Risk Management Associate
2 weeks ago
- Establish and maintain positive relationships with patients, visitors, physicians and other employees.
employees. Behave in a manner consistent with our values, maintaining and furthering a positive public perception of Stamford Health System (SHS) and its employees.
- Contribute to and participate in the Performance Improvement and Quality Improvement activities of the RM Department (Department). Contribution and participation includes data collection, analysis, report creation, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement (CQI) teams, consistent adherence to the specific rules and regulations of the SHS to include, but not be limited to: (a) Safety and Security Policies, (b) Risk Management: Incident and Occurrence Reporting, (c) Infection Control Policies and Procedures and (d) Patient and Customer Service.
- Risk Management Functions:
- Assist RM Leadership in the smooth operation of the Department.
- Develop and monitor reports of occurrence data and harm events. Produce reports as requested on various department activities.
- Respond to inquiries or reports regarding potential or actual occurrences in the SHS that implicate medical, legal, ethical or loss control issues.
- Analyze and evaluate occurrence reports generated by employees or physicians, departments and individuals responsible for Medical, Nursing and other departments in an effort to determine the significance and possible compensability and reportability of events.
- Assist departments in determining appropriate corrective actions involving risk and medical error reduction.
- Undertake investigation and follow up of occurrences involving risk management, quality of care issues or professional or general liability exposure.
- Review and evaluate requests for medical information and/or records to determine appropriate authority of request and screen potential requests for litigation implications.
- Develop and track department metrics and create reports as directed by RM Leadership. Provide analysis of departmental trends and risk activities. Prepare reports, including PowerPoint slides for various committees, underwriter community and Healthstar Board as requested by RM Leadership.
- Assist RM Leadership in supervision and maintenance of multiple databases used within the department.
- Complete timely reports which provide analysis of department trends and risk activities. Examples of these reports include: specific department reports, HSS Collaborative reports, Chair Reports, Stamford Health Medical Group report for SHMG leadership.
- Participate in SHS committees as need at the direction of Director or RM Leadership.
- Assist in the investigation and preparation of case summaries of presentation at Clinical Review and/or Apparent Cause or Root Cause Analysis meetings.
- Participate in Apparent Cause or Root Cause Analysis team meetings.
- Assure that physician or nursing leaders on the Claims Committee are alerted, in advance of any potentially compensable events (PCEs) or claims that they may be asked to discuss at the monthly meeting ang provide them any requested documentation as needed.
- Send concerning PCEs or claims to Manager, Medical Staff Peer Review, for review at the appropriate peer review committee.
- Assist in PCE or claim reporting, send any necessary litigation hold memos and assist in any additional work or verification activities as requested by RM Leadership.
- Participate in professional organizations, representing Stamford Health in a positive light, collaborate with external resources to identify and develop improvements for the RM Program.
- Interface with the medical records department as necessary to ensure efficient processing of inquiries from regulatory agencies and legal representatives of patients.
- Assist in the training and education of new RM team members.
- Performs other related duties as assigned or requests in order to maintain a high level of service.
- Completes required continuous training and education, including department specific requirements.
- Demonstrates professional work behavior by following Service Standards and Succes factors.
- Complies with departmental and organizational policies and adheres to external agency requirements (ex: maintain licensure).
- Performance Improvement Functions:
- Provide written critical analysis of cases and recommend policy or procedural changes as warranted.
- Follow up on risk reduction strategies and corrective action in response to sentinel or other critical events or quality of care issues.
- Interface with other departments to promptly and effectively address patient care issues, real or potential harm events or potential liability concerns.
- Develop and maintain programs for tracking and trending significant and/or reportable occurrences and professional practice concerns and create reports on findings at the request of RM Leadership.
- Coordinate or participate in Performance Improvement committees as necessary.
- Regulatory Functions:
Assist the ED, Regulatory Affairs and Compliance Programs, Administrative Director, Regulatory Affairs or Senior Regulatory Affairs Specialist Regulatory. by providing any occurrence reports, investigative notes or documents and assisting, as needed, in reporting to the Department of Public Health pursuant to legislative and regulatory guidelines.
- Provide assistance to other departments under the supervision of the EDs, Director, RM or Regulatory Leadership with preparation for regulatory surveys and site visits.
- Within Administrative policy guidelines or at the direction of the RM or Regulatory Leadership, coordinate or participate in meetings with regulatory agencies.
- Coordinate efforts to provide assistance to regulatory agencies in response to inquiries or requests for information and/or medical records consistent with Department and Hospital policy.
- Assist the Regulatory or RM leadership, as needed, in interfacing with regulatory agencies, in MEDSUN submission and other issues that may arise.
- Educational Functions:
- Provide in-service training at the new employee, nursing or other orientation sessions and other venues, as requested by RM Leadership regarding risk management issues and department functions.
- Participate in and/or attend education seminars and conferences at the request of RM Leadership.
- Assist with staff educational programs involving patient safety, including, but not limited to: medical injury prevention, documentation, informed consent policy and procedures, occurrence reporting, high level Joint Commission reporting and reporting involving other regulatory agencies, Guidelines for Withholding or Removing Life Support, Do Not Intubate/Do Not Resuscitate policies and procedures, Health Care Representative/Proxy policies and procedures, and other programs as requested or as determined by the Department of Risk Management.
QUALIFICATIONS/REQUIREMENTS:
- Registered Nurse is required.
- Bachelor's Degree in Nursing from an accredited college is required with a Master's Degree preferred.
- A minimum of 3 plus years clinical nursing experience is required.
- 1 plus years of relevant risk experience is preferred.
- Excellent written, oral and communication skills are essential.
- Demonstrated organization skills are essential.
- Experience in the utilization of quality improvement methods related to data management and
- Experience in developing reports and conducting educational programs and presentations.
- Competency with computer software such MS Office, Excel and PowerPoint is required.
analysis is required.
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