Unified Physician Management
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at Unified Physician Management
The Risk Manager is responsible for the facility’s risk management activities, which includes, but may not be limited to a general knowledge of facility insurance programs, managing claims against the facility, interfacing with defense legal counsel, administering the risk management services on a day-to-day basis, managing and analyzing risk management data, and conducting risk management educational programs, complying with risk management related standards by accrediting and regulatory agencies with the objective of enhancing patient safety, promoting patient safety, quality care, and minimizing loss to protect the assets of the facility. The individual participates in formulating policy and/or organizational changes but must seek advice and approval from higher authority.
Essential Job Functions
- Proactive analysis of patient safety and medical errors processes.
- Participates in the process of disclosure of medical errors.
- Participates in root cause analysis investigation and reporting of adverse drug events and sentinel events to the appropriate parties.
- Maintains awareness of legislative and regulatory activities related to healthcare risk management.
- Complies with various codes, laws, rules, and regulations concerning patient care, including those mandated by state and federal agencies, incident reporting. Includes investigation activities of federal, state, and local enforcement authorities.
- Provides in-service training to medical center personnel to enhance their awareness of their role in reducing liability exposures.
- Disseminates information on claim patterns and risk control, as well as legislative and regulatory changes.
- Takes steps to ascertain that risks are minimized through follow-up and actions on regulatory Insurance survey report recommendations/deficiencies.
- Receives and investigates reports of product problems to determine appropriate response (in-house recalls, independent evaluations, etc).
- Participates on select committees related to provision of patient care.
- Receives incident reports and other information regarding untoward occurrences in the facilities, such as quality assurance outliers or variations, and collates such information systematically to permit analysis pursuant to risk management policy and procedure.
- Reviews collated data to identify trends regarding accidents or occurrences, and recommends corrective action to management, if appropriate.
- Prepares reports to management regarding trends/patterns and findings. Recommends electronic data programming initiation and improvement.
- Investigates and analyzes actual and potential risks in the institution; assesses liability and probability of legal action for potential notification of insurance carriers.
- Directly refers to administration those incidents with claims potential; reports to higher authority and serious event involving actual or potential injury to patients, visitors, or employees.
- Participates in evaluation of claims for settlement, negotiates settlement of small claims within administrative authority.
- Notifies the liability insurance carrier of all actual and potential claims, including primary and excess carriers as necessary.
- May act as liaison with the insurance carrier; completes insurance applications and responds to surveys; prepares materials necessary for renewal of primary and excess insurance policies.
- 5 years in healthcare risk management
- Bachelor of Science in Nursing
- Strong written and oral communication skills, presentation skills, team player, ability to influence change without direct authority, and negotiation skills.