Risk Management Manager

Kaweah Health is a publicly owned, community healthcare organization that provides comprehensive health services to the greater Visalia area in central California. With more than 5,000 employees, Kaweah Health provides state-of-the-art medicine and high-quality preventive services in our acute care hospital, specialized health centers and clinics. Our eight-campus healthcare district has 613 beds and offers comprehensive health services across a broad continuum of care.

It takes a special person to work for Kaweah Health. We serve a region where the needs are great, which makes the rewards even greater. Every day, we care for people facing unique challenges and in need of healing. Throughout it all, our focus is to make a difference, and we do — in the health of our patients, our loved ones, and our community.

Benefits Eligible

Full-Time Benefit Eligible

Work Shift

Day - 8 Hour or less Shift (United States of America)

Department

8751 Risk Management

The Risk Management Manager is responsible for risk management activities including general knowledge of facility insurance programs, 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 and conducting risk management educational programs, complying with risk management related standards by TJC, CDPH, or Title 22 and other 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 Risk Management Manager participates in formulating policy and/or organization changes in partnership with Risk Management Leadership.

License /Certification
Required:

RN preferred or equivalent experience in the area of Risk Manager or regulatory/legal matters. Kaweah Health approved crisis intervention training within 60 days of hire/transfer.
Preferred: CA RN License Lean Six Sigma Certification
Education
Required: Bachelors in relevant field
Preferred: BSN MSN
Experience
Required: At least one year of experience in Quality, Risk Management and Patient Safety, in addition to a minimum of two to three years of clinical experience.
Knowledge/Skills/Abilities
LSS tools, Pro Risk Assessment Tools, and Critical thinking for proactive methodologies.
Excellent communication skills, computer skills, and project management skills
Essential
Coordinates education and consultations to Risk Management, other leaders of Quality and Patient Safety, CEO, and Board of Directors, medical staff, department heads and hospital staff.
Works collaboratively with multiple disciplines ensuring effective measures are developed, implemented and maintained to maximize efforts to decrease or eliminate issues identified as non-conforming with CDPH / CMS and other California Regulatory standards.
Conducts Root Cause Analysis, Focused Review Studies, Brief Case Studies, and any other studies required for event investigation and processes related to policies, procedures and adverse events across the organization in alignment with CMS/CDPH standards.
Organizes and maintains an ongoing mechanism for monitoring action plans and deficiencies. Establishes a pro-active process for areas at risk and reports it monthly. Works collaboratively with departments to investigate significant and sentinel events and to coordinate the root cause analysis process.
Develops, coordinates and administers facility wide systems for risk identification, investigation and reduction; maintains a network of informational sources and experts, performs risk surveys and inspects patient care areas. Reviews facility to assess loss potential.
Participates on committees directed towards promoting patient safety issues.
Informs director of service and department heads regarding occurrence issues, findings, and risk management suggestions; provides feedback to directors at all levels in the effort to eliminate risks; assists clinical chairs and department heads in designing risk management programs within their departments.
Works with legal counsel to coordinate the investigation, processing and defense of claims against the facility; records, collects, documents, maintains and provides to defense attorneys any requested information and documents necessary to prepare testimony in pending litigation.
Responds to professional and facility liability questions posed by physicians, nurses and other personnel.
Recommends appropriate revisions to new or existing policies and procedures to reduce the frequency of future occurrences. Recommends ways to minimize risk through system changes; reviews and revises facility policies as appropriate to maintain adherence to current standards and requirements.
Responsible for managing and providing leadership for Risk Management staff. Performs personnel functions including: hiring, training, mentoring, annual performance reviews, disciplinary actions/counseling.
Receives complaints/claims related to professional and general liability and transmits that information to the appropriate department manager, administrative representative, patient ombudsman, insurance carrier or legal counsel. At the request of management, legal counsel, or the adjuster, participates in responding to the complaint or claim to obtain information and facilities settlement at an early stage.
With director of patient representative, reviews patient complaints that may be the source of potential legal action; discusses and offers solutions when possible to resolve with patient and/or family any grievances perceived as potential liability claims.
Participates in evaluation of claims for settlement; negotiates settlement of small claims within administrative authority; advises collection department of appropriate action for unpaid accounts involved in litigation; approves payment for or replacement of lost property after evaluating claim.
Assists with patient care investigations, inspections, assisting both the Risk and Quality departments with identified issues, and working directly with senior leadership, management and physicians to develop any required action plans for deficiencies.
Additional
Demonstrates the knowledge and skills necessary to provide care and services appropriate to the population served on the assigned unit or work area.

Pay Range

$55.40 -$83.09

If you want to use your talents alongside people who face each day with courage and purpose, in an environment that empowers you to do your absolute best, this is where you belong.