Risk Manager

Overview

Job Summary

The Risk Manager will manage all investigational and evaluation activities associated with professional and general liability occurrences and claim pre-litigation files. Provides direction and leadership on complex preventive risk management assessment of processes, procedures, and programs, including in-service education, consultation, liaison activities, and on-call emergency assistance to providers. Corporate Risk Management serves all age populations of patients, visitors, staff and others.

Essential Functions

• Provides direction to organizational/clinical team members and leadership on issues related to professional liability and other risks.
• Fosters collaborative relationships with key departments, such as Quality Management, Nursing Administration, Medical Team, Infection Prevention, Office of General Counsel and Patient Safety in order to enhance overall program effectiveness.
• Creating educational programs for all levels of teammates on a variety of risk management and legal topics.
• Interprets statistical and qualitative reports on risk management trends and patterns, and communicates this information effectively to appropriate department leaders with recommendations for action.
• Manages formal and informal mechanisms for risk identification, such as incident reporting, staff referrals, medical record reviews, review of patient complaints, audits and review of pertinent quality-improvement information.
• Develops and conducts various orientations to provide information on Risk Management.
• Provides leadership and direction to assigned committees as it relates to the overall risk management function, the evaluation of incidents and serious patient safety events and potentially compensable events. and claims and the enhancement of patient safety.
• Manages the investigation of all potentially compensable events and pre-litigation occurrences to evaluate and determine potential liability.
• Negotiates settlements with patients and families with applicable and in cooperation with Leadership.
• Completes notifications and financial recommendations needed for compliance with tracking and insurer requirements.
• Evaluates the need for additional notification to external organization and agencies in compliance with state and federal reporting requirements.

Physical Requirements

The Risk Manager generally works in an office environment approximately one-half to three-quarters of their time, sitting at a desk, working with a computer, talking on the telephone, and preparing reports and other statistical data. Remainder of the time is spent in a variety of CMHA facilities, investigating claims and documenting conditions associated with the loss. Requires standing, walking throughout large medical facilities, outside and between buildings, and traveling in personal car to other facilities. Must be able to carry up to 20 pounds of materials. Position requires the ability to work rapidly and accurately under pressure, to work in a safe and effective manner, and to handle different issues and priorities simultaneously.

Education, Experience and Certifications

Bachelor's degree in business administration, nursing, hospital administration or a related field required. A Bachelor's degree in a clinical field (e.g. nursing, physician's assistant) must be supplemented by a clinical license (e.g. RN or PA license). May accept additional direct risk management experience or directly related certifications in lieu of college degree on a 1:1 basis. (e.g. a 2 year college degree and 2 years of risk manager experience are equivalent to a four year college degree.) Minimum 3 years of experience in a healthcare setting and/or handling large malpractice and general liability claims.