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Clinical Risk Manager assists with clinical identification, risk evaluation and coordination of corrective action implementation relates to risk issues. Conducts investigations of risk and claim matters and provides investigation information to legal counsel. Interviews staff and physicians involved in potential medical malpractice litigation. Provides intervention and education related to risk management issues to promote safe work practices and quality care and services in an environment that is beneficial to the safety, health and well being of all patients, visitors and hospital staff. Reports real and potential risk situations to the Director, Risk Management. Provides education to providers, staff and administration. Acts as resource person to administrative team, department managers and medical staff.
Essential Functions and Responsibilities:
- Conducts regular risk management surveys of hospital departments and other system owned facilities.
- Reports information gathered from risk identification assessments to the appropriate managers for analysis and corrective action to eliminate or reduce risk.
- Demonstrates knowledge of basic components of risk management, including root case analysis, potentially compensable events, loss control, risk investigation, reporting and claims management.
- Reviews, evaluates and recommends action in risk related matters pertaining to patients visitors, Associates, students, physical plant and personal property.
- Provides education to providers and staff on risk management practices including, but not limited to: risk identification, key elements of risk reduction, and education regarding proper documentation practices that present potential liability problems.
- Performs medical record review for the purpose of identification of real or potential risk and the monitoring of documentation practices.
- Assists in development and preparation of monthly, quarterly and yearly reports on risk incidents, claims and departmental activities.
- Investigates potential liability situations in all MWHC Programs and Facilities identified through various risk identification sources including conducting in-depth interviews of staff involved in general and professional liability matters and provides reports to legal counsel to assist in preparation of defense.
- Completes case summaries on all medical malpractice and general liability cases and provides to legal counsel, executive leadership and Claims Management Committee.
- Coordinates the gathering of medical and other records involved in litigation and assists legal counsel as required.
- Summarize risk management data for appropriate evaluation and risk trend analysis.
- Advises staff, providers and/or committees regarding real and potential liability situations.
- Consults other departments as appropriate to provide collaboration in patient care.
- Interacts professionally with patient/family to increase patient/family satisfaction and/or diffuse potential litigious occurrences related to patient/family perception.
- Maintains claims files and other documents/files associated with general and professional liability matters.
- Demonstrates knowledge of appropriate and current documentation practices related to the risk management.
- Assists in development of standards for the organization.
- Demonstrates knowledge of current methodology and practices. Maintains awareness of changes in the regulations and requirements by accrediting bodies.
- Serves as an on-call resource for staff and physicians on risk issues.
- Participates in risk management and safety activities.
- Ability to analyze complex clinical situations and deal with conflict and people who are upset. Provides a calming influence in difficult situations.
- Perform other duties as assigned.
- Valid RN License from Virginia or reciprocal compact state required.
- Bachelor's degree in Nursing (BSN) from an accredited school required
- Clinical experience within last 5 years preferred.
- CPHRM certification preferred.
- 3 or more years experience in risk management, patient safety or quality improvement in acute care setting
- Thorough understanding of acute and non-acute care delivery systems, including home health care agencies and ambulatory care and psychiatric units.
- Excellent interpersonal skills required.
- Personal computer knowledge including, but not limited to, word processing program, spread sheet programs, electronic calendars, data management programs, graphic presentation programs, Internet communication software and software applications used to support risk management (e.g., flowing charting, etc).
As an EOE/AA employer, the organization will not discriminate in its employment practices due to an applicant's race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status.