Job Summary :
Responsible for providing risk management counsel and oversight to prevent and control losses through proactive risk identification, strategic interventions and regulatory compliance in collaboration with administrative leaders. The Risk Manager focuses on facilitation of performance improvement activities, data analysis, risk assessment, coordination of loss control efforts, advising on potential sources of loss, supporting regulatory reporting functions and making recommendations for minimizing or eliminating risk exposure.
Essential Functions :
Designs and implements an Enterprise Risk Management framework
- Designs and maintains a robust enterprise risk management framework that integrates risk management into all aspects of the organization’s activities and decision-making processes.
Provides professional level leadership and support for the Enterprise Risk Management program
Leads the identification and assessment of risks across the organization. Prevents and / or minimizes liability exposure, including event reporting, follow-up, investigation and processing of variance reports. Reviews reports of incidents, serious events, infrastructure failures and other events entered by staff into the event reporting system. Evaluates and trends events to identify opportunities for improvement in the delivery of patient care, the provision of services, employee safety and the environment and recommends follow-up action. Provides investigational follow-up and research on problem specific events as may be assigned. Supports Patient Safety and other departments in the classification of events in accordance with regulatory standards and the preparation of event reports for submission to the appropriate regulatory entities. Performs risk assessments, assists in the grievance process and participates in environmental rounds. Provides administrative support in development of reports, presentations etc. Administers the electronic event reporting system.Educates, advises and counsels on relevant patient, employee and visitor safety, risk management and regulatory issues affecting the organization
Actively participates on various committees, including but not limited to the Patient Safety, Infection Control, Health and Safety, Facilities, Emergency Management, Ethics and Compliance and Products Committees, as assigned.Participates in the establishment and implementation of management policies and procedures.
Prevents and controls losses to patients, residents, clients, visitors, volunteers, and employees and to meet legal and regulatory requirements.Collaborates with Risk Coordinator, Third Party Administrator (TPA), outside legal counsel and staff regarding potential risk exposure affecting the organization.
Assures that claims are promptly reported and managed for optimal outcomes. Actively participates with the organization’s Claims Management Team in the investigation, analysis, and disposition of claims. Acts as the administrative liaison with the insurers, TPA and outside legal counsel.Coordinates the insurance program in collaboration with the Finance department.
Coordinates renewal and maintenance of self-insurance and commercial insurance in collaboration with the Finance Department to effectively protect the organization from insurable risk. Acts as the administrative liaison with the captive manager and service providers for the organization’s reciprocal risk retention group. Oversees the organization’s Risk Coordinator.Serves as a resource for Joint Commission, DOH, CARF, accreditation readiness.
Participates in periodic facility audits; by educating staff on results; by alerting Senior Leaders to key findings and needed improvements. Assists with scheduled and unannounced surveys / visits by licensing agencies and accrediting bodies.Participate in and / or conducts root cause analysis and failure mode effects and criticality analysis as appropriate.
Responds to all serious / sentinel events in compliance with established policies and regulatory and insurance requirements and in conjunction with the Patient Safety Plans and Risk Management Plan. Assists in the identification of high volume / high risk processes and the facilitation of proactive analysis and process improvement.Coordinates with staff development / education and staff
Develops and presents meaningful educational programs on risk management issues and loss prevention techniques for physicians and staff, and including orientation of new employees.Other duties as assigned.
Perform duties as assigned by the organization consistent with its needs, employee's professional license / certification and demonstration of applicable competencies.Qualifications :
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education
Bachelor’s degree required in risk management or risk management related field (e.g. healthcare, healthcare administration, business administration, business operations)Work Experience
Minimum of five (5) years’ risk management or related experience required. Knowledge of risk systems, policy / procedure, and ability to apply that knowledge to the interpretation of departmental / organizational requirementsLicenses / Certifications
Pennsylvania professional licensure, if required, in field.
