Risk Manager & Physician Relations - Registered Nurse
The Risk Manager and Physician Relations – Registered Nurse has the responsibility to protect and conserve the assets and resources of Premier Health through proactive clinical risk management, litigation & claims management, and enterprise risk management collaboration. This role encompasses a significant amount of system-level duties and responsibilities and is responsible for supervising the activities performed by the Risk Coordinator. This Risk Manager collaborates more closely with a higher number of initiatives led by System Quality Improvement, Quality Innovation, Corporate Compliance, Legal, Internal Audit, Nursing, and other system departments responsible for attaining results that decrease claims and improve the care delivered to patients of Premier Health. The Risk Manager and Physician Relations – Registered Nurse is also responsible for all system-level initiatives and projects aimed at mitigating clinical risk and enterprise risk, continuously seeking to minimize patient, staff and visitor injury across the Premier Health system, decreasing claims and lawsuits, thereby protecting and conserving the financial assets of the organization.
Essential Duties & Functions:
• The Risk Manager and Physician Relations – Registered Nurse has the responsibility for Premier Health system-level, hospital-level, and ambulatory care setting risk identification and mitigation for all individuals and entities insured by Premier Health Partners International Insurance, Ltd., as well as litigation management of lawsuits brought against the entities assigned to the incumbent. This includes, but is not limited to, the major health system, all hospitals and other interested entities within the Premier Health system.
• This incumbent is responsible for ensuring that proactive risk management activities (both clinical risk management and enterprise risk management) are identified, developed and maintained within the entities.
• The Risk Manager and Physician Relations – Registered Nurse is responsible for the initial identification and evaluation of claims, working at the direction of the Chief Legal Officer and with Risk Management, Claims & Insurance leadership as well as outside counsel on litigation management from the inception of a lawsuit through its conclusion by settlement or verdict.
• Additionally, this incumbent acts as an internal consultant to the system executives, physicians, and hospital staff on matters of policy development, disclosure of untoward patient outcomes, sentinel events, root cause analyses and the management of significant events.
• The Risk Manager and Physician Relations – Registered Nurse delegates and oversees appropriate activities/initiatives for incident reporting on behalf of the department.
• The Risk Manager and Physician Relations – Registered Nurse serves as a support to physicians both proactively and during the claim process
• This incumbent collaborates with system-level, hospital-level, and ambulatory care setting executives on initiatives and committees across Premier Health on all efforts that involve opportunities to decrease risk for the purpose of protecting and conserving the assets of the organization.
Minimum Level of Education Required: Master's degree
Additional requirements:
Type of degree: Nursing
Area of study or major: Related healthcare or business field
Preferred educational qualifications: N/A
Position specific testing requirement: N/A
Licensure/Certification/Registration
Certification in Healthcare Risk Management (CPHRM) preferred
Current Ohio Registered Nursing License required upon hire.
Experience
Minimum Level of Experience Required: 3 - 5 years of job related experience
Prior job title or occupational experience: Progressive management experience in a healthcare environment with three (3) years management required, five (5) years preferred
Prior specific functional responsibilities: Background in professional nursing, law, or insurance/claims.
Preferred experience: Prior experience in risk management and/or claims management, and physician relations preferred.
Other experience requirements: N/A
Knowledge/Skills
o A professional whose credibility and expertise can gain immediate acceptance and respect.
o Ability to work independently and possess much flexibility.
o Ability to quickly identify, analyze and evaluate problems and recommend solutions.
o Strong communication skills with the ability to promote relationships, foster teamwork and collaboration.
o Strong interpersonal skills and ability to manage external and internal customers
o Possess skills to relate well and interface with patients, medical staff, visitors and those external to all systems and entities within Premier Health.