Job Title – RN Risk Management Specialist
Job Location – Lynwood CA 90262
Length – Contract (13 Weeks) – Possible extension
The risk management specialist supports the operations of our Client is responsible for the investigation, analysis and management of patient occurrences and reportable adverse events. This position also serves as the on-site contact for insurance claims and lawsuits. The risk management specialist provides education and guidance on a variety of risk management topics designed to improve the delivery of safe patient care and decrease financial losses to the organization. The risk management specialist reports to the Executive Director, Risk Management, and is also accountable to the Verity Health System Vice President, Risk Management.
Client is dedicated to serving the healthcare needs of the communities of Southeast Los Angeles. Our vision is to be a values-driven integrated health care delivery system in collaboration with those who share our values. We operate a 384-bed acute care hospital and one of the largest and busiest private emergency trauma centers in Los Angeles County — treating more than 84,000 children and adults each year. Last year, more than 5,000 babies were born at Family Life Center, with 875 babies cared for in our state-of-the-art Neonatal Intensive Care Center. We are a Primary Stroke Care Center and STEMI Receiving Center, both of which are approved by the Los Angeles County Emergency Medical Services Agency.
MAJOR JOB OBJECTIVES AND RESPONSIBILITIES:
Investigation and Analysis
Investigates reported occurrences and develops strategies for management of serious adverse events.
Interviews health care providers, patients and family members involved in occurrences. Researches medical records, policies and procedures to gather information required for further analysis.
Serves as facilitator for root cause analysis meetings conducted in response to serious safety events.
Monitors compliance with action plans in collaboration with Quality Department leaders.
Analyzes individual occurrence reports and trends to identify opportunities to improve the delivery of safe patient care.
Recommends changes in policies, practice and procedures to prevent patient injury.
Monitors compliance with loss prevention activities.
Prepares and maintains summaries of investigations, recommendations and corrective action plans in RL6 database.
Coordinates FDA MedWatch reporting.
Coordinates EMTALA investigations in collaboration with Verity Health System Vice President, Risk Management.
Participates in appropriate committees and meetings as Risk Management representative.
Insurance and Claims Management
Works with patients, physicians and other personnel to resolve adverse events and claims. Negotiates patient bill write-offs when appropriate.
Obtains internal and external expert reviews to assist with evaluation of occurrences and claims.
Works with Verity Health System Risk Management Department to coordinate the collection of information needed to complete applications for property and casualty insurance program.
Requests certificates of insurance needed for business operations.
Serves as facility contact for outside counsel retained to defend claims.
Gathers information and documents required for responses to discovery requests.
Education and Guidance
Provides educational presentations to health care providers and other staff members on topics related to patient safety and loss prevention and reduction issues.
Provides risk management advice and guidance to [insert entity] personnel.
REQUIREMENTS AND QUALIFICATIONS:
Bachelor’s degree, preferably in nursing or related health care field.
Minimum of three years of experience in nursing or Risk Management in a health care setting.
Position requires excellent written and oral communication skills.
Preference given to applicants with clinical experience in a hospital setting.
APN Software Service INC