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Risk Management Analyst
2 months ago
Provides support and service by assisting in the prevention, reduction, and control of loss to patients, visitors, volunteers, physicians and employees. Promotes collaborative relationships among risk management throughout Aurora.
Major Responsibilities:
- Manages claims in collaboration with claims adjustors and defense counsel including assessment of liability, ensuring establishment of appropriate reserves, maintaining complete and up-to-date case files, and assisting in procurement of medical records and documents necessary for evaluation and defense of cases. Facilitates timely response and investigation of adverse and significant events.
- Manages, collects, and evaluates data concerning incident reports, aggregates data summaries, and develops monthly and quarterly risk management reports that provide a summary of current claims and litigation, to include an analysis of trends. Shares risk management reports with appropriate leadership and advises and recommends actions for process improvement. Maintains an accurate, up-to-date database reflecting the status and essential elements of current claims and litigation.
- Assists with the design and implementation of risk management assessments and studies. Assists with surveys, studies, and special projects to promote proactive risk activities. Assists with periodic assessments of system risk management activities to determine program effectiveness.
- Collaborates with other risk staff in the prompt, equitable resolution of claims. Provides consultative and resource support to staff regarding all aspects of risk management.
- Assists in the preparation of reports to outside agencies as required by regulatory agencies. Assists in maintaining compliance with JCAHO and other state and federal regulatory agencies.
- Collaborates in the development, delivery and evaluation of educational programs or tools that relate to safety and risk management. May conduct risk management educational programs to both staff and physicians at all levels.
- Assists with carrying out established processes for risk identification, risk investigation and risk reduction that may include risk surveys, inspection of patient care areas and chart auditing.
- Facilitates root cause analysis investigations, FMEA methodologies, reporting of adverse, significant and sentinel events.
- Complies with various codes, laws, rules, and regulations concerning patient care, including those mandated by state and federal agencies; assisting with the investigation activities of federal, state, and local enforcement authorities.
Licensure, Registration, and/or Certification Required:
- None Required.
Education Required:
- Associate's Degree in Health Care Administration or related field.
Experience Required:
- Typically requires 3 years of experience in a healthcare setting that include experiences in a Risk Management environment.
Knowledge, Skills & Abilities Required:
- Knowledge of statistics, data analysis and experience with claims or litigation management.
- Must be proficient in Microsoft Office (Excel, Word, Power Point, Access) or similar products.
- Strong written and oral communication skills with good presentation skills.
- Detail oriented with excellent organizational skills.
- Team player with ability to interact with all levels of staff often in sensitive situations.
- Ability to influence change without direct authority and strong negotiation skills.
- Ability to work flexible hours as situations demand including on call responsibilities.
Physical Requirements and Working Conditions:
- Generally exposed to a normal office environment.
- May be exposed to blood and body fluids when at sites.
- Operates all equipment necessary to perform the job.
- Job requires travel, therefore may be exposed to inclement weather and adverse road conditions.
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.
