Quality/Risk Manager
About The Position
The Quality/Risk Manager works in the Quality Department and oversees the Event Management Program, Complaint and Grievance Management Program, provider peer and quality reviews, liability claims and suits, and the Patient Satisfaction Survey program. The role investigates and follows up on patient- and facility-related events and grievances, supports corrective actions and performance improvement, reports findings and trends to leadership, and liaises with insurers and attorneys on liability matters. The employee must maintain the certification, permit, and licensure requirements applicable to their profession under the New York State Office of Professions and notify the employer of any certification or licensure issue or potential issue.
Requirements
- Registered Nurse with a current New York State license.
- Comply with applicable New York State Office of Professions requirements for certification, limited permits, and licensure.
- Notify the employer of the status of any certification or licensure issue or potential issue.
Nice To Haves
- Experience with Risk Management.
- Experience working in Quality Management or a similar role.
- Bachelor of Science in Nursing (BSN).
- Familiarity with agency support availability.
Responsibilities
- Review, log, and ensure investigation and follow-up of patient- and facility-related events.
- Conduct root cause analyses (RCAs), help develop corrective action plans (CAPs), and ensure their completion.
- Oversee auditing of corrective actions.
- Report events to NYPORTS and create plans of correction (POCs).
- Report event trends, types, volume, and outcome severity to leadership.
- Receive and respond to formal grievances; log them and ensure thorough investigation.
- Report grievance trends, types, volume, and problem-area locations to leadership.
- Pursue corrective actions in response to grievance trends.
- Oversee the routine peer review process coordinated by the Medical Staff Specialist.
- Log and distribute Quality Reviews based on triggering indicators.
- Ensure physician leader (MEC) scoring and management of findings.
- Serve as the point person for general and professional liability claims and suits.
- Inform the insurance company of PCEs, claims, and suits.
- Act as contact and liaison for attorneys defending providers and the facility in professional and general liability cases.
- Help collect medical records and other documents for use in legal defense.
- Oversee the Patient Satisfaction Survey program, including providing data to vendors and collecting and presenting satisfaction data to leadership.
- Assist managers with performance improvement projects based on survey results.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
No Education Listed
