Location: New Hanover Regional Medical Center
Department: Risk Management
Full Time Equivalent: FTE: 1.000000
Work Type: 64 to 80 Hours Pay Period
Work Schedule: STD HRS - Standard-Exe or Office w flex
Exempt from Overtime: Exempt: Yes
The Clinical Risk Manager will work under the direction of the Director of Risk Management. Evaluates, investigates, and manages claims independently within designated authority and assists in the evaluation, investigation, and management of larger claims and suits. Accountable for minimizing and reducing claims and losses and for initiating risk reduction/loss prevention strategies and tracking and achieving results. Acts as a liaison to Administration and Medical Staff on risk management issues.
1. Investigates and analyzes actual and potential risk.
2. Assesses liability and probability of legal action for the actual or potential compensable event.
3. Initiates and implements strategies for actual and potential risk.
4. Works with departments/service lines to monitor implementation and evaluation of event related action plans.
5. Initiates risk reduction, loss control and loss prevention strategies to minimize and reduce recurrence of claims and losses.
6. Educates employees on the function of Risk Management & Event Reporting
7. Provides in-services to NHRMC staff on Risk Management, Risk Reduction, Variance Reporting, Claims Management, Mock Trials / Litigation, and other risk management topics.
8. Provides community education on Risk Management topics.
9. Evaluates, investigates, manages and negotiates claims settlements within designated authority.
10. Responsible for the management of larger claims and lawsuits as assigned by the Supervisor/Director of Risk Management. Works directly with the TPA and Defense Counsel.
11. Provides consultation and support to staff/physicians throughout the life of a claim/lawsuit.
12. Coordinates and schedules meetings with Defense Counsel and other risk management functions.
13. Identifies risk exposure and trends from the electronic event reporting system and by referrals from other departments, physicians, patients, and family members.
14. Analyze event reports to identify Serious reportable events, PCEs and developing trends.
15. Participates on selected organizational committees related to, but not limited to patient care, research, safety, regulatory and accreditation.
16. A member of the Serious Safety Event Team/Task Force to investigate and analyze serious safety events.
17. Reviews, summarizes, and analyzes medical records and pertinent documents, interviews staff, visitors and patients and creates event timelines/clinical chart reviews for the RCA process.
18. Researches and integrated evidence based practice, best practices, standards and regulations related to a claim/lawsuit, PCE, risk exposure or new proposed service.
19. Collaborates with the Patient Advocate Liaison as needed.
20. Shares on-call to ensure 24/7/365 coverage.
21. Effectively demonstrates the mission, vision and values of the medical center on a daily basis.
22. Responsible for RM services that include departments/service lines of moderate risks.
23. Assists with Proactive Risk Assessments, A3s and project management.
24. Assists with development of organizational policy and procedures, recommend revision to new and existing policies/procedures to eliminate/reduce future loss.
* Registered Nurse
* Bachelor of Science
1. Education: Baccalaureate degree in Nursing or a Healthcare related field
2. Licensure / Certifications: none.
3. Experience: At least 5 years’ healthcare experience (clinical experience preferred) and experience in risk management (preferred).
Demonstrates standards of performance (ownership, teamwork, communication, compassion) that support patient satisfaction and principles of service excellence.
Performs other duties as assigned.
Individual will possess commensurate combination of education, experience and qualifications.