Employment Type:

Shift:

Description:

CLINICAL RISK MANAGER

EASTERN OREGON

SUMMARY:

The Clinical Risk Manager is to ultimately provide a safer hospital and clinic environment by mitigating or reducing risks for all individuals within the organization. Serves as a resource for all colleagues and providers on medical/legal concerns. Investigates Event Reports and EMTALA related concerns and identifies major trending patterns.

Analyzes allegations of claims and complaints against the organization and corresponding documentation (including medical record review security reports/video etc.). Interviews employees and physicians for details of events. Documents chronological summaries of events and research processes in a medical/legal perspective. Participates in the risk management reduction strategies with the Risk Management team. The Clinical Risk Manager will provide additional support to the Nampa and Boise Medical Centers as needed.

ENVIRONMENT: Hybrid. Traditional day time hours. The Clinical Risk Managers office could be located in either Baker City or Ontario Oregon. Rotating call coverage for one week to be performed via telephone.

REQUIREMENTS:

1. Must have active RN license; BSN preferred.

2. Certified Professional in Healthcare Risk Management (CPHRM) preferred.

3. 3 years of nursing experience in a clinical role that gives exposure to Risk and process improvement required.

WHAT YOU WILL DO:

• Knows understands incorporates and demonstrates the Organizations Mission Vision and Values in behaviors practices and decisions.

• Must have the ability to work under pressure with time constraints including presenting to all associates in a respectful and professional manner as part of SAHs Core Values Participates in daily Safety Huddles and provides reports for the department and support for other departments as needed.

• Assists in the oversight and maintenance of the system-wide Event reporting system.

• Analyzes Event reports to determine causes and to suggest remedial actions. Reassign events to appropriate department/clinic leadership and/or to peer review.

• Ascertain clinical course of patient event from documentation and demonstrate knowledge of regular processes pertaining to nursing care departmental/clinic functions etc.

• In collaboration with the AOC Clinical Coordinators or applicable department/clinic leadership determines and coordinates initiation leading and follow up of CERTs and Root Cause Analysis (RCA) processes. Expert in Apparent Cause Analysis (ACA) processes and can lead and/or provide guidance and education as needed.

• Oversees and tracks the implementation of corrective action plans resulting from the CERTs ACAs and RCAs process as needed.

• Notifies TH insurance of all actual and potential adverse events SREs SSEs and/or potential compensable events.

• Clinical Risk Manager will work with legal department to conduct EMTALA investigations and provides summary reports to legal for determinations on a case-by-case basis.

• Serves as a lesion with Patient Relations or office manager/director if the patient grievance is elevated.

• Medical Group Clinical Risk Manager will work with providers and/or group managers/directors on patient dismissals/terminations.

• Assists with the billing adjustments and write off determinations and Patient Accounts Review Team.

• Is the contact and local support for claims processing related to general or professional liability.

• Interacts with claims management in the system office local attorneys and external defense attorneys. Processes requests for interrogatory or requests for production materials and provides it to defense attorneys per their request.

• Conducts pro-active Risk Assessment to identify evaluate and develop action plans.

• Collaborates with Performance Improvement and Patient Safety in all serious adverse events and the associated corrective action plans.

• Collects evaluates and distributes relevant data related to Events SREs SSEs and claims that may include aggregate data summaries monthly/annual trend analyses.

• Prepares or provides materials for reports for applicable committees the medical staff and the governing board.

• Participates in hospital or medical group committees/teams and/or Boards as requested.

• Provides education for colleagues and providers on risk management related topics. Provides New Hire Orientation and/or annual educational information regarding Event reporting processes and other risk management related topics.

• Maintains awareness of legislative and regulatory activities related to health care risk management.

• Assists the Manager Safety and Risk Management and other Risk Management staff in the triage and assessment of day-to-day risk management needs to include supporting Baker City Nampa and the Boise Regional Medical Centers.

• Participates in after-hours and weekend Risk Management on-call rotation as requested by the SAHS Manager Safety and Risk Management.

Highlights and Benefits:

When Saint Alphonsus takes care of you you can take better care of our patients. We foster personal and professional growth and offer opportunities that empower our colleagues to develop their careers. Our belief in work-life balance compliments the natural beauty diverse landscapes and outdoor recreation lifestyle that is unique to Idaho and Oregon.

• We offer market-competitive pay generous PTO and multiple options for comprehensive benefits that begin on day one.

• Benefits for your future include retirement planning and matching college savings plans for your family and multiple life insurance plans that can change as your needs develop.

• We are proud to offer Employee Assistance Programs tuition reimbursement and educational opportunities to help you learn and grow.

Ministry/Facility Information:

Saint Alphonsus Health System is a faith-based ministry and not-for-profit health system serving Idaho Oregon and northern Nevada communities. The health system boasts 4 hospitals 609 licensed beds and 73 clinic locations. Through innovative technologies compassionate staff and healing environments Saint Alphonsus goal is to improve the health and well-being of people by emphasizing care that is patient-centered physician-led innovative and community-based.

• Top 15 Health Systems in the country by IBM Watson Health;

• The regions most advanced Trauma Center (Level II);

• Commission on Cancer Accredited Program through demonstrating an uncompromising commitment to improving patient survival and quality of life

Saint Alphonsus and Trinity Health are committed to promoting diversity in its workforce and to providing an inclusive work environment where everyone is treated with fairness dignity and respect. We are committed to recruit and retain a diverse staff reflective of the communities we serve. Saint Alphonsus and Trinity Health are equal opportunity employers and prohibit discrimination against any individual with regard to race color religion gender marital status national origin age disability sexual orientation or any other characteristic protected by law.

Our Commitment

Rooted in our Mission and Core Values we honor the dignity of every person and recognize the unique perspectives experiences and talents each colleague brings. By finding common ground and embracing our differences we grow stronger together and deliver more compassionate person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin disability veteran status or any other status protected by federal state or local law.