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Healthcare Risk Management Specialist
2 months ago
PeaceHealth is in search of a Healthcare Risk Management Specialist for a Full Time, 1.00 FTE, Day position. The compensation for this role is competitive and commensurate with experience and qualifications.
The role involves overseeing risk management initiatives across designated Network inpatient and outpatient facilities. The specialist will be tasked with identifying, evaluating, and proposing measures for actual and potential risks to enhance patient safety and safeguard the organization's resources. Compliance with regulatory standards and accreditation requirements is essential, alongside the development and execution of policies and procedures that bolster risk management frameworks. The specialist will collaborate with network, community, or leadership teams to design, implement, and assess the risk management program, ensuring it aligns with the mission and values of PeaceHealth.
Key Responsibilities:
- Coordinate and manage risk identification, investigation, and mitigation efforts while monitoring risk functions and conducting risk assessments to evaluate potential losses. Collaborate with the Patient Safety Consultant to enhance patient safety and share on-call responsibilities as part of a team.
- Conduct investigations and address incidents/events, potential claims, and complaints involving caregivers, physicians, and the organization. Maintain documentation and evidence in compliance with legal standards and manage claims processes.
- Engage with patients and their families during grievance situations, conducting thorough reviews and providing written responses. Support the Complaint/Grievance Management program in line with regulatory requirements.
- Work alongside patient safety and medical teams to ensure prompt risk management reviews of significant patient events and medical errors. Facilitate reviews of incidents that escalate to Sentinel Events and manage communications regarding unexpected events with patients.
- Analyze data trends related to variances and report findings to inform risk management strategies. Provide leadership with regular updates and recommendations based on risk management data.
- Represent risk management in various committees, including Quality, Patient Safety, Ethics, and Grievance Committees.
- Investigate potential violations of regulations and ensure proactive compliance with applicable standards. Participate in developing systems to recognize and share performance improvements across the organization.
- Facilitate teams focused on organization-wide risk mitigation strategies. Develop training materials and deliver education to leadership and staff on risk management competencies.
- Communicate with senior management regarding appropriate responses to risk events and medical care complaints, ensuring adherence to legal standards.
- Act as a liaison for enterprise risk prevention related to new clinical services and programs, facilitating studies and meetings to address serious reportable events.
- Perform additional duties as required.
Education:
- Bachelor's Degree in Healthcare, Nursing, Business, Computer Science, or a related field, or equivalent combination of education and experience.
- Minimum of 3 years of experience in clinical risk management.
- Preferred experience in utilizing administrative and quality data with statistical validity.
- Certification as a Professional Healthcare Risk Manager is required within 1.5 years.
- In-depth knowledge of state, federal, and accreditation regulations, including CMS Conditions of Participation.
- General understanding of other regulatory areas such as OSHA, EMTALA, and HIPAA.
- Proficiency in MS Office applications.
- Excellent written and verbal communication skills.
- Ability to work flexible hours and participate in on-call coverage.
Lifting:
- Regularly operates office equipment and may occasionally lift up to 10 pounds.
- Primarily sedentary work.
- Predominantly office-based with some time spent in medical settings.
- Ability to communicate effectively and maintain close visual acuity for data analysis and documentation.
PeaceHealth values inclusivity, diversity, and cultural humility. For full consideration, please submit a current resume with your application. PeaceHealth is an Equal Employment Opportunity and Affirmative Action Employer.
