Risk Management Specialist RN (1.0 FTE Evenings)

Francisan Health•Olympia Fields, IL

42d•$56,971 - $84,750•Onsite

About The Position

The Risk Management Specialist RN is responsible for assisting the Risk Management Department in managing and directing department operations, including interacting with physicians and legal counsel, reviewing incident reports and medical malpractice case reviews. This position is responsible for coordinating and performing quality performance assessment and patient safety activities. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Alliance is one of the largest Catholic health care systems in the Midwest. Franciscan Alliance takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Risk Mitigation Identifies high-risk areas for improvement and provides recommendations/solutions to eliminate/mitigate exposure to liability, and provides follow-up to enhance local entity/hospital operations resulting in improved efficiencies and increased patient safety. Risk Management Collaboratively works with the manager/director and other departments for the identification of high-risk areas providing recommendations and solutions to eliminate/mitigate exposure to liability and enhance compliance with regulatory and accrediting agency requirements. Risk Resolution Serves as a resource to the local entity/hospital in problem identification, educational needs, and problem resolution, which have or may have an adverse effect on patient care, including the education of coworkers on hospital risk management and liability issues. Quarterly Reporting Prepares and submits quarterly reports of all patient occurrences, maintains statistics and other records required in order to communicate information to administration and external agencies. Prepares and submits annual evaluation reports. Risk Management As requested by the Director/Corporate Legal Counsel/Administration conducts nursing/medical reviews for potential or existing risk management issues; interviews hospital staff to work towards solutions. Incident Reporting Administers corporate electronic Incident Reporting system including but not limited to resource for staff, educator, incident report closer, report writer, insurance and medical malpractice claims entry and management. Policy and Procedure Assists in drafting and implementations of risk policies and procedures to minimize risk. Deposition Scheduling Assists in setting up meetings for depositions and for other legal matters. Risk Management Assists in the evaluation of coworkersâ€ claims to identify problems or trends and takes action to assist in reducing problem areas. Outside Inquiry Support Assists with inquiries from outside agencies and interacts with defense lawyers and corporate counsels as necessary in managing insurance claims, medical malpractice claims, patient complaint, coworker injuries, and legal case preparation. Risk Management Collaboratively works with the Risk Manager/Director to track trends and analyzes local entity/hospital occurrences, investigates potential liability issues, and provides updates to the manager/director. Communication Communicates potentially significant issues on a timely basis in order to facilitate continuity of investigation and resolution. Clinical & Critical Thinking Demonstrates the clinical critical thinking and clinical reasoning necessitated in medical/nursing case reviews in addition to the ability to gather, collect, and analyze data. Possess knowledge in medical and basic legal terminology. Liability Claims Interviews coworkers, patients, and witnesses as requested by Corporate Legal Counsel and Administration in regards to incidents/potential liability claims. Confidentiality Maintains confidentiality in issues related to PHI, coworkers, physicians and all legal matters. Compliance Support Maintains current knowledge of regulatory agency requirements and serves as a resource person to local entity/hospital departments to achieve compliance with regulatory agency standards. Quality of Care Analysis Plans, organizes, coordinates, and assists in the collection of data/information in order to analyze, monitor, and evaluate the quality of care provided by the local entity/hospital. Incident Management Reviews all Incident Reports and follows up as required. Enters claims and notifies the insurance company. Tracks and trends claims to reduce risk, promote patient safety, and ensure quality of care. Patient Care Investigation Reviews patient occurrences and investigates reports, patient safety/quality issues, in order to identify potential risks and opportunities for enhancing patient care, including medical errors for potential malpractice claims. Workers Compensation Serves as a resource in discussing problematic workerâ€s compensation cases or issues. Performs other services as required by the Risk Management Department.

Requirements

Bachelor's Degree Nursing
5 years healthcare operations or clinical experience
Registered Nurse (RN) - State Licensing Board

Nice To Haves

Master's Degree Nursing
2 years Quality/Accreditation (may be concurrent)

Responsibilities

Identifies high-risk areas for improvement and provides recommendations/solutions to eliminate/mitigate exposure to liability, and provides follow-up to enhance local entity/hospital operations resulting in improved efficiencies and increased patient safety.
Collaboratively works with the manager/director and other departments for the identification of high-risk areas providing recommendations and solutions to eliminate/mitigate exposure to liability and enhance compliance with regulatory and accrediting agency requirements.
Serves as a resource to the local entity/hospital in problem identification, educational needs, and problem resolution, which have or may have an adverse effect on patient care, including the education of coworkers on hospital risk management and liability issues.
Prepares and submits quarterly reports of all patient occurrences, maintains statistics and other records required in order to communicate information to administration and external agencies. Prepares and submits annual evaluation reports.
As requested by the Director/Corporate Legal Counsel/Administration conducts nursing/medical reviews for potential or existing risk management issues; interviews hospital staff to work towards solutions.
Administers corporate electronic Incident Reporting system including but not limited to resource for staff, educator, incident report closer, report writer, insurance and medical malpractice claims entry and management.
Assists in drafting and implementations of risk policies and procedures to minimize risk.
Assists in setting up meetings for depositions and for other legal matters.
Assists in the evaluation of coworkersâ€ claims to identify problems or trends and takes action to assist in reducing problem areas.
Assists with inquiries from outside agencies and interacts with defense lawyers and corporate counsels as necessary in managing insurance claims, medical malpractice claims, patient complaint, coworker injuries, and legal case preparation.
Collaboratively works with the Risk Manager/Director to track trends and analyzes local entity/hospital occurrences, investigates potential liability issues, and provides updates to the manager/director.
Communicates potentially significant issues on a timely basis in order to facilitate continuity of investigation and resolution.
Demonstrates the clinical critical thinking and clinical reasoning necessitated in medical/nursing case reviews in addition to the ability to gather, collect, and analyze data. Possess knowledge in medical and basic legal terminology.
Interviews coworkers, patients, and witnesses as requested by Corporate Legal Counsel and Administration in regards to incidents/potential liability claims.
Maintains confidentiality in issues related to PHI, coworkers, physicians and all legal matters.
Maintains current knowledge of regulatory agency requirements and serves as a resource person to local entity/hospital departments to achieve compliance with regulatory agency standards.
Plans, organizes, coordinates, and assists in the collection of data/information in order to analyze, monitor, and evaluate the quality of care provided by the local entity/hospital.
Reviews all Incident Reports and follows up as required. Enters claims and notifies the insurance company. Tracks and trends claims to reduce risk, promote patient safety, and ensure quality of care.
Reviews patient occurrences and investigates reports, patient safety/quality issues, in order to identify potential risks and opportunities for enhancing patient care, including medical errors for potential malpractice claims.
Serves as a resource in discussing problematic workerâ€s compensation cases or issues. Performs other services as required by the Risk Management Department.