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Risk Management Specialist

2 months ago

Oak Lawn, Illinois, United States Advocate Health Full time
Job Summary

We are seeking a highly skilled and experienced Risk Management Specialist to join our team at Advocate Health. The successful candidate will be responsible for assisting the Manager in the daily operation of the Risk Management Program, identifying and evaluating areas of risk and liability exposure, and implementing risk reduction strategies to improve patient safety and reduce liability exposures.

Key Responsibilities
  • Adverse Event Reporting and Investigation
    • Support the adverse event reporting process via the Risk Management database, and investigate events to improve quality of patient care and health outcomes.
    • Follow the process for reporting and review of events as per Advocate Policy, and identify events that require claims notification and referral for further quality or peer review.
  • Education and Training
    • Provide education and training to associates and physicians on the use of the electronic event reporting system, and ensure routine updates and changes are communicated.
  • Risk Data Analysis
    • Analyze risk data received through event forms, anonymous reporting, telephone referrals, and personal contacts, and make corrections to event form data elements for accurate and complete information.
  • Claims Management
    • Perform claims management and insurance responsibilities in compliance with Advocate policy, and support defense legal counsel and claims administrators in the investigation and management of claims.
    • Identify and report incidents, accidents, and events that could lead to financial loss, including professional and general liability claims.
  • Proactive Risk Assessments
    • Perform proactive risk assessments of high-risk clinical and facility areas, and follow up on the implementation of risk reduction strategies.
  • Site Risk Management
    • Perform daily activities within the site Risk Management program, including event review, risk identification, loss prevention, and claims management to improve patient care and reduce risk.
  • Education and Training
    • Develop and provide educational programs on healthcare risk management, general and professional liability, and related topics for healthcare practitioners.
  • Patient Relations and Grievance Resolution
    • Work with Patient Relations/Guest Services staff to identify patient complaints that require reporting as event reports, and refer patient/customer complaints with potential liability exposures to the Manager and Claims Administration.
Requirements

We are looking for a candidate with a Bachelor's Degree, certification/certificate in a legal field, RN or other clinical licensure in a healthcare field, and at least five years of recent healthcare experience. Previous risk management, claims, or insurance experience is preferred. Knowledge of federal and Illinois law related to healthcare is also required.