Risk Manager | Massachusetts
Our client is a nationally recognized, growing, teaching hospital. This is an opportunity to work at a facility whose leaders have great vision and a staff focused on providing quality patient care. It offers a family atmosphere, where everyone works as a team. This is a great environment to build your skills, apply your experience and advance your career.
The area is steeped in history and known for local access to the arts, exceptional restaurants, and outstanding shopping. Top notch schools and high quality of living; the residents have a deep sense of pride and respect for their community. Cultural events, entertainment activities and natural attractions abound!
Key Responsibilities and Duties:
• Utilizes multiple methods for case finding using triggers, quality screens, complication reports, and mortality reports as well as incident reports, medical record requests and patient / family complaints
• Conducts an initial review and develops a case summary, inclusive of focused questions, if the case requires further review; Disseminates summaries to respective Medical Chiefs and collaborates with Associate VP Medical Affairs to determine appropriate cases for interdisciplinary medical peer review
• Assures all peer reviewed cases have a completed analysis, conclusions, recommendations and actions documented in both the case summary and in the peer review meeting minutes
• Evaluates reviews completed by leadership, provides oversight of data aggregation and reports back to leadership summarizing data
• Supports claim managementstrategies and activities including: investigations, ongoing monitoring ofdefense activities, discovery requests/interrogatories
• Prepares reports and data,assures accuracy, integrity and authorizations necessary prior todistribution and for submission of reports internally and to externalagencies
• Maintains overall accountability for semi-annual, annual and monthly safety/quality reports for the Board of Registration in Medicine
• Collaborates with quality staff to support ongoing regulatory compliance and management of on-site regulatory/accreditation visits and after-action planning/implementation and reporting
• Participates in Performance Improvement activities such as Root Cause Analysis or Healthcare Failure Mode and Effect Analysis (HFMEA) when appropriate and required
• Registered Nurse and Master’s Degree strongly preferred
• CPHRM and CPHQ preferred
• Five to seven years of relevant experience in hospital health care, quality improvement, patient safety and/or risk management required
• Experience with LEAN methodology and certification preferred
• Experience with Just Culture and Culture of Safety principles preferred
• Knowledge of clinical quality, patient safety and/or patient satisfaction performance measures and indicators
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