Risk Manager

Baystate Health•Springfield, MA

19d•Hybrid

About The Position

Under the direction of the Senior Director of Clinical Safety and Risk Management, the Risk Manager is responsible for: 1. The management, administration, and application of the system-wide clinical and enterprise risk management (ERM) programs across all coverage lines 2. Systematically applying the risk management process to proactively identify, analyze, and mitigate risk 3. Engagement in the patient and family-centered Communication, Apology, and Resolution (CARe) response to all serious adverse events 4. Identifying potential losses to the organization 5. Conducting immediate/appropriate response to any serious occurrence/complaint representing the actual or potential patient, visitor, and/or employee injury 6. Monitoring and taking subsequent actions to assure learning, compliance, and documentation 7. Developing and maintaining appropriate loss prevention programs and strategies within Baystate Health’s just culture framework, consistent with high-reliability organization principles (HRO), to enhance patient safety, support the just culture of provider transparency, prevent/reduce injury to patients, employees, and visitors, and mitigate the frequency and severity of financial exposure to the organization 8. Managing loss exposures to minimize economic impact on patients and the organization 9. Risk identification, evaluation, reporting, and loss control, including compliance with applicable regulatory, accreditation, and professional standards 10. Coordinating with the captive insurance program in the identification and processing of potentially compensable events, claims, and lawsuits brought against insured Baystate Health entities and hospital-based and community-based practitioners 11. Assisting with the development and implementation of initiatives, including clinical education activities and other risk prevention/reduction/elimination throughout the organization 12. Supporting the process of responding to product and safety recalls and alerts and safe medical device reporting of adverse events 13. Serving as a liaison to external regulatory agencies for purposes of patient and nursing reporting, event investigation, and response, including, but not limited to, the Department of Public Health and Board of Registration in Nursing, preparing and submitting required reports to state and federal agencies and, when applicable, coordinating external investigations 14. Disseminating information on claim patterns and risk control and legislative and regulatory changes and utilizes this information to educate personnel as to changes in practice 15. Actively participating in a variety of committees within the hospital system as assigned 16. Keeping up to date with new and revised state and federal regulations and statutes related to hospitals and patient care, advising medical and hospital staff of changes in governmental and professional standards that affect practice with recommendations for compliance 17. Reviewing and evaluating related policies and procedures, recommending revisions as needed, and creating new policies for approval as required 18. Providing guidance relative to civil and criminal matters, including responses to subpoenas requesting testimony, document production, and disclosure of protected health information 19. Serving as a consultant to the Claims Manager in the identification of areas of potential liability and the application of legal theory and case law 20. Maintaining a direct referral system for staff to report adverse events with access to timely consultation, including the sharing by rotation of 24-hour On-Call coverage service 21. Supporting enterprise risk management goals, strategies, and processes under the direction of the Senior Director of Clinical Safety and Risk Management and the Vice President/Chief Risk Officer

Requirements

Previous experience in healthcare, professional liability insurance, and/or law
Bachelor’s or master’s degree in healthcare administration, risk management, nursing, or another related field
Basic computer skills
Effective communication, writing, presentation, and analytical research skills
Strong problem-solving and decision-making skills
Familiarity with healthcare delivery processes and best practices
General familiarity with legal, regulatory, and accreditation standards
Bachelors Degree

Nice To Haves

Healthcare risk management or professional liability experience preferred
Bachelor’s or master’s degree in healthcare administration, risk management, nursing, or another related field
Paralegal experience or any healthcare delivery role will be considered
CPHRM, ARM, ARM-E preferred

Responsibilities

The management, administration, and application of the system-wide clinical and enterprise risk management (ERM) programs across all coverage lines
Systematically applying the risk management process to proactively identify, analyze, and mitigate risk
Engagement in the patient and family-centered Communication, Apology, and Resolution (CARe) response to all serious adverse events
Identifying potential losses to the organization
Conducting immediate/appropriate response to any serious occurrence/complaint representing the actual or potential patient, visitor, and/or employee injury
Monitoring and taking subsequent actions to assure learning, compliance, and documentation
Developing and maintaining appropriate loss prevention programs and strategies within Baystate Health’s just culture framework, consistent with high-reliability organization principles (HRO), to enhance patient safety, support the just culture of provider transparency, prevent/reduce injury to patients, employees, and visitors, and mitigate the frequency and severity of financial exposure to the organization
Managing loss exposures to minimize economic impact on patients and the organization
Risk identification, evaluation, reporting, and loss control, including compliance with applicable regulatory, accreditation, and professional standards
Coordinating with the captive insurance program in the identification and processing of potentially compensable events, claims, and lawsuits brought against insured Baystate Health entities and hospital-based and community-based practitioners
Assisting with the development and implementation of initiatives, including clinical education activities and other risk prevention/reduction/elimination throughout the organization
Supporting the process of responding to product and safety recalls and alerts and safe medical device reporting of adverse events
Serving as a liaison to external regulatory agencies for purposes of patient and nursing reporting, event investigation, and response, including, but not limited to, the Department of Public Health and Board of Registration in Nursing, preparing and submitting required reports to state and federal agencies and, when applicable, coordinating external investigations
Disseminating information on claim patterns and risk control and legislative and regulatory changes and utilizes this information to educate personnel as to changes in practice
Actively participating in a variety of committees within the hospital system as assigned
Keeping up to date with new and revised state and federal regulations and statutes related to hospitals and patient care, advising medical and hospital staff of changes in governmental and professional standards that affect practice with recommendations for compliance
Reviewing and evaluating related policies and procedures, recommending revisions as needed, and creating new policies for approval as required
Providing guidance relative to civil and criminal matters, including responses to subpoenas requesting testimony, document production, and disclosure of protected health information
Serving as a consultant to the Claims Manager in the identification of areas of potential liability and the application of legal theory and case law
Maintaining a direct referral system for staff to report adverse events with access to timely consultation, including the sharing by rotation of 24-hour On-Call coverage service
Supporting enterprise risk management goals, strategies, and processes under the direction of the Senior Director of Clinical Safety and Risk Management and the Vice President/Chief Risk Officer