CORE JOB FUNCTIONS

• Investigates and analyzes the frequency and cause of patient injuries.  

• Directs the coordination and maintenance of the event reporting system (ERS), including systematic reviews of all event reports filed at the facility, to identify trends or patterns, and develop recommendations for appropriate corrective actions.

• Provides and directs basic and complex preventive risk management assessment(s) of processes, procedures, and programs.

​Department Specific Functions

• Oversight and management of the Incident reporting system to include timely review, analysis and investigation of event reports and patient grievances and complaints to identify areas of high risk, patient experience as well as potentially compensable events.

• Facilitate resolution of complaints/grievances pertaining to quality-of-care issues.

• Facilitate interventions as necessary with Patient Relations, Physician Leadership and Corporate Patient Advocate of Risk Management Department.

• Review, analyze and identify AHCA, DOH and other regulatory agency reportable events and prepare submission for approval by Associate Medical Risk management Officer and the Chief Medical Risk Officer.

• Facilitate and/or participate in Root Cause and FMEA analysis as necessary in conjunction with the Quality Team.

• Analyze complaint/grievance data and collaborate with Leadership on an Ad hoc basis.

• Develop a consultant relationship with departments and units to build and sustain a patient focused culture.

• Provide notification and documentation of potentially compensable events to Chief Medical Risk Officer, Director of Medical Claims and Assistant General Counsel.

• Conduct additional investigation and assist with discovery requests as directed.

• Provides interpretation of risk management and patient safety standards and procedures to medical and hospital staff; counsels staff and physicians in sensitive situations involving actual or potential claims.

• Analyze and trend data as captured through the event reporting system to identify trends of areas of high risk.

• Develop summary reports of trending analysis and submit to appropriate committees.

• Review, revise and develop policies and procedures in association with the Associate Medical Risk Officer pertaining to or having a bearing on risk management and patient safety in accordance with regulatory requirements.

• Develop and present Risk Management Program summary reports as required.

• Participate on committees, work groups and/or process improvement teams that improve patient/customer satisfaction.

• Identify educational needs and develop and present Risk Management and Event Reporting education to staff, faculty and community physicians.

• Attend national and local conferences to keep abreast of national trends in determining institutional priorities.

• Plan, coordinate and supervise the activities of the Risk Management staff.

• Perform other related duties incidental to the work described herein.

• Co-chair the Patient Safety Committee: collaborate with team and finalize agenda for meeting.

• Collaborate with team, and assesses, monitors, and recommends, and prepares annual patient safety evaluation.

• Coordinate credentialing and meet on a monthly basis.

• Plan, Develop and maintain structure for AAAHC, AHCA and CMS survey readiness. a) Survey readiness preparation

• Provides oversight of quality activities and performance improvement activities.  Establish key performance measures.

• Provides oversight of regulatory activities.

• Provides ongoing update on regulatory changes and update policy and procedure.

This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.

CORE QUALIFICATIONS                                             

• Bachelor’s Degree in relevant field required

• Minimum 5 years of relevant experience required

• Medical/Legal background is a plus

• RN Training and licensure is a plus

• Certified Professional in Health Care Risk Management (CPHRM), Certified Professional in Patient Safety (CPPS) is highly desired.

Knowledge, Skills and Attitudes:

• Ability to maintain effective interpersonal relationships

• Ability to communicate effectively in both oral and written form

• Ability to recognize, analyze, and solve a variety of problems

• Ability to exercise sound judgment in making critical decisions

• Proficiency in computer software (i.e. Microsoft Office)

Any appropriate combination of relevant education, experience and/or certifications may be considered.