Risk Management Specialist
2 months ago
Sierra Vista
Nestled on the Central California Coast, Adventist Health Sierra Vista has been providing care to our community since 1959. Our 162-bed acute care facility includes a Level III Neonatal Intensive Care Unit and county designated trauma center. San Luis Obispo offers the excitement of a lively community while being a fifteen-minute drive from the serenity of Avila Beach, known for their natural hot springs, and Pismo Beach, known for their sand dunes and eucalyptus trees. Featuring a charming downtown, comfortable coastal weather, idyllic views, and an active lifestyle San Luis Obispo offers much to be had.
POSITION SUMMARY:
The Risk Management Specialist provides response and support to patient and/or family when receiving concerns or complaints. Acts as liaison between patient/family and hospital staff/Supervisors. Clarifies and resolves concerns or refers to leadership for more investigation or resolution. Conducting risk management educational programs, complying with risk management related standards by JCAHO and other accrediting and regulatory agencies with the objective of enhancing patient safety, promoting patient safety, quality care, and minimizing loss to protect the assets of the facility. Assists leadership in risk activities such as legal preparation and staff training. Practices, adheres to an models the hospital's mission, vision and code of conduct.
JOB REQUIREMENTS:
Conducts investigation of event with appropriate parties in a timely manner. Submits both claims and potential claims to corporate leadership. Coordinates timely interrogatory responses with hospital counsel. Collaborates with nursing units to identify opportunities to improve their patient experience practices. Collaborates and works closely with leadership, bedside nurses, case supervisors, social workers and others. Shares responsibility for ensuring compliance with interpretive guidelines for Medicare and Medicaid conditions of participation. Builds reports of tracking and monitoring data that is regulary disseminated to appropriate committees. Conducts root cause analysis and performance improvement activities as necessary and as a part of findings from reported activities. Investigates staff reported events and patients' complaints and follows through in the electronic occurrence systems. Performs other job-related duties as assigned.
Education and Work Experience:
- Bachelor's degree in healthcare related field: Required
- Bachelor's degree in nursing (BSN): Preferred
- Two years' clinical or risk management experience in healthcare setting: Preferred
Licenses and Certifications:
- Registered Nurse (RN) licensure in the state of practice: Preferred
- Certified Professional in Health Care Risk Management (CPHRM): Preferred
ORGANIZATIONAL REQUIREMENTS:
Adheres to the Adventist Health Mission, Vision and Values statements. Complies with behavioral standards, policies, procedures and handbooks established by the organization and their respective ministries. Abides by the guiding principles of the Code of Conduct.
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.
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