Under the direction of the Vice-President and ChiefRisk Officer (CRO), the Clinical Risk Manager implements and maintains the riskmanagement program for Health First Enterprise Risk (4 hospitals, MedicalGroup, Outpatient Services, Health Plan) ensuring effective lossprevention/control and compliance with\:
State and federal guidelines;
Health First's service standards;
Organizational and strategic priorities.
The clinical risk manager is primarily accountablefor administering Health First's risk management program on a day-to-day basis,documenting, managing and analyzing risk management data, conducting proactiverisk assessments, providing targeted risk management education, and providingrisk management consultation with the objective of promoting patient safety andloss prevention activity to protect organizational assets.
The primary accountabilities listed are examples ofwork performed by positions in this job classification. They are not designedto contain or be interpreted as a comprehensive inventory of all duties, tasksand responsibilities. Employees may also perform other relevant duties asassigned and in accordance with Health First's service standards andorganizational and strategic priorities\: Customer experience andstewardship and No Harm/Quality
Consistently demonstrates and lives out the I-CARE values of Health First in all work-related activities
Reaches across the spectrum to work 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
Promotes the field of risk management and encourages department associates to seek continuing education so that they remain the industry experts
Monitors incident reporting system for injuries and adverse incidents.
Monitor 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.
Follows the ISO 31000 risk management process\: identification, assessment, evaluation, mitigation and monitoring.
Maintains awareness of internal and external factors (ex\: new legislation and regulations) that may affect Health First's risk management program and communicates relevant findings to the appropriate departments.
Prepares and presents quarterly reports to seniorleadership and the Board of Trustees regarding risk trends and findings analyzed from risk sources, such as incident reports and patient grievances.
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.
Writes and reviews administrative policies and procedures that fall within Risk Management's purview.
Remains available as scheduled for risk management on-call service 24 hours a day, 7 days a week.
Oversees FDA medical device reporting where devices have caused or have the potential to cause significant harm or death.
Participates in established hospital quality and patient safety oversight committees.
Develops innovative approaches intended to reduce the frequency and severity of medical malpractice and patient injury claims.
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.
Acts as a liaison between Health First and the Patient Safety Organization in which Health First participates.
Assures submission of special category incident reporting (ex\: Annual reports of incidents causing patient injury and Code 15 reports to the Agency for Health Care Administration within 15 days of the occurrence or respectively, in accordance with Florida Administrative Code 59-A10 and State Statute 395.0197).
Timely documents cases of liability (potential and actual) into the Claims application.
Work collaboratively with the General Counsel, providing input and assistance with performance improvement activities and support the legal department with ongoing litigation and claims.
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.
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.
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.
Achieves financial goals established for risk management department.
Identifies and implements ways to reduce present and future costs and expenses without sacrificing quality or customer satisfaction.
Promote the containment of claims and losses.
Authority to settle hospital claims in an amount notexceed $5,000
Anycombination of education and experience that would likely provide the requiredknowledge, skills and abilities.
Graduatedegree in a work-related discipline/field from an accredited college oruniversity, nursing/clinical background preferred but not mandatory dependingupon applicant's education, background and experience.
Five(5) years of progressively responsible and directly related healthcare riskmanagement experience including a minimum of three (3) years as position ofRisk Manager or with primary responsibility for risk management activities inan acute care hospital, licensed health care facility, medical group or healthinsurer
Acurrent Florida licensed health care risk management license or willing toobtain within six months of the date of hiring.
Abilityto handle high stress areas
Excellentoral and written communication skills
Abilityto foster effective working relationships and build consensus
Proficientcomputer skills (ex\: PowerPoint, Excel, extracting data and reports
Continuousand consistent utilization of the ISO 31000 risk management process
Knowledgeof Health First's strategic and organizational goals
o Maintainconfidentially in all areas
o Mediateand resolve complex problems and issues
o Motivateand influence others
o Research,write and present effectively on risk management topics and trends
Internal Number: 229_035053
About Health First
Health First is Central Florida's only fully integrated health system. With a mission to positively change the health and wellness of the communities we serve, Health First offers the latest technological advances and quality care at our four hospitals and through our many Outpatient & Wellness Services, as well as the area's only Trauma and Heart Centers. Health First also offers multiple commercial and Medicare health plans, the largest multi-specialty physician group in Brevard County, and four fitness centers to help members of our community stay healthy.