The Risk Manager assumes direct responsibility for incident investigation and identification/management of areas considered to be risk management liabilities. The Risk Manager acts as a consultant to physicians, leadership, and staff on matters of risk management. The Risk Manager serves as a member of the risk management team which aims to mitigate risk to AVMC and ensures quality of care in a constantly changing health care environment. The Risk Manager will promote the development of the facility risk management and patient safety programs at AVMC, including identification of risk exposure, assessment, risk prevention, appraisal, education, and training. This role will ensure the safest possible environment exists for AVMC patients, employees, and visitors across all health center sites. Additionally, this role will develop and maintain systems within the organization to detect, monitor, prevent, organize, measure, investigate, report, and manage patient adverse events, incident reports, and other indicators of potential patient harm.
Duties and Responsibilities:
Risk Evaluation, Investigation, and Reporting
Evaluates and reports incidents for severity, frequency, and probability of loss to appropriate administration, committees, and personnel.
Develops and maintains an incident reporting system by establishing a comprehensive incident reporting plan of policies, educational programs, and reporting methods for all areas within Neighborhood.
Directs information on incidents to medical staff and nursing peer review processes.
Uses industry risk management benchmarking data to compare various key performance indicators, such as patient access responses and quality/service complaints.
Directs the risk investigation of all identified events, including patients, visitors, and employees.
Develops loss control measures relating to patient care complaints, including access to medical care and the provision of services and treatments.
Documents and presents patient safety summary information to the leadership with an opinion as to potential for litigation.
Manages legal documentation and computerized files to ensure appropriate documents are delivered in a timely manner to various organizations upon request.
Develops and implements preventative risk management programs, including educating and training staff in appropriate procedures, documentation, reporting, and follow-up in key areas of risk management interest.
Acts as the facility's expert resource in risk reduction and keeps abreast of trends in the industry.
Conducts risk assessments across the organization and uses the results to formulate future goals and objectives for the risk management functions.
Builds and maintains trusting relationships with both internal and external customers to enhance communication regarding risk and safety.
Maintains chain of custody on all medical records with outstanding claims and maintains evidence, documents, and communications on legal cases in a confidential manner, including sequestering medical records, as needed.
Acts as the primary spokesperson for the facility to persons with complaints that may be considered a potentially compensable claim, including aiding the patient advocate and/or site leadership in analyzing patient complaints and directs inquiries to appropriate personnel.
Acts as liaison to outside litigation counsel in the management and investigation of filed lawsuits and related litigation processes, as needed.
Reviews and revises the risk management plan and policies on an annual basis.
Participates as a member of appropriate committees and task forces assigned to improve quality and safety and to reduce organizational risk, including informing appropriate individuals of significant cases.
Works with providers and clinicians to control risk and related issues.
Prepares documentation and promotes compliance with internal policies and external regulations regarding areas of risk management responsibility, including sentinel events and root-case analyses.
Develops statistical and qualitative reports on risk management trends/patterns and communicates this information to appropriate audiences.
Consults with personnel on bioethical dilemmas by reviewing applicable policies and providing education regarding patient's rights.
Promotes compliance with all applicable regulations, including Safe Medical Devices Act (SMDA), Cal-OSHA and Health Insurance Portability and Accountability Act (HIPAA).
Serves as a resource to facility staff on issues related to risk management and patient safety.
Develops annual goals for the risk management functions.
Ascertains that risks are minimized through follow-up and actions on all regulatory, insurance survey report recommendations, and deficiencies.
Manages and maintains the incident reporting database and reporting process, including assigning incidents to appropriate individuals for investigation and follow-up.
Processes feedback on incidents to direct the risk investigation of all potentially compensable events on behalf of patients, visitors, and employees.
Contributes to the administration of the workers' compensation program with Human Resources, specifically in return-to-work programs to reduce indemnity lost time accidents.
Works closely with the insurance carrier claims department, AVMC leadership, and the Human Resources department to provide information related to legal documents.
Co-Chairs the environment of care safety committee, as needed; including creating the agenda, ensure effective delegation of action items, and prepare, distribute minutes for the meetings, and ensure the agreed upon action items are completed within deadlines.
Participates as a member of appropriate committees where issues of quality, safety and organizational risk reduction may arise.
Management
Assesses training needs and promotes developmental activities.
Conducts team meetings to promote communication, assess and resolve needs, and foster teamwork as needed.
Evaluates, coaches, and develops team performance by using job requirements and competency assessments.
Informs team of organizational activities and promotes mission and goal.
Non-Essential Duties:
Copying.
Faxing.
Other duties as assigned.
Knowledge, Skills and Abilities:
Knowledge/Skills
Knowledgeable about and experience with risk information management systems (RIMS).
Knowledgeable about and experience with implementation of creative and innovative risk management processes.
Knowledgeable about and experience with the legal components of the risk management industry.
Knowledgeable about and experience quality improvement process, tools, and techniques.
Excellent verbal and written communication skills, including superior composition, typing and proofreading skills.
Excellent planning and organizational ability.
Abilities
Ability to interpret a variety of instructions in written, oral, diagram, or schedule form.
Ability to use Microsoft applications at an expert level, including Outlook, Word, PowerPoint, and Excel.
Ability to perform quality measurement reporting, root cause analysis, and preventive risk management strategies, accrediting bodies' standards, and state/federal regulations.
Ability to recognize and analyze problems and make difficult choices under uncertain conditions.
Ability to meet deadlines.
Ability to identify, disclose, and manage the organization's risk.
Ability to listen, manage conflicts, and achieve compromise.
Ability to successfully manage multiple tasks simultaneously.
Ability to work as part of a team as well as independently.
Ability to work with highly confidential information in a professional and ethical manner.
Ability to demonstrate advanced critical thinking skills.
Ability to execute results within required deadlines.
All AVMC management (Supervisor, Manager, and Assistant Director) will effectively demonstrate these behaviors:
Conflict Management.
Problem Solving.
Timely Decision Making.
Process Management.
Fairness to Direct Reports.
Hiring & Staffing.
Developing Direct Reports.
Perseverance.
Education and Experience:
Education
Bachelor's degree required or equivalent combination of education and experience.
Two years training and/or presenting to groups experience required.
Five years' quality management and clinical experience within healthcare setting required; occupational safety experience preferred.
Experience in auditing for process improvement and/or quality assurance preferred.
Experience in Database Management and systems preferred.
Required Licensure and/or Certifications:
None.
A detailed description of the physical requirements of this job is maintained in the Employee Health Department.
NOTE: THE ABOVE STATEMENTS ARE INTENDED TO DESCRIBE THE GENERAL NATURE AND LEVEL OF WORK PERFORMED BY PEOPLE ASSIGNED TO THIS JOB. THIS DOCUMENT IS NOT INTENDED TO BE AN EXHAUSTIVE LIST OF ALL RESPONSIBILITIES, SKILLS, AND WORKING CONDITIONS FOR THE PERSONNEL SO CLASSIFIED.