Risk Management Analyst

Job Description

Primary Accountability

The Risk Management Analyst is responsible for programs that identify safety and security risks associated with the environment of care that could affect individuals served, staff, and other people coming to the organization’s facilities. Through working with leadership to coordinate the appropriate management of the environment of care, the Risk Management Analyst plays a vital role in minimizing or eliminating legal, financial, and health care related risks.

Description Of Primary Responsibilities

• Responsible for risk identification, risk analysis, and notification of the need for risk control.
• Assists FHCN staff in following the organizational risk management and patient safety plan involving minor, daily problems as well as major, unexpected events.
• Manages FHCN information about system or process failures as well as conducts proactive risk assessments to improve safety and limit risk associated with adverse outcomes. Key areas of responsibility include risk to property, equipment, patients, and staff through tracking adverse events involving, but not limited to: patient complaints; patient injuries; staff injuries; theft, loss, and/or damage to FHCN property; equipment sterilization/sanitization issues; breaches of PHI, etc.
• By analyzing and trending ARMS reports, identifies if an adverse outcome is random, due to a system issue, or due to a personnel performance issue/someone working outside of workflow. If a system issue is suspected, the Risk Manager engages QI to complete a PDSA. If a personnel issue is suspected, the Risk Manager engages HR for appropriate review and intervention.
• Works in conjunction with other departments including, but not limited to, Quality Improvement (QI), Purchasing, and Human Resources (HR) to analyze high risk/high cost areas. Examples of such collaboration by issue include, but are not limited to:
• Patient complaints – While the QI Department oversees regular patient satisfaction surveying, the Risk Management Analyst tracks and trends patient service complaints to assist leadership personnel in addressing repeated concerns involving a particular site, staff member, etc.
• Medication or other supply loss – While the Purchasing Department is responsible for replacing lost supplies, trends in theft, loss, or damage are trended and mitigating strategies suggested by the Risk Management Analyst.
• Lost work days due to injury – While the HR Department oversees the Workers Compensation program for FHCN, the Risk Management Analyst would be concerned with the cost associated with not mitigating a specific issue that resulted in multiple injuries that kept staff out of work.
• Provides risk-management training to key health care organization staff, leadership personnel.
• Serves as the Safety Officer for the Network and ensures overall implementation of the Injury and Illness Prevention Program.
• Maintains a risk management education calendar for all levels of staff on a variety of risk management and patient safety topics.
• Ensures compliance with standard risk management guidelines related to Environment of Care issues that are overseen by external entities, such as The Joint Commission (TJC), OSHA, Title 22 and other regulatory entities.
• Responsible for FHCN’s emergency preparedness through adherence with existing plans.
• Ensures emergency preparedness plans are in compliance with guidelines and regulatory requirement that are overseen by external entities such as the Health Resources Services Administration (HRSA), TJC, etc.
• Maintains the necessary documents, certifications, and coverages that limit medical malpractice risk for FHCN.
• Maintains medical malpractice insurance affairs including coverage for the Federal Torts Claims Act (FTCA) and NorCal gap insurance programs.
• Accountable for receiving claims related to both professional and general liability, as well as following existing workflows for processing data with the appropriate departments, outside agencies, and analyzing potential claims.
• Works with Corporate Counsel and FHCN staff to ensure adherence with the existing risk plan during the processing of organizational responses to claims against FHCN and ensures legal files are maintained protected.
• Ensures that senior management is kept informed of high-exposure cases with claims potential and aggregate-claims experience, including their effect on insurance coverage.
• Maintains documents and registrations for Clinical Laboratory Improvement Amendments (CLIA) certification, and transportation fleet registration.
• Follows existing plan for maintaining transportation fleet certification of personnel eligibility for employment.
• Acts as a liaison with FHCN medical malpractice insurance carrier.
• Maintains medical malpractice insurance applications and renewals.
• Evaluates medical malpractice coverage limits to ensure exposures are adequately addressed.
• Provides analysis for national and local claims data; analyzes prior claims, lawsuits, and complaints against the facility; and submits analysis to senior leadership.
• Tracks and trends adverse outcomes to ensure risk mitigation if systematic errors are occurring that lead to liability and malpractice issues.
• Maintains FHCN’s policy and procedures manual and ensures an annual review.
• Ensures policies and procedures are updated to reflect relevant legislation and regulations in key areas of risk management and patient safety.
• Maintains current knowledge of regulatory requirements, including Title 22, HIPAA, HITECH, CDPH, OSHA, health plans, and other applicable local, state, and federal agencies.
• Serves as point person for planned and unannounced visits by law and other code enforcement personnel, including but not limited to local, state, and federal law enforcement, CDPH personnel, and OSHA personnel.
• Coordinates appropriate response needed to resolve operational issues arising from such visits.
• Receives and processes subpoenas/warrants relevant to FHCN operations.
• Performs other duties as assigned.
  

Description Of Primary Attributes

Professional & Technical Knowledge:

• Possesses specific advanced knowledge skills, including written and verbal communications skills, computational, computer and technical skills, and mathematical knowledge acquired through the completion of a Bachelor’s Degree program with a recognized major or a comparable level of business/industry acumen.
• Performance of the duties and responsibilities of the job requires the equivalent of formal training in quality improvement analytics, usually in the form of a major involving health-care or other analytics/as part of a Bachelor’s Degree program.
• Knowledge of regulatory requirements, including HIPAA, Title 22, CDPH and OSHA; and accreditation processes of the Joint Commission preferred.
  
  

Technical Skills

• Ability to create highly complex documents in Microsoft Word, including linking multiple files and embedding objects linked to other documents.
• Ability to use advanced functions of Microsoft Excel, such as to create and manage databases, including creating standardized reports, or link multiple worksheets and workbooks.
• Ability to develop sophisticated presentations in Microsoft PowerPoint, including the use of embedded objects, transitions and other elements.
• Two years of relevant experience, preferably in healthcare risk management.
  
  

Licenses & Certifications: Risk Management certification must be completed within first year of employment through organizations such as the American Society for Healthcare Risk Management (ASHRM), California Primary Care Association (CPCA) or certification from another accredited agency may be considered.

Communications Skills

• Job duties require the compilation and analysis of information prepared in effective written form, including correspondence, reports, articles or other documentation.
• Duties require preparation and execution of presentations to large groups.
  
  

Physical Demands: The physical demands here in this job description are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this position, the employee is regularly required to sit and use repetitive hand movement to type and grasp. The employee is frequently required to stand or walk; and the employee must occasionally lift and/or move up to 20 pounds.

Pay Scale

Min Hourly Rate: $29.02

Max Hourly Rate: $40.04