Risk Management Specialist

4 days ago

Crown Point, Indiana, United States Franciscan Health Full time
About This Role

Franciscan Health is seeking a highly skilled Risk Management Specialist to join our team. As a Risk Management Specialist, you will play a critical role in identifying and mitigating risks that could impact our patients, staff, and operations.

Key Responsibilities
  • Risk Assessment and Mitigation: Assist in the evaluation of coworker's claims to identify problems or trends; take action to assist in reducing problem areas.
  • Policy and Procedure Development: Assist in drafting and implementing risk policies and procedures to minimize risk.
  • Workers Compensation Support: Serve as a resource in discussing problematic worker's compensation cases or issues. Perform other services as required by the Risk Management Department.
  • Risk Management Collaboration: Collaborate 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.
  • Trend Analysis and Reporting: Work with the Risk Manager/Director to track trends and analyze local entity/hospital occurrences, investigate potential liability issues, and provide updates to the manager/director.
  • Liability Claims Investigation: Interview coworkers, patients, and witnesses as requested by Corporate Legal Counsel and Administration in regards to incidents/potential liability claims.
  • Risk Management Review: Conduct nursing or medical reviews for potential or existing risk management issues, as requested by the Director/Corporate Legal Counsel/Administration; interview hospital staff to work towards solutions.
  • Incident Reporting and Management: Administer 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 and Support: Assist in setting up meetings for depositions and other legal matters.
  • Outside Inquiry Support: Assist with inquiries from outside agencies and interact with defense lawyers and corporate counsels as necessary in managing insurance claims, medical malpractice claims, patient complaint, coworker injuries, and legal case preparation.
  • Communication and Confidentiality: Communicate potentially significant issues on a timely basis to facilitate continuity of investigation and resolution. Maintain confidentiality in issues related to PHI, coworkers, physicians and all legal matters.
  • Compliance and Quality of Care Analysis: Maintain current knowledge of regulatory agency requirements and serve as a resource to local entity/hospital departments to achieve compliance with regulatory agency standards. Plan, organize, coordinate, and assist 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 and Incident Management: Prepare and submit quarterly reports of all patient occurrences, maintains statistics and other records required in order to communicate information to administration and external agencies. Review all Incident Reports and follow up as required. Enter claims and notify the insurance company. Track and trends claims to reduce risk, promote patient safety, and ensure quality of care.
  • Patient Care Investigation and Risk Resolution: Review patient occurrences and investigate reports, patient safety/quality issues, in order to identify potential risks and opportunities for enhancing patient care, including medical errors for potential malpractice claims. Serve 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 Management: Maintain hospital Fleet information, coordinates registration renewals and assists in accident claims. Notify insurance carrier of new/traded vehicles, and new coworker drivers.
  • Billing and Reporting: Reconcile 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 plaintiff's attorneys.
  • Department Liaison: Assist 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. Apprise the department Director of all activities on a consistent basis or dependent on the level of severity. Assist 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: Maintain confidential legal and department files in an organized and timely manner and enter all correspondence in the RL system.
Qualifications
  • Education: Preferred Bachelor's Degree
  • Experience: Required 2 years Healthcare operations or Clinical Experience
  • Preferred Qualifications: 2 years Quality/Accreditation (may be concurrent) Preferred, Administrative Assistant experience Preferred
Travel Requirements

Never or Rarely

Equal Opportunity Employer

Franciscan Health is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to providing a work environment that is free from discrimination and harassment. We are an affirmative action employer and are committed to taking affirmative action to employ and advance in employment qualified women, minorities, individuals with disabilities, and protected veterans.

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