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Risk Management Specialist

2 months ago

Crown Point, United States Franciscan Health Full time

Franciscan Health Crown Point

12750 S Francis Dr Crown Point, Indiana 46307

WHO WE ARE

With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve.

WHAT YOU CAN EXPECT

  • Risk Management Assists in the evaluation of coworkers"™ claims to identify problems or trends; takes action to assist in reducing problem areas.
  • Policy and Procedure Assists in drafting and implementations of risk policies and procedures to minimize risk.
  • Workers Compensation Serves as a resource in discussing problematic worker"'s compensation cases or issues. Performs other services as required by the Risk Management Department.
  • Risk Management Collaborates with the manager/director and other departments for the identification of high-risk areas providing recommendations and solutions to eliminate or mitigate exposure to liability and enhance compliance with regulatory and accrediting agency requirements.
  • Risk Management Works with the Risk Manager/Director to track trends and analyzes local entity/hospital occurrences, investigates potential liability issues, and provides updates to the manager/director.
  • Liability Claims Interviews coworkers, patients, and witnesses as requested by Corporate Legal Counsel and Administration in regards to incidents/potential liability claims.
  • Risk Management Conducts nursing or medical reviews for potential or existing risk management issues, as requested by the Director/Corporate Legal Counsel/Administration; interviews hospital staff to work towards solutions.
  • Incident Reporting Administers corporate electronic Incident Reporting system including but not limited to resource for staff, educator, incident report closer, report writer, insurance and medical malpractice claims entry and management.
  • Deposition Scheduling Assists in setting up meetings for depositions and other legal matters.
  • Outside Inquiry Support Assists with inquiries from outside agencies and interacts with defense lawyers and corporate counsels as necessary in managing insurance claims, medical malpractice claims, patient complaint, coworker injuries, and legal case preparation.
  • Communication Communicates potentially significant issues on a timely basis to facilitate continuity of investigation and resolution.
  • Clinical & Critical Thinking Demonstrates the clinical critical thinking and clinical reasoning necessitated in medical/nursing case reviews in addition to the ability to gather, collect, and analyze data. Possesses knowledge in medical and basic legal terminology.
  • Confidentiality Maintains confidentiality in issues related to PHI, coworkers, physicians and all legal matters.
  • Compliance Support Maintains current knowledge of regulatory agency requirements and serves as a resource to local entity/hospital departments to achieve compliance with regulatory agency standards.
  • Quality of Care Analysis Plans, organizes, coordinates, and assists in the collection of data/information in order to analyze, monitor, and evaluate the quality of care provided by the local entity/hospital.
  • Quarterly Reporting Prepares and submits quarterly reports of all patient occurrences, maintains statistics and other records required in order to communicate information to administration and external agencies. Prepares and submits annual evaluation reports.
  • Incident Management Reviews all Incident Reports and follows up as required. Enters claims and notifies the insurance company. Tracks and trends claims to reduce risk, promote patient safety, and ensure quality of care.
  • Patient Care Investigation Reviews patient occurrences and investigates reports, patient safety/quality issues, in order to identify potential risks and opportunities for enhancing patient care, including medical errors for potential malpractice claims.
  • Risk Resolution Serves as a resource to the local entity/hospital in problem identification, educational needs, and problem resolution, which have or may have an adverse effect on patient care, including the education of coworkers on hospital risk management and liability issues.
  • Accident and Insurance Claims Maintains hospital Fleet information, coordinates registration renewals and assists in accident claims. Notifies insurance carrier of new/traded vehicles, and new coworker drivers.
  • Billing and Reporting Reconciles litigation billing and completes monthly legal summary for the corporate office and insurance company.
  • Records and Documentation Assist the Director with obtaining and securing records and other materials requested from plaintiffs"™ attorneys.
  • Department Liaison Assists Department Director with interaction of defense attorneys and corporate legal counsel to coordinate the investigation, processing, and defense of claims, suits, liens and incidents against the facility.
  • Apprises the department Director of all activities on a consistent basis or dependent on the level of severity. Assists the Department Director with the timely completion of the Annual Corporate Liability Survey; involving all medical departments within each campus for appropriate insurability.
  • Documentation and Recordkeeping Maintains confidential legal and department files in an organized and timely manner and enter all correspondence in the RL system.
Qualifications
  • Preferred Bachelor's Degree
  • Required High School Diploma/GED
  • 2 years Healthcare operations or Clinical Experience Required
  • 2 years Quality/Accreditation (may be concurrent) Preferred
  • Administrative Assistant experience Preferred


TRAVEL IS REQUIRED:

Never or Rarely

EQUAL OPPORTUNITY EMPLOYER

It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.

Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.

Franciscan Alliance is committed to equal employment opportunity.