Clinical Risk Manager

CoxHealth•Springfield, MO

6d•Onsite

About The Position

The Clinical Risk Manager reports to the Administrative Director of Insurance and Risk Management and is responsible for identifying, investigating, analyzing, and mitigating clinical risk across the healthcare system. This role conducts comprehensive investigations of adverse medical events to assess potential liability exposure, identify contributing factors and system vulnerabilities, and detect trends impacting patient safety and quality of care. The Clinical Risk Manager supports the management of claims and litigation by developing factual analyses, coordinating with internal stakeholders, and providing risk-based insights. The Clinical Risk Manager collaborates closely with Legal, Patient Safety, Regulatory Affairs, Medical Staff Quality, Compliance, Patient Experience, Security, Patient Financial Services, clinical partners, and leadership to reduce organizational risk and promote high-quality, safe care. Responsibilities include investigating and responding to adverse events, patient grievances, and billing disputes; participating in multidisciplinary case reviews and committees; and contributing to systemwide initiatives focused on patient safety, quality improvement, and risk reduction. In addition, the Clinical Risk Manager plays a key role in risk education and prevention by providing consultation and education to providers, clinical staff, leaders, and interdisciplinary teams. The role proactively analyzes data, trends, and emerging risks related to patient safety and professional liability, and develops and implements targeted risk mitigation and educational strategies. Working in partnership with clinical and operational leaders, the Clinical Risk Manager recommends and supports the implementation of sustainable risk reduction initiatives aligned with the organization’s mission, values, and strategic goals.

Requirements

Bachelor’s Degree in Nursing
5 years of clinical experience
Strong clinical judgment and critical thinking skills.
Excellent assessment, investigation, and analytical skills.
Excellent written and verbal communication skills.
Skilled in active listening and use of effective interview techniques.
Ability to collaborate across disciplines and levels of the organization.
Ability to develop and deliver effective educational content.
Ability to manage sensitive and confidential information with discretion.
RN license

Nice To Haves

Experience in clinical risk management, claims management, patient safety, or a related healthcare quality role.
CPHRM, ARM, CPCU, CPHQ

Responsibilities

Identifying, investigating, analyzing, and mitigating clinical risk across the healthcare system.
Conducting comprehensive investigations of adverse medical events to assess potential liability exposure, identify contributing factors and system vulnerabilities, and detect trends impacting patient safety and quality of care.
Supporting the management of claims and litigation by developing factual analyses, coordinating with internal stakeholders, and providing risk-based insights.
Collaborating closely with Legal, Patient Safety, Regulatory Affairs, Medical Staff Quality, Compliance, Patient Experience, Security, Patient Financial Services, clinical partners, and leadership to reduce organizational risk and promote high-quality, safe care.
Investigating and responding to adverse events, patient grievances, and billing disputes.
Participating in multidisciplinary case reviews and committees.
Contributing to systemwide initiatives focused on patient safety, quality improvement, and risk reduction.
Providing consultation and education to providers, clinical staff, leaders, and interdisciplinary teams.
Proactively analyzing data, trends, and emerging risks related to patient safety and professional liability, and develops and implements targeted risk mitigation and educational strategies.
Recommending and supporting the implementation of sustainable risk reduction initiatives aligned with the organization’s mission, values, and strategic goals.