Job: Clinical Risk Manager - Job #: 92528BR
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At Aurora Health Care we believe that each of us can use our knowledge, experience and creativity to help people live well. We're a non-profit organization with a clear vision of providing people with better health care then they can get anywhere else. Our strength stems from teamwork and collaboration among a talented and diverse group of professionals.
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Clinical Risk Manager
Aurora West Allis Medical Center-172
8901 W Lincoln Ave
# Hours Per Pay Period (Bi-weekly)
Monday thru Friday, 8:00 am- 5:00 pm
Req # (optional)
Explore a Career In
*Developing and managing the effective implementation of systems and process for risk management. Providing support and service to the hospital and its clinics by assisting in the prevention, reduction, and control of loss to its patients, visitors, volunteers, physicians, and employees.
*Developing and coordinating the processes for risk identification, risk investigation, and risk reduction; to include risk surveys, inspection of patient care areas, and chart auditing; assisting in reviewing the facility to assess for loss potential.
*Managing, collecting and evaluating data concerning patient incident reports, aggregates data summaries, and developing monthly and quarterly risk management reports that include trend analysis of incidents, claims, complaints and profiles.
*Assisting in resolution of treatment issues including patient refusal of treatment, consent issues, AMA's; may assist in issues surrounding end of life, advanced directives, and power of attorney. Acting as a resource for medical/legal inquiries of physicians, nurses, and administrators regarding emergent patient care issues and loss control.
*Maintaining hospital wide incident reporting system and investigates and follows up potentially compensable events identified through the incident reporting process.
*Conducting surveys, studies, and special projects to assist in proactive risk activities. Conducting periodic assessments of hospital wide risk management activities to determine program effectiveness and assist in the development of corrective action plans.
*Assisting clinical, loss prevention and department management in designing and conducting risk management programs, and on procedures to prevent or minimize loss of property or assets.
*Facilitating root cause analysis investigations, FMEA methodologies, reporting of adverse events, and reporting of sentinel events to the appropriate parties. Standing member of all RCA's and Roundtable meetings.
*Managing claims against the hospital interfacing with defense legal counsel, insurance adjustors, and corporate risk management. Investigates and analyzes actual and potential risks in the hospital; assess liability and probability of legal action for potential notification of insurance carriers.
*Notifying the liability insurance carrier of actual and potential claims and acting as a liaison with the insurance adjustor. Working actively with legal counsel and the adjustor in investigating claims, developing defense strategy, and evaluating the monetary value of the claim. Negotiating settlement of small claims within administrative authority. Advises billing department of appropriate action for unpaid accounts involved in litigation.
*Evaluating correspondence from attorneys, patients, and other outside sources and formulates responses as necessary.
*Recording, collecting, documenting, maintaining, and providing attorneys any requested information and documents necessary to prepare testimony in pending litigation.
Skills / Requirements
*Requires 7 years of experience in administrative work in a hospital setting in order to have knowledge of problems encountered in the delivery of healthcare, including experience in insurance/loss control, risk management/quality assurance issues, and claims management/insurance industry.
*Bachelor's degree (or equivalent knowledge) in Nursing.
Licensure, Registration and/or Certification Required:
*Registered Nurse license issued by the state of Wisconsin.
This position is open due to a military leave:
Discover the Benefits:
Imagine a work environment where you are valued for finding better ways of caring for our patients and are offered flexibility, mobility and growth through a wide range of career options. With Aurora you'll find a diverse and comprehensive blend of benefits designed to make your life better both inside and outside of the workplace.
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