.
• Excellent communication and interpersonal skills to communicate clearly and effectively verbally, in writing and in person with a diverse range of individuals at all levels, required.
• Excellent customer service skills, required.
• Knowledge of medical terminology, medical practices and procedures and experience with medical record review techniques, preferred.

Education:

• Bachelor's degree in healthcare or related healthcare area from an accredited university, required.
• May consider current CA RN license with two (2) years applicable quality and/or risk experience in lieu of degree.
• May consider four (4) years applicable quality and/or risk experience in lieu of degree.
• Master's degree, preferred.

Licenses:

• California RN license or other healthcare profession, preferred.

Certifications:

• Hospital or Healthcare Risk Management certification required upon hire or within two (2) years, required.

Each new hire candidate who is offered employment must pass a physical evaluation, urine drug screen and pre-employment background checks before starting work.

• Salary/Hourly wage range for this position is posted. Actual pay will be determined based on verified experience as well as internal equity.

TCHD is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, sexual orientation, or gender identity/expression), age, marital status, status as a protected veteran, among other things, or status as a qualified individual with a disability.