Clinical Risk Manager

Job Description

Job Summary

Under the supervision of the Director of Risk Managment, the clinical risk manager is responsible for the day to day risk management activities of the Quality and Risk Department. To that end, the clinical risk manager assists in the planning, direction and coordination of activities of risk identification, prevention, and evaluation, with recommendations for action to prevent and/or reduce the frequency and severity of events to improve the quality of care and patient safety and reduce the risk of financial loss. The clinical risk manager will investigate, manage, and analyze risk management data in accordance with The Joint Commission and other regulatory agencies, including but not limited to, the Centers for Medicare and Medicaid Services and the New York State Department of Health.

Duties and Responsibilities

To receive, review and track and trend all event reports at SBH Health System.

To gather information and conduct investigations associated with events.

To ensure effective follow up on investigations through continuous ongoing monitoring.

To participate in, lead case reviews, PI projects, root cause analysis and sentinel event reviews in order to reduce and minimize risks to improve the quality of care and promote patient safety.

To prepare and submit root cause analysis to the New York State Department of Health.

To identify, analyze, evaluate and expose actual or potential hazards inherent in the SBH Health System activities.

To participate in and be a member of committees as appointed by the Director of Risk Management.

To respond to general risk management consultations and inquiries from all staff within SBH Health System.

To assist in the coordination of investigations and responses to inquiries, citations and complaints received from The Joint Commission(TJC), Centers for Medicare and Medicaid Services(CMS), and the New York State Department of Health(NYSDOH).

To participate in data collection and complete systematic monitoring and evaluation of data and performance improvement measures via the PDSA improvement model.

To provide educational in-service training and orientation to SBH Health System staff to current TJC, CMS and NYSDOH.

To perform any duty as may be assigned within the scope of the job.

Core Expectations

• Promote a safe, cooperative and professional healthcare environment to ensure optimum patient care consistent with SBH policies.
• Adheres to all hospital policies, procedures, rules and regulations, including but not limited to absenteeism, ETIME, cellular phone usage, dress code, and rules of conduct.
• Makes customer service a priority, treating customers (patients, visitors, and co-workers) in a professional manner exercising courtesy and tact. Effectively communicates with patients and others about SBH services in their area(s) of expertise or responsibility and ensures that concerns, questions or issues reach the right person(s) in SBH in a timely manner.
• Comply with all required training including but not limited to training posted on the intranet and Healthstream.
• Embody and demonstrate behaviors consistent with the DRIVE to Patient Excellence.

Requirements

Minimum Education

Bachelor' degree required, Master's degree preferred.

Minimum Related Experience

At least 3-5 years' experience in risk management which includes knowledge of The Joint Commission standards for healthcare, as well as federal and state regulatory requirements for CMS and the NYSDOH.

Minimum Licensing Requirements

Registered Nurse required.

Minimum Certification Requirements

Professional certification/or equivalent in healthcare risk management preferred.

Minimum Computer Skills

Proficient in Microsoft Office applications (Word, Excel, PowerPoint, Outlook)

General Skills

Excellent written and verbal communication skills including negotiation experience, strong conflict and relationship management, team building skills and strong program management skills are required.