Sr. Clinical Risk Manager

Job Summary:

The Sr. Clinical Risk Manager is responsible for implementing and participating in the Risk Management Plan of minimizing the adverse effects of loss(es) and protecting the financial assets of the Organization. The plan includes identification, assessment, and recommendations for corrective action to avoid reoccurrences. Develops and implements a loss prevention program(s) and coordinate of claims to reduce legal expenses.

Job Description:

• Evaluates, reviews, and documents on each reported incident reported from the assigned unit.
• Performs statistical analysis of incident reporting database to include tracking & trending, for intra-departmental review and reporting to various committees as requested.
• Serves on assigned committee(s) and attends monthly Departmental meetings and unit meetings.
• Prepares the physicians and other health care providers for presentations at the Risk Management Committee meeting.
• Conducts a detailed investigation of those occurrences which are or are anticipated to be cases of significant exposure to the organization.
• Establishes a file for all Investigated occurrences to include the chronology of the medical record and investigation, and an assessment of the liability and damages, as well as the anticipated outcome should a claim or litigation follow.
• Recommends, monitors, and reserves (indemnity & expense) for all ascertained & litigated cases based upon the investigation and discovery.
• Assists defense counsel with investigation of assigned litigation as well as preparing the case for final resolution (trial and/or settlement).
• Requests settlement authority with a memo outlining the pros & cons of the case, the potential verdict range, settlement value, and final recommendations.
• Assumes responsibility for settlement of a case once authority provided by the Director &/or General counsel is received.
• Assumes responsibility for settlement of a case once authority provided by the Director &/or General counsel is received.
• Develops and provides assigned units programs to enhance safety within the organization including; patients, employees, visitors, and families.

Job Qualifications:

• Bachelor's degree is required.
• Four or more years of Hospital Management, Risk Management, or Insurance experience is required.
• Prior experience with database systems.
• Claims Management experience preferred