Clinical & Operational Risk Manager

Location

Marietta, GA | United States

Job description

Functions under the supervision of the Executive Director of Risk Management to support the mission, vision, and values of Wellstar Health System. With leadership assistance from the Executive Director of Risk Management, this team member works to optimize patient safety, reduce the adverse consequences of accidental loss through protective risk management and education, train and update leaders on risk management matters and topics, and drive overall reduced clinical and operational claims. Collaborates with and supports the Executive Director and Risk Management and Legal Department leadership by providing information and data to facilitate decisions regarding insurance renewal and risk program financing. Responsible to regularly monitor and review Wellstar's online event reporting system for reporting, investigation, and filing of adverse events. Reviews incidents on receipt and conducts appropriate investigation, reporting, follow-up education, and knowledge sharing to prevent reoccurrence. Works collaboratively with Claim Managers to facilitate knowledge sharing and best practices for legal claim management.

Core Responsibilites and Essential Functions

• 1. Clinical and Operational Risk Management
  a. Assists in the development and implementation of risk control plans to enhance patient safety, minimize risk exposures, and reduce losses.
  b. Coordinates the clinical and operational risk management program.
  c. Develops learning plan to educate Wellstar leaders on proactive risk management.
  d. Reviews and analyzes all event reporting reports for risk management and quality of care concerns.
  e. Conducts investigations into risk management matters.
  f. Prepares various incident reports
  g. Maintains database of risk management matters and investigations.
  h. Assists with peer review process and completion of safety solutions, in partnership with other departments and team members.
  i. Identifies organizational risk trends through analysis of incident, incident letters, and reports.
  j. Provides on-site support for regulatory investigations, reviews, and surveys.
  k. Develops learning plan to educate Wellstar leaders on proactive risk management.
  l. Review's Wellstar policies and team member training materials to ensure consistency with Wellstar's risk prevention strategies.
  m. Stays informed about trends, best practices, and regulatory requirements related to clinical and operational risk management matters.
  n. Provides rotating 24x7 on-call responsibility to field inquiries and support needs from Wellstar leaders on risk management and other concerns.
  o. Conducts regular rounding with facility/medical group leadership.

Required for All Jobs

• Performs other duties as assigned
• Complies with all WellStar Health System policies, standards of work, and code of conduct.

Required Minimum Education

• Bachelor's Degree Required and
• BSN Preferred

Required Minimum Experience

• Minimum 2 years RN or clinician with at least two years clinical experience Required and
• Minimum 2 years medical claims experience and/or risk management/quality assurance principles in the healthcare setting Required and
• Working knowledge of the medical/legal process, professional liability insurance, claims administration and insurance program management in healthcare. Required

Required Minimum Skills

• Intermediate computer skills including Microsoft Word, Excel and PowerPoint.
• Must be self-motivating and capable of effectively communicating with physicians, patients, staff and attorneys.
• Ability to interface with all levels of the healthcare system and utilize discretion in handling confidential information.
• Must have an insatiable desire to make things better.

Required Minimum License(s) and Certification(s)

• Reg Nurse (Single State) 1.00 Preferred 1.00
• RN - Multi-state Compact 1.00 Preferred 1.00
• Cert Prof Healthcare Risk Mgt Preferred
• Legal Nurse Consultant Cert Preferred

Additional Licenses and Certifications

We’d like to invite you on a career journey like no other! In return for your contributions, we’ll help you make the most of all life’s moments – on and off the job. Wellstar Total Rewards is designed to provide for your total well-being, including: Your Wellness, Your Pay, Your Future, Your Joy. We think it’s pretty simple – we care for our team members and our team members care for the community.

Make a difference in patients’ lives… and your own! Here, it’s more than healthcare – it’s CareerCare!

Job tags

Salary