Risk Manager

1 week ago

Milwaukee, Wisconsin, United States Advocate Health Full time

Identifies, analyzes, mitigates and prevents risk at Aurora St. Luke's, with the overall objective of improving clinical outcomes, team member safety, and reducing litigation potential.

Major Responsibilities:

  • Utilizes a proactive risk management approach that relates to an enterprise scope of practice Establishes relationships with site executive and medical staff leadership to identify and facilitate development and resolution of system and site risk identification and reduction measures. Oversees the development of site risk management programs, ensuring standard assessment and measures. Supports appropriate risk management coverage within site.
  • Addresses health outcomes, risk identification, loss prevention, and claims management to improve the quality of patient care; prevent, mitigate and/or reduce risk of potential and actual financial, physical and reputational loss at assigned sites. Participates in site health outcomes goals and strategic plan development, implementation and measurement including provision of data and recommendation within the site. Participates in site level safety huddles; participate in weekly risk huddles. Identifies, in conjunction with site and other departments, high risk areas requiring proactive risk assessments.
  • Coordinates resources to achieve review, findings and action plan. Presents results to applicable groups. Develops goals and plans through multiple internal data sources including the complaint and event reporting system, claims, write-offs, risk and quality assessments, recalls; and external sources such as literature evidence based practice, and alerts from national and international sources. Shares quarterly site-based Risk Management reports with appropriate groups. Develops educational programs for site and departments addressing risk management issues, outcomes, and topics.
  • Manages assigned site Risk Management roles, processes responsibilities in regard to claims management and the insurance program. Reviews, analyzes, and develops improvement actions based on claims loss runs. Submits site and physician exposure data for the annual insurance renewal.
  • Maintains site adverse event reporting, investigation, and resolution process. Participates in web-based reporting design, access, training and implementation. Reviews and tracks reported events. Maintains and improves process to identify significant events and notify appropriate system and site executives, claims, patient safety, legal, compliance, safety/security, and media relations. Facilitates patient disclosure meetings. Tracks, trend, analyzes data to mitigate, reduce or eliminate harm and/or liability issues. Works with public safety/security to identify, mitigate and prevent safety issues and exposure for the organization, including teammates and visitors.
  • Acts as the site risk expert and resource for medical/legal inquiries of physicians, nurses, administrators, and others regarding emergent patient care issues and loss control, in conjunction with Legal Counsel; for policy and procedure development, including event reporting, consent, and disclosure policies; for applicable contract review.
  • Works with site, and if needed other sites, to address patient complaints and grievances. Ensures regulatory compliance and appropriate responses. Ensures referral, review and response of patient complaints with significant quality or service concerns. Involves language services and civil rights departments as needed. Tracks and trend complaints and grievances, identifying risk or liability issues.
  • Works collaboratively with Legal and Compliance on site issues, contracts, regulatory and accreditation issues, operational and policy issues, governmental, litigation and other relevant issues.
  • Keeps management informed of site-based issues; coordinate communication to site from system.

Licensure, Registration, and/or Certification Required:

  • Certified Professional in Patient Safety (CPPS) designation issued by the Certification Board for Professionals in Patient Safety (CBPPS) needs to be obtained within 1 year, or
  • Certified Professional in Health Care Risk Management designation issued by the American Hospital Association (AHA) needs to be obtained within 1 year.
  • RN License is HIGHLY PREFERRED.

Education Required:

  • Bachelor's Degree in Health Care Administration or related field.

Experience Required:

  • Typically requires 7 years of experience in in system healthcare setting, experience with risk management, patient safety and quality.
  • Ideal candidate will have inpatient experience.

Knowledge, Skills & Abilities Required:

  • Proficient in Microsoft Office (Excel, Word, PowerPoint, Access) or similar products.
  • Ability to guide and mentor physicians, including disruptive behavior and in situations where failure to follow policy is not an option.
  • Strong decision-making and critical thinking skills.
  • Significant successful high-level interaction with medical staff.
  • Strong skills in successfully managing multiple units.
  • Strong skills in diplomacy and conflict resolution at various levels within the organization.
  • Strong aptitude in human resource management.
  • Ability to handle multiple demands simultaneously.
  • Excellent communication skills (oral and written, group and one-on-one).
  • Extensive knowledge of statistical methods, data analysis and presentation.

Scheduling Details

Full time, salaried position - Typically 1st shift hours; M-F some page call after hours and a weekend call rotation (once a month typically) with other Risk Managers. Can work remotely 1-2 days a week as calendar permits.

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