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Employment Type:

Full time

Shift:

Day Shift

Description:

CLINICAL RISK MANAGER

BOISE REGIONAL MEDICAL CENTER, Level II Trauma Center

SUMMARY:

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.

Analyzes allegations of claims and complaints against the organization, and corresponding documentation. Interviews employees, patients, families, and physicians for details of events. Documents chronological summaries of events and research processes in a medical/legal perspective. Participates in the risk management reduction strategies with the Risk Management team.

REQUIREMENTS:

+ Must have active RN license.

+ BSN preferred.

+ Certified Professional in Healthcare Risk Management (CPHRM) preferred.

+ 3 years of nursing experience in a clinical role that gives exposure to Infection Control, Quality, Risk, etc. required.

WHAT YOU WILL DO:

+ Analyzes allegations of claims and complaints against the organization, and corresponding documentation (including medical record review, security reports/video, etc.).

+ Analyzes Event reports to determine causes and to suggest remedial actions. Reassign events to appropriate department/clinic leadership and/or to peer review. Interviews employees, patients, families, and physicians for details of events.

+ Investigates Event Reports and EMTALA related concerns and identifies major trending patterns.

+ Ascertain clinical course of patient from documentation and demonstrate knowledge of regular processes pertaining to nursing care, departmental/clinic functions, etc.

+ In collaboration with the AOC, Clinical Coordinators, or applicable department/clinic leadership, determines and coordinates initiation, leading, and follow up of CERT’s and Root Cause Analysis (RCA) processes. 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 resulting from the CERT’s, ACA’s RCA’s process, including Common Cause Analysis (CCA) as needed.

+ Notifies TH insurance of all actual and potential adverse 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.

+ Assists with the billing adjustments and write off determinations.

+ Manages or supports processing of subpoenas, court orders or other legal requests from attorneys.

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

+ Assists with coordination of the Trinity MPL Annual Audits. May serve as a lesion and/or resource between Trinity IRMS and leadership working on components of the audit.

+ Collaborates with Performance Improvement and Patient Safety in all serious adverse events and associated corrective action plans.

+ 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.

+ Participates in after-hours and weekend Risk Management on-call rotation, as request

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

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are 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, veteran status, or any other status protected by federal, state, or local 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