Risk Manager - Morristown, United States - Atlantic Health System

Description

Job Description

The Risk Manager is responsible for the review and evaluation of events, and to identify as potential claims, lawsuits, and reportability under the Patient Safety Act. Refers events to Peer Review, Quality & Outcomes Management and other committees to address as appropriate. Organizes and moderates Root Cause Analysis and assists with the development of corrective action plans. Coordinates and facilitates regulatory investigations and responds as needed. Management of the resolution process related to complaint/grievances. Provides education to nursing, medical residency staff and all ancillary departments as needed. Manages translation services.

•Evaluates incident for severity, frequency and probability of financial loss

•Reports as appropriate to administration and committees

•Responds to significant occurrences; review facts; review medical record/documentation; preserve any evidence; interview staff

•Provide recommendations to staff re: investigation/handling of event to appropriate management, administrators

•Refer to peer review, Quality & Outcomes Management Committees to address as appropriate

•Develops educational programs as appropriate or needed based on incident findings and trends.

•Reviews incidents and identifies potential claims/lawsuits

•Prepares potential files, documenting factual investigation of event

•Communicates findings to the legal team as appropriate for case preparation

•Reviews incidents and determines whether constitutes Serious Preventable Event under the Patient Safety Act

•Conducts initial team call and determines plan along with Executive Sponsorship

•Submits initial notification of SPE to DHSS

•Organizes and moderates Root Cause Analysis meeting with health care providers involved to identify contributing factors to the event and develop a corrective action plan

•Coordinates case presentations to Preventable Events Review Committee

•Advises site nursing staff, medical staff and administration on legal issues, billing, insurance, risk management, corporate compliance, EMTALA, HIPAA and other regulatory concerns following the review of regulations and standards.

•Responds to clinical queries related to clinical needs following policy review

•Acts as resource to all inquiries, encouraging ongoing open communication

•Provides in-service training, education to nursing staff, medical staff, residency staff, as requested or recommended based on identified need through case review

•Topics include litigation process, documentation, incident management, hospital policies, protocols

•Triages events, escalates, investigates and refers as appropriate, close events

•Acknowledges clinical staff for Good Catches
- Coordinates the Risk is Real Publication - tell the story format of things that happen or can happen with emphasis on Patient Safety

•Provide training to nursing staff, medical staff, and residency staff on use of program

•Coordinate and facilitate investigations (DHSS)(FDA) (CMS)

•Facilitate, prepare and submit material to agency and respond to deficiencies

•Coordinate voluntary and required reporting to the FDA

•Proactive management of difficult patients and family members of complex care cases in order to mitigate complaints

•Liaison between patient/family and nursing/physician teams to resolve concerns

•Manage the response process as well as the electronic documentation of all complaints/grievances in the database

•Track and trend patterns of complaints/grievances and reports to leadership

•Ensure compliance with DOH/CMS regulations regarding clinical patient complaints/grievances

•Manage and arrange language translation services for patients and families while ensuring compliance with regulations

•Provide training to teams on language translation services as needed

Qualifications

• Experienced in Microsoft Office Suite, with ability to create powerpoint presentations and excel spreadsheets
• Excellent interpersonal skills; ability to work as a team member; strong work ethic; 5 years of clinical nursing experience
• Management and/or Risk Management experience
• 7+ years experience relevant to the description of this job
  
  Required Licenses, Certifications or Registrations:
  RN
  BSN (preferred)
  CPHRM (preferred... must be ok with getting in within 2yrs)

About Us

ABOUT US

At Atlantic Health System, our promise to our communities is; Anyone who enters one of our facilities, will receive the highest quality care delivered at the right time, at the right place, and at the right cost. This commitment is also echoed in the respect, development and opportunities we give to our more than 20,000 team members. Headquartered in Morristown, New Jersey, we are one of the leading non-profit health care systems in the nation. Our facilities and sites of care include:

• Morristown Medical Center, Morristown, NJ
• Overlook Medical Center, Summit, NJ
• Newton Medical Center, Newton, NJ
• Chilton Medical Center, Pompton Plains, NJ
• Hackettstown Medical Center, Hackettstown, NJ
• Goryeb Children's Hospital, Morristown, NJ
• CentraState Healthcare System, Freehold, NJ
• Atlantic Home Care and Hospice
• Atlantic Mobile Health
• Atlantic Rehabilitation

We also have more than 900 community-based healthcare providers affiliated through Atlantic Medical Group. Atlantic Accountable Care Organization is one of the largest ACOs in the nation, and we are a member of AllSpire Health Partners.

We have received awards and recognition for the services we have provided to our patients, team members and communities. Below are just a few of our accolades:

• 100 Best Companies to Work For and FORTUNE magazine for 15 years
• Best Places to Work in Healthcare - Modern Healthcare
• 150 Top Places to work in Healthcare - Becker's Healthcare
• 100 Accountable Care Organizations to Know - Becker's Hospital Review
• Best Employers for Workers over 50 - AARP
• Gold-Level "Well Workplace": Wellness Council of America (WELCOA)
• One of the 100 Best Workplaces for "Millennials" Great Place to Work and FORTUNE magazine
• One of the 20 Best Workplaces in Health Care: Great Place to Work and FORTUNE magazine
• Official Health Care Partner of the New York Jets
• NJ Sustainable Business

EEO STATEMENT

Atlantic Health System, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran status.

About the Team

Atlantic Health System is at the forefront of medicine, setting standards for quality health care powered by a workforce of more than 18,000 team members and 4,800 affiliated physicians dedicated to building healthier communities, the system offers more than 400 sites of care, including eight award-winning medical centers. Specializing in cardiovascular care, cancer care, orthopedics, neuroscience, pediatrics, women's health and rehabilitation medicine. Atlantic Medical Group, comprised of 1,000 physicians and advanced practice providers, represents one of the largest multi-specialty practices in New Jersey and includes finance, legal, marketing, human resources, talent acquisition, ISS and more. Caring for our patients, our team members and the communities we serve is our central mission.