Director-Market Risk-Mgmt/Exempt

4 weeks ago

Kennewick Washington, Benton County, WA, United States Trios Health Full time

Risk Manager - Assesses, plans, implements, manages, and coordinates the risk management activities at Trios Health, which include: management, analysis, monitoring and reporting of risk management information; occurrence tracking; medical, safety, and quality follow-up in compliance with applicable laws and regulations; insurance coverage and risk financing; management of claims against the facility, interface with legal counsel, analysis and management of safety/environment of care issues. Conducts risk management educational programs with the objective of controlling and minimizing loss to protect the Hospital and the Hospital District.

Patient Safety Officer – Responsible for primary oversight of the organization-wide patient safety program which includes providing leadership for safety assessments, educating other practitioners on the system-based cause for medical errors, consult with management and staff, and oversee the development and implementation of medical error reduction strategies in collaboration with all departments and patient care areas leadership. Reports patient safety program activity at Quality Council.

  • Department Operations:
  1. Maintains Hospital District-wide systems for claims management and occurrence reporting.
  2. Provides assistance to legal counsel in gathering information regarding claims or claims history.
  3. Participates in the collection of data necessary for insurance renewals.
  4. Integrates patient safety function within the organization.
  5. Reports serious health care events to appropriate agencies; DOH, CMS, Washing State Insurance Commission, etc.
  6. Maintains confidentiality of patient information.
  7. Abides by the District’s Human Resource Policy Manual and Compliance Plan
  8. As the Patient Safety Officer is responsible for oversight of the organization-wide patient safety program, including but not limited to, providing leadership for safety assessments, educating staff and other practitioners on system-based cause for medical errors, consults with management and staff, and oversees the development and implementation of medical error reduction strategies in collaboration with all departments and patient care areas of leadership.

  • Fiscal Management:
  1. Prepares and submits budget to Director of Quality, including financial and capital expenditures within established guidelines.
  2. Monitors Risk Management budget. Reports variances to Director.
  3. Maintains Risk Management files.
  4. Prepares Patient Safety Program annual report.
  5. Prepares and reports risk management activity to the Joint Conference Committee quarterly.

  • Interpersonal Relations:
  1. Utilizes and encourages a variety of communication means, both written and verbal, to facilitate positive interaction and information sharing.
  2. Through attitude and example, contributes toward intradepartmental and interdepartmental teamwork.
  3. Works collaboratively with Patient Relations following established complaint resolution procedures.
  4. Promotes and supports an environment for high morale, teamwork and cooperative spirit.
  5. Actively participates and contributes on various committees, teams and task forces as appropriate.

  • Performance Improvement:
  1. Follows Plan-Do-Check-Act process for performance improvement.
  • Compliance:
  1. Develops, reviews, and updates, policies and procedures to reflect compliance with CMS, TJC, and other regulatory agencies as appropriate.

  • Civic Activities:
  1. Represents Trios Health at civic and community organizations and events as appropriate.

  • Patient Age Groups Served:

NA

NEONATAL

PEDIATRIC

ADOLESCENT

ADULT

GERIATRIC

IV. ESSENTIAL JOB FUNCTIONS

  • Establishes and implements policies and procedures to carry out goals and objectives. `
  • Maintains risk management statistics and files in compliance with Joint Commission, CMS, and other regulatory agencies.
  • Assists department leaders in designing risk management mechanisms in their departments as appropriate.
  • Receives claims or potential claims related to professional liability, analyzes actual and potential risk, assesses liability and probability of legal action; and transmits and coordinates with legal counsel.
  • Assists in processing summons and complaints served on present and previous employees.
  • Interacts with management and legal counsel to respond to claims or issues to facilitate settlement at an early stage. Works to resolve complaints/issues before they develop into professional liability claims.
  • Coordinates legal activities for Trios Health.
  • Takes appropriate steps to ascertain that risks are minimized through follow-up and action on all regulatory/insurance survey reports recommendations/deficiencies.
  • Receives and manages information on occurrences; reviews and analyzes for potential liability; provides investigation and follow-up of serious occurrences and sentinel events with participation at the level appropriate to the event in conjunction with the Director of Quality.
  • Interfaces with insurance carriers regarding claims, applications, and on-going communication.
  • Works with hospital legal counsel in investigations, processing and defense of claims against the hospital. With consultation with Director of Quality may request legal opinions or advice. In collaboration with legal counsel, works out effective mechanisms and procedures to ensure appropriate and timely response to issues or events with serious potential for liability.
  • Responds to professional liability and hospital liability questions posed by hospital staff and medical staff.
  • Maintains awareness of legislative and regulatory activities related to health care risk management.
  • Presents periodic in-services and routine orientation for employees and medical staff regarding healthcare risk management and related subjects to enhance awareness of their role in reducing liability exposures and for reporting occurrences.
  • Disseminates information on claim patterns and risk control, provides recommendations and guidance for managing and reducing risk.
  • Manages incident reporting system.
  • Recommends and facilitates change in the organization to improve patient safety.
  • Leads initiatives to develop proactive risk assessment strategies across services to identify and mitigate patient safety risks.
  • Leads in development of a mechanism for internal communication of patient safety issues

v. TRIOS HEALTH REQUIRED RESPONSIBILITIES
  1. Demonstrates support and adherence to the Mission and Values as set forth by Trios Health.
  2. Responsible for becoming knowledgeable and compliant with Hospital, Department, Fire/Safety/Disaster, Educational Requirements and Personnel Policies.
  3. Adheres to the Corporate Compliance Program.
  4. Responsible for maintaining and protecting the confidentiality of all information received.
  5. Performs department specific competencies satisfactorily.
  6. All other duties as assigned.

Wage: $52.99 - $71.54

This is designated as a safety-sensitive position.

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