Manager, Clinical Risk Management

Overview

Our team members are the heart of what makes us better.

At Hackensack Meridian Health we help our patients live better, healthier lives - and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It's also about how we support one another and how we show up for our community.

Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.

The Manager, Risk Management provides basic and complex preventive risk management assessment of processes, procedures, and programs, including risk mitigation activities, in-service education, consultation, liaison activities, and on-call emergency assistance to facility(s) and providers. Formulates and recommends safety policies, practices and procedures. Initiate, coordinate, and manage all investigational and evaluation activities associated with professional and general liability occurrences and claim pre-litigation files and claim pre-litigation files.

This position covers Raritan Bay Medical Center and Old Bridge Medical Center.

Responsibilities

A day in the life of a Manager, Risk Management at Hackensack Meridian Health includes:

• Provide prompt notification to the Regional Risk Director and network office upon receipt of claim or lawsuit. Assist network Litigation Management leadership and external counsel in defense of the claims as instructed.
• Develops a safety culture where reporting is encouraged and use of the Onelink adverse event reporting system is monitored, with interventions to address issues as needed.
• Provides site leadership with prompt notification of any significant organizational risk activity working closely with key stakeholders and local leaders.
• Ensures timely response to urgent matters and works closely with leaders for entry of event into ONElink adverse event reporting platform. Completes necessary trend analysis of occurrence reports. Collects data for risk exposures and provides feedback to the involved departments.
• Ensure identified risk management strategies are undertaken by affected areas.
• Create and implement new programs to foster a culture of safety and safe environment for patients, visitors, Team Members and customers of the facility.
• Provide statistical analysis for review by appropriate committees as requested.
• Collaborates with site Quality/Patient Safety Dept to identify, review and make appropriate recommendations concerning identified issues, as well as participate in the Root Cause Analysis process.
• Work with Patient Experience and Quality/Patient Safety leadership to respond to patient grievances. Uses decision making ability to analyze and recommend disposition strategies.
• Oversee and direct ONElink occurrence reporting process for site.
• Work with outside counsel to obtain necessary documentation and resolution.
• Provide on-call assistance 24/7 for emergent/urgent risk management issues to all Team Members and Medical/Dental Staff. Investigates, evaluates and documents occurrences and claims as appropriate.
• Responds to site Team Members and Medical/Dental staff on risk related issues and offers risk management guidance to resolve or manage situations.
• Provides on-site support and/or leads survey activity for State and Federal agencies as needed.
• Assists in the process of accepting Subpoenas, and Summonses and Complaints; 16. Investigates and analyzes claims/litigation and potential claims upon receipt including:
  
  • Obtains and sequesters evidence
  • Obtains visit history and pertinent medical records
  • Notifies the liability insurance carrier of actual and potential claims
  • Obtains insurance information and performs insurance coverage analysis
  • Processes claims with the appropriate carrier(s) and broker within policy period
  • Obtains coverage determinations, and partners with the risk leader to resolve unfavorable determinations
  • Coordinates day-to day discovery (document production, interrogatories, scheduling interviews and depositions)
• Provide in-service education on risk management topics, both standard basic education and complex focused topics as needed and/or requested by team members, hospital leadership; medical and dental staff; or system leadership. Provide Risk Management reports to stakeholder groups as necessary such as administration, leadership, etc.
• Participates in the network Early Event Resolution Committee (EERC) for any identified claims, as appropriate.
• Provide timely monthly reports to the Regional Risk Director and/or Sr. VP & Chief Risk Officer of activities at site.
• Leads or co-leads facility committees as requested. Ensure data flows through committees.
• Participates in RCA/ACA/PI teams and monitors these activities for mitigation of organization risk with regular review.
• Participate as an active representative on the system Safety Event Classification group; Patient Safety Committee; Safety Council and other committees as assigned.
• Represent the Corporate Risk Management Department on various site facility and entity committees as required.
• Create and implement new programs or process improvements to foster a culture of safety and safe environment for Team Members and Visitors by serving as Chair or Co-Chair of site Safety Committee and serving as Safety Officer as needed.
• Investigate Team Member safety events and creates shared learning with the Risk team, Team Safety and Team Health.
• Provide data and statistical analysis for review by appropriate leadership, committees or departments as requested.
• Provides risk management services to HMH affiliated companies (i. e Physician Practices, Post-Acute Care organizations) as directed.
• Assist the Insurance team with data gathering and insurance renewals.
• Circulate all FDA Recall Alerts received to ensure any required action is completed.

Qualifications

Education, Knowledge, Skills and Abilities Required:

• Bachelor's degree in Nursing, Business Management or related health field.
• Minimum of 5 years of experience in progressively responsible experience in the healthcare industry with preference in healthcare risk management, patient safety quality improvement or nursing.
• Strong understanding of
  • Process Review
  • Root Cause Analysis
  • Department of Health and Joint Commission requirements
  • Emergency Management
  • Regulatory Compliance.

Education, Knowledge, Skills and Abilities Preferred:

• Master's degree in Business Management or related health field.

Licenses and Certifications Preferred:

• Certified Professional in Healthcare Risk Management.
• Certified Professional in Patient Safety.

If you feel that the above description speaks directly to your strengths and capabilities, then please apply today!

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