What are the responsibilities and job description for the Clinical Risk Manager position at Unified Women's Healthcare?
Overview
We are currently seeking a Clinical Risk Manager with a lab risk management background to be fully engaged in and supervise/implement providing Quality/No Harm, Customer Service and Stewardship by supporting the implementation and administration of the Clinical Risk Management Program for Unified Women’s Care ensuring effective loss prevention/control and compliance with: Multi-State and Federal guidelines. The Clinical Risk Manager is primarily accountable for supporting the administration of Unified Women’s risk management program on a day-to-day basis, documenting, managing, and analyzing risk management data, conducting proactive risk assessments, providing targeted risk management education, and providing risk management consultation with the objective of mitigating loss across the affiliates.
Responsibilities
Qualifications
Unified Women’s Healthcare is a company dedicated to caring for Ob-Gyn providers who care for others, be they physicians or their support staff. A team of like-minded professionals with significant business and healthcare experience, we operate with a singular mindset - great care needs great care. We take great pride in not just speaking about this but executing on it.
As a company, our mission is to be an indispensable source of business knowledge, innovation and support to the practices in our network. We are advocates for our Ob-Gyn medical affiliates – enabling them to focus solely on the practice of medicine while we focus on the business of medicine.
We are action oriented. We strategize, implement and execute – on behalf of the practices we serve.
We are currently seeking a Clinical Risk Manager with a lab risk management background to be fully engaged in and supervise/implement providing Quality/No Harm, Customer Service and Stewardship by supporting the implementation and administration of the Clinical Risk Management Program for Unified Women’s Care ensuring effective loss prevention/control and compliance with: Multi-State and Federal guidelines. The Clinical Risk Manager is primarily accountable for supporting the administration of Unified Women’s risk management program on a day-to-day basis, documenting, managing, and analyzing risk management data, conducting proactive risk assessments, providing targeted risk management education, and providing risk management consultation with the objective of mitigating loss across the affiliates.
Responsibilities
- Reaches across the spectrum to work collaboratively with members of the medical staff, administration, patients, visitors, vendors, and regulatory agency personnel to comply with legal and regulatory requirements in a way that is transparent, honest, and respectful
- Maintains awareness of internal and external factors (ex: new legislation and regulations) that may affect risk management program and communicates relevant findings to the appropriate departments.
- Assist affiliates and corporate support functions in complying with codes, laws, rules, and regulations concerning patient care and safety, including those mandated by state and federal agencies, and investigation activities of federal, state and local authorities.
- Fields issues of concurrent risk management concerns, and/or of a medical, legal, and ethical nature
- Recommends to senior management new risk policies and/or amendments to existing policies. Advises management of emerging risk and compliance issues and consults and guides the organization in the establishment of controls to mitigate risks
- Participates in policy and procedure development.
- Proactively makes suggestions to improve process workflow or enhance patient satisfaction.
- Reviews and analyzes all incoming occurrence reports for regulatory and insurance concerns
- Completes trending analysis to identify top priority areas for improvement
- Conducts critical analysis of occurrences to determine next steps of requisite follow-up
- Investigates complex clinical patient complaints and ethical questions that are referred to the Department.
- Investigates all serious events. Assists with communication and documentation of errors or serious events in accordance with legal requirements and/or accreditation standards.
- Acts as a liaison between Affiliates and the insurance carriers in an effort to assure the accurate and timely reporting of claims
- Promotes the containment of claims and losses.
- Reviews collated data to identify trends regarding accidents or occurrences, and recommends corrective action to management, if appropriate.
- Prepares reports to management regarding trends/patterns and findings. Recommends electronic data programming initiation and improvement.
- Directly refers to administration those incidents with claims potential; reports to higher authority and serious event involving actual or potential injury to patients, visitors, or employees.
- Provides in-service training to medical center personnel to enhance their awareness of their role in reducing liability exposures
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Data Analysis:
- Generate reports for affiliate quality committees
- Collaborate with insurance carriers and brokers to collect and analyze data
- Use graphs, infographics, and other methods to visualize data
- Structure large data sets to find usable information
- Create presentations and reports based on recommendations and findings
- Work with team and affiliates to identify opportunities for improvement
- Conducts Root Cause Analysis investigations which include assessing need for focused review by departments, and/or clinical chairpersons for peer reviews
- Active participation on committees directed toward promoting quality and patient safety as support staff as needed to communicate findings, recommendations, actions, and results.
- Performs other duties as assigned
Qualifications
- 3-5 years of related experience
- IVF Lab or Lab experience preferred
- Bachelor's degree in a work-related discipline/field from an accredited college or university
- Masters preferred
- Excellent oral and written communication skills.
- Proficient computer skills (ex: PowerPoint, Excel, extracting data and reports).
- Ability to foster effective working relationships and build consensus
