The risk manager is responsible for the assigned entitys risk management activities, which includes, but may not be limited to a general knowledge of corporate insurance programs, administering the risk management program on a day-to-day basis, managing and analyzing risk management data and conducting risk management educational programs, complying with risk management related standards by The Joint Commission (TJC) and other accrediting and regulatory agencies, all with the objective of enhancing and promoting patient safety and quality of care, and minimizing loss to protect the assets of the organization. This individual is responsible for reviewing and formulating policy or organizational changes and making recommendations for final approval by senior management.While the Senior Risk Manager position may be responsible for the functions in the Risk Manager and Risk Specialist job descriptions, this position most often supervises and offers overall program direction to the Risk Manager and Risk Specialist. Oversees budget development for assigned entities and obtains management approval.
Has full responsibility for operations of the risk management program that may include an enterprise liability approach to exposures. Plans and implements a program for both loss prevention and loss control at assigned entities, and a comprehensive orientation program; those programs will be directed to all current and future employees, physicians, and residents to advise them of their responsibilities, obligations, and part in the facilitys risk management program. Maintains awareness of legislative activities that may affect risk management programs in assigned entities and participates in the legislative process.
Develops, implements and monitors risk management plans for assigned entities. Develops and monitors progress on annual entity-specific risk management goals. Conducts systems analyses to uncover and identify patterns that could result in compensable events. Designs and implements risk management surveys and studies; conducts surveys, studies, and special projects to assist in long-term planning and changes to facility policies and systems that reduce risk and losses. Participates in new business development activities by providing due diligence on new ventures/acquisitions.
Assumes an active role in planning and decision making efforts through membership in various entity committees: hospital, clinic, and ambulatory. Provides consultative advice to senior management, administrators, physicians, relevant internal department, nurses, and other personnel regarding patient safety and risk management issues. Works with Medical Staff Services to develop and maintain risk management profiles on physicians and integrates that information into the credentialing process in compliance with state and federal agencies, TJC and/or other accrediting bodies, and institutional requirements.
Informs service line and department directors of occurrences, issues, findings and risk management recommendations; provides feedback to directors at all levels in an effort to eliminate risks; assists clinical chairs and department heads in designing risk management programs within their departments. Works in conjunction with the patient safety officer, service excellence, and management in the investigation of potential or actual events/concerns. Participates in root cause analysis investigation and reporting of adverse drug events and sentinel events to the appropriate parties. Provides assistance to departments in complying with TJC or other accrediting agencies, regarding risk management related standards.
Responds to professional liability and facility liability questions posed by physicians, nurses, and other personnel. Leads development of organization-wide approach on disclosure of medical errors and obtains physician support. Answers inquiries of physicians, nurses, and administrators regarding emergent patient care issues to minimize risk and control loss. Assist in resolving treatment issues, including patient decisions made against medical advice (AMA), refusals of treatment, and consent issues; initiates court orders as appropriate via in-house and outside legal counsel. Responsible for being on call as scheduled.
Recommends appropriate revisions to new or existing policies and procedures to reduce the frequency of future occurrences; recommends ways to minimize risks through system changes; reviews and revises facility policies as appropriate to maintain adherence to current standards. In litigated claims, assists Banner Health Claims team and legal counsel in accessing facility records and personnel. Directs and coordinates release of records and information in response to subpoenas, court orders, attorney requests, state and federal agency investigations, and other inquiries from outside sources.
Must possess a knowledge of risk management as normally obtained through a bachelors degree in nursing or related field.
ARM, CPHRM, DFASHRM, CPCU. CPHRM is required within one year of hire.
Experience is senior level position with 6 to 9 years in risk management required.
Must possess strong written and oral communications skills, presentation skills, team player, ability to influence change without direct authority, and negotiation skills.Must demonstrate and apply knowledge of federal and state statutes specific to health care, medical terminology and hospital or department policies, procedures and practices. Requires ability to manage and negotiate in emotional and confrontational situations, with sensitivity to operations and culture of facilities and organization as a whole.
ARM, CPHRM, DFASHRM, CPCU.
Additional related education and/or experience preferred.