RN Clinical Risk Coordinator & Claims

AdventHealth•Riverview, FL

50d•Onsite

About The Position

The Clinical Risk Management Coordinator (CRMC) is responsible for the risk management program for the assigned areas. This position is responsible for working in collaboration with the clinical team to ensure adherence to all federal regulations and hospital policies. This position engages in activities which contribute to a safer environment for patients, employees, and visitors. These activities promote customer service, minimize liability risk for the Hospital and proactively identify areas for improvement. The CRMC will systematically investigate clinical incidents/accidents/events that could lead to patient harm and/or financial loss and ensures all risk management activities, including the internal event report system and patient grievance process are in compliance with FL State Statute 395.0197. The CRMC will identify areas of risk and facilitate risk mitigation/safety strategies including the Root Cause Analysis and Response. The focus of this position is on review, investigation and response of incidents that include general/premises liability, medical liability, regulatory investigations and other potentially compensable events including lost or damaged belongings incidents, providing timely communication and submission of required documents to support legal defense response. The CRMC also acts as the internal system administrator for the voluntary event reporting system.

Requirements

Associate degree in business or healthcare related field
3 years clinical experience in healthcare related field
Registered Nurse (RN)

Responsibilities

Performs other duties as assigned.
Assists in regulatory surveys and legal investigations, including patient complaint surveys and compliance with CMS reporting requirements.
Manages the internal event report system, ensuring compliance with relevant statutes and timely reporting of adverse events.
Reviews reported events for data completeness and accuracy, initiating follow-up with appropriate Directors and Managers within three days.
Identifies, investigates, and reports on Sentinel Events/Never Events, facilitating Root Cause Analyses.