Career Center

The Risk Manager is responsible for the review and evaluation of events, and to identify as potential claims, lawsuits, and reportability under the Patient Safety Act. Refers events to Peer Review, Quality & Outcomes Management and other committees to address as appropriate. Organizes and moderates Root Cause Analysis and assists with the development of corrective action plans. Coordinates and facilitates regulatory investigations and responds as needed. Management of the resolution process related to complaint/grievances. Provides education to nursing, medical residency staff and all ancillary departments as needed. Manages translation services.

 

Principal Accountabilities:

 

 

Evaluates incident for severity, frequency and probability of financial loss

• Reports as appropriate to administration and committees

• Responds to significant occurrences; review facts; review medical record/documentation; preserve any evidence; interview staff

• Provide recommendations to staff re: investigation/handling of event to appropriate management, administrators

• Refer to peer review, Quality & Outcomes Management Committees to address as appropriate

• Develops educational programs as appropriate or needed based on incident findings and trends.

• Reviews incidents and identifies potential claims/lawsuits

• Prepares potential files, documenting factual investigation of event

• Communicates findings to the legal team as appropriate for case preparation

• Reviews incidents and determines whether constitutes Serious Preventable Event under the Patient Safety Act

• Conducts initial team call and determines plan along with Executive Sponsorship

• Submits initial notification of SPE to DHSS

• Organizes and moderates Root Cause Analysis meeting with health care providers involved to identify contributing factors to the event and develop a corrective action plan

• Coordinates case presentations to Preventable Events Review Committee

• Advises site nursing staff, medical staff and administration on legal issues, billing, insurance, risk management, corporate compliance, EMTALA, HIPAA and other regulatory concerns following the review of regulations and standards.

• Responds to clinical queries related to clinical needs following policy review

• Acts as resource to all inquiries, encouraging ongoing open communication

• Provides in-service training, education to nursing staff, medical staff, residency staff, as requested or recommended based on identified need through case review

• Topics include litigation process, documentation, incident management, hospital policies, protocols

• Triages events, escalates, investigates and refers as appropriate, closes events

• Acknowledges clinical staff for Good Catches

- Coordinates the Risk is Real Publication – tell the story format of things that happen or can happen with emphasis on Patient Safety

• Provide training to nursing staff, medical staff, and residency staff on use of program

• Coordinate and facilitate investigations (DHSS)(FDA) (CMS)

• Facilitate, prepare and submit material to agency and respond to deficiencies

• Coordinate voluntary and required reporting to the FDA

• Proactive management of difficult patients and family members of complex care cases in order to mitigate complaints

• Liaison between patient/family and nursing/physician teams to resolve concerns

• Manage the response process as well as the electronic documentation of all complaints/grievances in the database

• Track and trend patterns of complaints/grievances and reports to leadership

• Ensure compliance with DOH/CMS regulations regarding clinical patient complaints/grievances

• Manage and arrange language translation services for patients and families while ensuring compliance with regulations

• Provide training to teams on language translation services as needed

Required Education Licenses, Certifications or Registrations

RN

BSN

CPHRM

7+ years of Risk Management experience preferred

Proficient in the use of Microsoft Office Applications

Excellent written and verbal communication skills

Independent problem solver

Self-motivated and interested in learning

Atlantic Health System is at the forefront of medicine, setting standards for quality health care powered by a workforce of more than 18,000 team members and 4,800 affiliated physicians dedicated to building healthier communities, the system offers more than 400 sites of care, including eight award-winning medical centers. Specializing in cardiovascular care, cancer care, orthopedics, neuroscience, pediatrics, women's health and rehabilitation medicine. Atlantic Medical Group, comprised of 1,000 physicians and advanced practice providers, represents one of the largest multi-specialty practices in New Jersey and includes finance, legal, marketing, human resources, talent acquisition, ISS and more. Caring for our patients, our team members and the communities we serve is our central mission.