Under the direction of the System Director of Risk Administration and Reporting, the Clinical Risk Manager implements and maintains the risk management program for the Health First enterprise (4 hospitals, Medical Group, Outpatient Services, Health Plan) ensuring effective loss prevention/control and compliance with State and Federal guidelines, Health First’s service standards, and organizational and strategic priorities.
The Clinical Risk Manager is primarily accountable for administering Health First’s risk management program on a day-to-day basis, documenting, managing, and analyzing risk management data, conducting proactive risk assessments, providing targeted risk management education, and providing risk management consultation with the objective of promoting patient safety and loss prevention activity to protect organizational assets.
Oversees the management of complaints and grievances in a manner that expresses concern and caring for those who were provided services that did not meet their expectations.
Monitors the investigations of adverse events resulting in patient injuries at the direction of General Counsel for the purpose of seeking legal advice and assisting General Counsel with fact finding that is critical to assessing general and professional liability. Acts as a conduit between the Office of General Counsel and Health First physicians and staff regarding liability issues. Works collaboratively with the General Counsel, providing input and assistance with performance improvement activities and support the legal department with ongoing litigation and claims.
Monitors incident reporting system for injuries and adverse incidents.
Documents required reports case liability cases as required in compliance with organizational, state and other regulatory agency requirements in a timely, appropriate manner.
Provides risk management education and consultation to all clients and stakeholders on topics, including but not limited to informed consent, disclosure of unanticipated/adverse events, medical marijuana, and termination of the patient-physician relationship.
Serves as a resource for our medical, nursing, and allied health staff for compliance with regulatory requirements and in the area of risk reduction and elimination.
Works collaboratively with members of the medical staff, administration, patients, visitors, vendors, and regulatory agency personnel to comply with legal and regulatory requirements in a way that is transparent, honest, and respectful.
Supports and encourages a service atmosphere through routine communication and collaboration with key partners, including but not limited to the Office of General Counsel, Quality, Compliance, Medical Staff, Nursing, etc.
Routinely identifies risk through review of medical staff peer review issues, patient/family grievances, committee minutes, third party reports, attorney requests for medical records and administrative or associate referrals.
Participates in established hospital quality and patient safety oversight committees.
Identifies and implements ways to reduce present and future costs and expenses without sacrificing quality or customer satisfaction. Promotes the containment of claims and losses. Develops innovative approaches intended to reduce the frequency and severity of medical malpractice and patient injury claims.
The primary accountabilities listed are examples of work performed by positions in this job classification. They are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Employees may also perform other relevant duties as assigned and in accordance with Health First’s service standards and organizational and strategic priorities. The Clinical Risk Manager is an onsite position that will have travel to multiple Health First sites around Brevard County.
Bachelor's degree in a work-related discipline/field from an accredited college or university, nursing/clinical background required.
Current clinical license in Florida, but not limited to Registered Nurse required.
Three (3) years related healthcare risk management experience as position of Risk Manager or with primary responsibility for risk management or patient safety activities in an acute care hospital, licensed health care facility, medical group, or health insurer required.
Solid knowledge of Microsoft Office applications
Ability to cover for risk management on-call service 24 hours a day, 7 days a week as scheduled.
Health First works alongside other organizations and physicians in our community. Health First donates to the Brevard Health Alliance that provides healthcare services to thousands of underinsured or uninsured Brevard residents otherwise unable to pay for healthcare services.Our associates are also actively building a healthier community through volunteering for organizations dedicated to preventing and treating health concerns such as cancer, diabetes and heart disease.