General Description: Reporting to the Senior Vice President, Transformation, initiates, coordinates, and manages all investigational and evaluation activities associated with professional and general liability occurrences and claim pre-litigation files. Negotiates resolution with authority from the Chief Transformation Officer. Provide basic and complex preventive risk management assessment of processes, procedures, and programs, including in-service education, consultation, liaison activities, and on-call emergency assistance to providers. The Risk Manager has the authority and responsibility to administer the risk management program for the facility and related entities. The Risk Manager is responsible for developing and implementing appropriate measures to identify and minimize the risk of injury to patients, visitors and staff, and to minimize loss or damage to property. Key Responsibilities: Investigate and analyze potential and actual professional liability and general liability exposures in the Health System; evaluate the extent and elements of exposure and recommend appropriate actions for risk mitigation. Investigate, evaluate and document pre-litigation occurrences and claims. Recommend resolution, and complete negotiation of resolution within authority granted by Chief Transformation Officer or CEO. Complete notifications and financial recommendations needed for compliance with tracking and insurer requirements, including insurance carrier notifications, reserve recommendations, and any federal, state, or entity reporting requirements (including AHCA, NPDataBank, etc.) as necessary. Review, code and investigate occurrence reports; recommend corrective actions based on individual reports or trends. Provide quality assurance and peer review referrals as appropriate. Provide in-service education on risk management topics, both standard basic education and complex focused topics as needed and/or requested. Provide on-call assistance for emergent/urgent risk management issues to all PMC staff as needed. On-call duties are assigned on a rotation basis when possible. Prepare reports and analyses setting forth progress, adverse trends and appropriate recommendations or conclusions. Participate on various PMC and entity committees as required. Perform other related duties incidental to the work described herein. Develop and enhance existing risk management programs to be consistent with the established philosophies and procedures of the PMC Risk Management function. Direct and assure efficient and effective occurrence review and claim file management. Set and reinforce investigation and response standards. Identify and resolve staff and system issues, which impede compliance with departmental standards. Respond promptly to client and claimant concerns with regard to response time or investigation time frame. Report exposures identified through incident and claims investigations to the Chief Transformation Officer and the Vice President of Acute Care Services. Assure departmental support and participation in the Patient Safety process. Evaluate individual files and trend data for issues for referral to the Patient Safety Officer and compliance with regulatory requirements. Conduct departmental performance improvement as required. Provide risk management data and support to the facility patient safety and quality improvement processes as needed. Assure compliance with the information reporting needs of Florida Medical Insurance and the risk management standards required by the reinsurance market. Provide risk management information on medical and allied health staff to medical staff services for use in the credentialing process. Determine and recommend appropriate reserve levels for claim files; ensure adequate financial coverage to support resolution of claims. Authorize financial settlement of claims within limits prescribed by PMC Counsel and Florida Medical Insurance. Attend national and local conferences to keep abreast of national trends in determining institutional priorities. Plan, coordinate and supervise the activities of Risk Management staff. Work requires a Bachelor's degree in business administration, public policy, hospital administration or a related field to acquire appropriate analytical, communicative and organizational skills. A Bachelor's degree in a clinical field (e.g. nursing, physician's associate) may be substituted if supplemented by additional courses or training in business or a related field (at least one year). Work requires a minimum of four years experience in one or more of the following fields: patient care, public policy, health care administration, business administration, legal support or insurance/claims investigation and settlement. Graduate education beyond the bachelor's degree in hospital administration, business administration or a related field may be substituted for the required experiencea1:1basis. Or an equivalent combination of education and job-related work experience. Florida Risk Manager License Required. Associate in Risk Management or Certified Professional in Healthcare Risk Management preferred.Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
Parrish Medical Center (PMC) is a caring community of healthcare professionals. Excellence is expected. Caring, loving individuals who are passionate about being the very best people they can be are valued. You will find no other career more challenging or rewarding than a career in healthcare with Parrish Medical Center, where healing experiences for everyone all the time is our mission. PMC is a nationally recognized industry leader having earned a number of prestigious recognitions, including Modern Healthcare Magazine's Top 100 Best Places to Work in Healthcare and Spirit of Excellence Awards, America's #1 Healing Hospital for three consecutive years, HealthGrades Outstanding Patient Experience Award, Hospital of Choice Award, National Spirit of Women Premier Hospital, and the Nations first Certified Integrated Care Network.
PMC is a publicly owned, not-for-profit hospital with 210 beds, providing care to the residents of North Brevard and surrounding communities. Providing care and comfort is PMC's highest mission and is reflected in our Vision and Values. We pledge to our guests and each other the finest in personal service, courtesy and respect and a healing experience. PMC will deliver personalized care and health-related services consistent with the highest quality medical and ethical standards to improve the health status of the people we serve.
Parrish Medical Center is an Equal Opportunity Employer and provides a smoke-free and drug-free workplace. Applications from all minority groups are encouraged.
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