Risk Management Associate

Overview

Job Description
Stamford Health has a full-time opportunity for a Risk Management Associate! The Risk Management (RM) Associate will assist RM Leadership in all phases of RM, including litigation and claims evaluation, medical record review, preparation of summary reports and participation in Apparent Cause Analysis or Root Cause Analysis Teams related to actual or potential sentinel or other critical events. The incumbent will also participate in Quality Improvement Committees, projects or other work as requested by RM leadership.

Schedule
4 days onsite, 1 day remote (after probationary period).

• Contribute to and participate in the Performance Improvement and Quality Improvement activities of the RM Department. This includes data collection, analysis, report creation, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement (CQI) teams, and adherence to the specific SHS rules and regulations such as Safety and Security Policies,
  
  Risk Management:
  
  Incident and Occurrence Reporting, Infection Control Policies and Procedures, and Patient and Customer Service.
• Risk Management Functions: assist RM Leadership in the smooth operation of the Department.
• Develop and monitor reports of occurrence data and harm events. Produce reports as requested on various department activities.
• Respond to inquiries or reports regarding potential or actual occurrences in the SHS that implicate medical, legal, ethical or loss control issues.
• Analyze and evaluate occurrence reports to determine significance and possible compensability and reportability of events.
• Assist departments in determining appropriate corrective actions involving risk and medical error reduction.
• Undertake investigation and follow up of occurrences involving risk management, quality of care issues or professional or general liability exposure.
• Review and evaluate requests for medical information and/or records to determine appropriate authority of request and screen potential requests for litigation implications.
• Develop and track department metrics and create reports as directed by RM Leadership. Provide analysis of departmental trends and risk activities. Prepare reports, including PowerPoint slides for various committees, underwriter community and Healthstar Board as requested by RM Leadership.
• Assist RM Leadership in supervision and maintenance of multiple databases used within the department.
• Complete timely reports which provide analysis of department trends and risk activities, including department reports, HSS Collaborative reports, Chair Reports, Stamford Health Medical Group reports for SHMG leadership.
• Participate in SHS committees as needed at the direction of Director or RM Leadership.
• Assist in the investigation and preparation of case summaries for presentation at Clinical Review and/or Apparent Cause or Root Cause Analysis meetings.
• Participate in Apparent Cause or Root Cause Analysis team meetings.
• Assure that physician or nursing leaders on the Claims Committee are alerted in advance of potentially compensable events (PCEs) or claims and provide any requested documentation as needed.
• Send concerning PCEs or claims to Manager, Medical Staff Peer Review, for review at the appropriate peer review committee.
• Assist in PCE or claim reporting, send any necessary litigation hold memos and assist in any additional work or verification activities as requested by RM Leadership.
• Participate in professional organizations, representing Stamford Health in a positive light, and collaborate with external resources to identify and develop improvements for the RM Program.
• Interface with the medical records department as necessary to ensure efficient processing of inquiries from regulatory agencies and legal representatives of patients.
• Assist in the training and education of new RM team members.
• Performance Improvement Functions: provide written critical analysis of cases and recommend policy or procedural changes as warranted. Follow up on risk reduction strategies and corrective action in response to sentinel or other critical events or quality of care issues.
• Regulatory Functions: provide occurrence reports, investigative notes or documents and assist, as needed, in reporting to the Department of Public Health pursuant to legislative and regulatory guidelines. Assist the ED, Regulatory Affairs and Compliance Programs, Administrative Director, Regulatory Affairs or Senior Regulatory Affairs Specialist in regulatory activities.
• Provide assistance to other departments under the supervision of the EDs, Director, RM or Regulatory Leadership with preparation for regulatory surveys and site visits.
• Coordinate or participate in meetings with regulatory agencies and assist in interfacing with regulatory agencies, in MEDSUN submission and other issues as they may arise.
• Educational Functions: provide in-service training at new employee, nursing or other orientation sessions regarding risk…