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Risk Management Specialist
2 months ago
The Risk Management Specialist plays a critical role in ensuring the highest level of patient safety and quality care at Adventist Health. This position is responsible for responding to patient and family concerns, acting as a liaison between patients/families and hospital staff/supervisors, and clarifying and resolving concerns or referring them to leadership for further investigation or resolution.
Key Responsibilities- Conduct thorough investigations of events in a timely manner, involving appropriate parties as necessary.
- Submit claims and potential claims to corporate leadership, ensuring timely and accurate reporting.
- Coordinate interrogatory responses with hospital counsel, maintaining open communication and ensuring compliance with regulatory requirements.
- Collaborate with nursing units to identify opportunities for improving patient experience practices, promoting a culture of safety and quality.
- Work closely with leadership, bedside nurses, case supervisors, social workers, and other stakeholders to ensure compliance with interpretive guidelines for Medicare and Medicaid conditions of participation.
- Develop and disseminate reports on tracking and monitoring data to relevant committees, informing strategic decision-making and driving improvement initiatives.
- Conduct root cause analysis and performance improvement activities as necessary, based on findings from reported activities.
- Investigate staff-reported events and patient complaints, ensuring accurate documentation and follow-through in electronic occurrence systems.
- Bachelor's degree in a healthcare-related field (required).
- Bachelor's degree in nursing (BSN) (preferred).
- Two years' clinical or risk management experience in a healthcare setting (preferred).
- Registered Nurse (RN) licensure in the state of practice (preferred).
- Certified Professional in Health Care Risk Management (CPHRM) (preferred).
Adventist Health is committed to the safety and well-being of our associates and patients. We require all associates to receive all required vaccinations, including measles, mumps, flu, COVID-19 vaccine, etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.
