Lafayette General Medical Center
Lafayette, LA, USA
Clinical Risk Manager-LGH Quality-Full Time (Job ID: 1680) Location: LGMC Employment Status: FT SUMMARY: The Risk Manager is responsible for the
system’s risk management activities, which include, but may not be limited to, coordinating insurance
coverage and risk financing, managing claims against the facility, interfacing
with defense legal counsel, administering the risk management program on a
day-to-day basis, managing and analyzing risk management data, conducting risk
management educational programs, complying with related standards by TJC, all
with the objective of maintaining patient safety, enhancing quality care, and
minimizing loss to protect assets of the facility. Additionally, this
individual is responsible for reviewing and formulating policy or
organizational changes and making recommendations for final approval by senior
management. The Clinical Risk Manager shall work closely with the Quality
Department, Compliance Department and the Patient Representative in performing
the duties outlined above. ESSENTIAL DUTIES AND RESPONSIBILITIES: Operation/Compliance 1.
loss control/loss prevention activities and reports results to senior
statistical trending of losses and analyzes patterns 3.
and implements risk management surveys and studies; conducts surveys, studies,
and special projects to assist in long-term planning and changes to policies and systems that reduce risk and losses 4.
for identifying and communicating regulatory requirements 5.
development of system-wide approach on disclosure of medical errors and obtains
physician support 6.
with OSHA regulations 7.
the risk of loss versus cost of reducing risk 8.
with senior leadership to collate cost data for budgetary and historical
with Medical Staff Services to develop and maintain risk management profiles on
physicians and integrates that information into the credentialing process in
compliance with state and federal agencies, TJC, and/or other institutional or
accreditation requirements 10.
recommendations for changes in the existing risk control and risk-financing
procedures based on changes in properties, operations, or activities 11.
correspondence from attorneys, patients, and other outside sources, and
formulates responses, as needed 12.
collects, documents, maintains, and communicates to insurance carrier and/or
attorney any information necessary to prepare testimony in pending litigation 13.
and coordinates release of records and information in response to subpoenas,
court orders, attorney requests, state and federal agency investigations, and
other inquiries from outside sources 14.
legal case files and strives to maintain maximum protection from
discoverability of such files 15.
medical/legal inquiries of physicians, nurses, and administrators regarding
emergent patient care issues and loss control 16.
treatment issues, including patient decisions made against medical advice,
refusals of treatment, and consent issues; initiates court orders as
appropriate via in-house and outside legal counsel 17.
awareness of legislative activities that may affect risk management programs
and participates in the legislative process Loss Prevention/Patient Safety 1.
develops, and presents educational material to administration, the medical
staff, nursing personnel, and other department personnel on topics related to
risk management 2.
and implements educational programs designed to minimize the frequency and
reduce the severity of actual and potential safety hazards throughout the
product safety recall notifications 4.
FDA reports on failed medical devices 5.
root cause analysis, FMEA and makes recommendations for improvement 6.
participation in patient safety goals by providing data to support policies 7.
as a resource, internal consultant, and educator for patient safety/risk
management issues 8.
with various codes, laws, rules and regulations concerning patient care,
including those mandated by state and federal agencies, incident reporting,
also includes investigative activities with federal, state and local
enforcement authorities 9.
investigations for adverse drug and sentinel events 10.
the efforts of the state Patient Safety Organization Claims Management 1.
to initiate medical write-offs to mitigate potential claims 2.
with the investigation of incidents/events that could lead to financial loss,
including professional and general liability 3.
legal in the compilation of information supplied to brokers and insurance
company representatives in negotiating and settling specific general liability
claims and participates in conferences with claimants, attorneys, and insurance
carriers when applicable. 4.
risks involving actual or potential injury to patients, visitors, and
employees; collects information necessary to prepare for defense claims 5.
with legal counsel, insurance carrier, and patient’s/families to effect timely settlement 6.
patient-care related incidents to the Department of Health if required by law;
directs investigation and development of corrective plans; submits required
reports to state and federal agencies EDUCATION/TRAINING/EXPERIENCE: Current Registered Nurse
Licensure by the Louisiana State Board of Nurse Examiners Minimum of 3 years’
experience in clinical risk management preferred CPHRM and/or FASHRM
certification preferred Broad knowledge and
familiarity with healthcare related regulatory and accreditation requirements Meets requirements of local
jurisdiction for risk management certification SKILLS Required for completely
satisfactory performance in this job is: ·
function independently, to manage time, and prioritize workload on a daily basis. ·
Ability to manage
highly confidential information ·
skills with sensitivity in handling anxious staff and excellent written communication
resolution skills ·
monitor quality of care by observing trends in event reports ·
Ability to work
with physicians, health care providers and other stakeholders in the
Proficiency in PC
programs to allow preparation of documents for presentations EQUIPMENT OPERATED: ·
Various types of
medical instruments & equipment PHYSICAL
DEMANDS AND WORKING CONDITIONS: Conditions,
which differ from the normal office work environment, include: ·
Flexibility in scheduling to accommodate hospital shift
workers; however, normal business hours will be the scheduling norm ·
Frequently commuting between hospital and meeting locations ·
Frequent and potential hazards include: exposure to blood
or body fluids, needles or other sharp objects, ·
Communicable diseases; repetitive motions, computer monitor ·
Some and potential hazards include: toxic/caustic
chemicals, dust/fumes/gases (including asbestos),
Moving mechanical parts, electric shock, x-ray
electro-magnetic energy, high-pitched noises. Qualification Requirements: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Must comply with all SERVICE Standards of Behavior