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Employment Type:

Full time

Shift:

Day Shift

Description:

CLINICAL RISK MANAGER

The Clinical Risk Manager is to ultimately provide a safer hospital and clinic environment by mitigating or reducing risks for all individuals within the organization. Serves as a resource for all colleagues and providers on medico/legal concerns. Investigates Event Reports and EMTALA related concerns and identifies major trending patterns.

REQUIREMENTS:

+ Bachelor's degree required; BSN preferred. Certified Professional in Healthcare Risk Management (CPHRM) preferred.

+ Ambulatory experience required.

+ Minimum of three years’ experience in healthcare. **RN required.**

**Hours:** Flexible daytime, traditional office hours. There will be shared, after hours and weekend call responsibilities which could be once every four weeks.

WHAT YOU WILL DO:

+ Huddles and provides reports for the department and support for other departments as needed. Assists in the oversight and maintenance of the system-wide Event reporting system.

+ Analyzes Event reports to determine causes and to suggest remedial actions. Reassign events to appropriate department/clinic leadership and/or to peer review.

+ Expert in Apparent Cause Analysis (ACA) and Common Cause Analysis (CCA) processes and can lead and/or provide guidance and education as needed. Oversees and tracks the implementation of corrective action plans.

+ Notifies TH insurance of all actual and potential adverse events, SRE’s, SSE’s and/or potential compensable events.

+ Clinical Risk Manager will work with legal department to conduct EMTALA investigations and provides summary reports to legal for determinations.

+ Works collaboratively with the Patient Relations Department to complete appropriate responses on patient complaints and grievances.

+ Medical Group Clinical Risk Manager will work with providers and/or group managers/directors on patient dismissals/terminations. Assists with the billing adjustments and write off determinations, and Patient Accounts Review Team.

+ Manages or supports processing of subpoenas, court orders or other legal requests from attorneys. Interacts with the system office to manage corporate lines of insurance related issues or requests.

+ Manages and uploads new claims in the STARs “ClearSight” module. Interacts with claims management in the system office, local attorneys, and external defense attorneys. Participates in Board of Medicine hearings, court hearings or trials as requested.

+ Conducts pro-active Risk Assessment to identify, evaluate and develop action plans targeted on addressing variables, insufficient findings, and other opportunities for improvement.

+ Collects, evaluates, and distributes relevant data related to Events, SRE’s, SSEs, and claims that may include aggregate data, summaries, monthly/annual trend analyses.

+ Provides education for colleagues and providers on risk management related topics.

+ Provides New Hire Orientation and/or annual educational information regarding Event reporting processes and other risk management topics. Maintains awareness of legislative and regulatory activities related to health care risk management.

+ Maintains and revises relevant Risk Management policies, plans, and processes as needed.

•Colleagues of Saint Alphonsus Health System enjoy competitive compensation with a full benefits package and opportunity for growth throughout SAHS and Trinity Health.

Visit www.saintalphonsus.org/careers (https://www.saintalphonsus.org/careers/search-openings/details?j=00137722\_Speech%20Therapist%20PRN) to learn more about the benefits, culture and career development opportunities available to you at Saint Alphonsus Health System.

Saint Alphonsus and Trinity Health are committed to promoting diversity in its workforce and to providing an inclusive work environment where everyone is treated with fairness, dignity and respect. We are committed to recruit and retain a diverse staff reflective of the communities we serve. Saint Alphonsus and Trinity Health are equal opportunity employers and prohibit discrimination against any individual with regard to race, color, religion, gender, marital status, national origin, age, disability, sexual orientation, or any other characteristic protected by law.

Our Commitment to Diversity and Inclusion

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

EOE including disability/veteran