Clinical Risk Manager

Position Details

• Title:
  
  Clinical Risk Manager
• Location:
  
  Denver, CO (Onsite possible hybrid)
• Duration: 2+ months contract (possible extension)
• Shift: Day 5x8-Hour (08:00 - 17:00)

Under minimal supervision, the RN Clinical Risk Manager is responsible for the clinical review and analysis of significant occurrences as related to risk management, quality, and patient safety. This role will be an integral part of the organization’s Controlled Substance Diversion program.

• Review notice of claims, summons and complaints and perform a detailed claim investigation. Facilitate a thorough quality review of claims with internal and/or external reviewers and present findings to the Risk Management Committee for defense recommendations.
• Confer and work directly with claimants, attorneys, physicians, employees, and consultants involved in the claim.
• Act as a resource and liaison for individuals named in a notice of claim or summons and complaint.
• In collaboration with the Risk Management Director, determine whether the occurrence meets the elements for a state reportable event to the Colorado Department of Public Health and Environment (CDPHE).
• Facilitate a thorough investigation of the occurrence via interviews, chart audits, video and supporting documentation and timely submit final findings to CDPHE along with proposed action items, if applicable.
• Determine if significant occurrences meet the Joint Commission criteria for a sentinel event or near miss. Prepare and present Root Cause Analysis (RCA) and proposed risk reduction strategies to the appropriate audience. May be called upon to participate in a disclosure meeting with the affected individual(s).
• Assist with monthly Controlled Substance usage reviews and audits.
• Review the monthly RxAuditor report and identify high users across the organization. Prepare monthly audit reports for managers or designated person to complete.
• Prepare monthly reports of audit results, findings, trend data.
• Assist with investigations and collaborate with leadership when suspected controlled substance diversion has occurred. Attend diversion ad hoc meetings and assist in reporting to law enforcement.
• Participate in Controlled Substance Diversion committee, prepare reports for meetings and assist where needed.
• Develop and expand the Controlled Substance Diversion program in collaboration with pharmacy.
• Act as a backup for the subpoena process and the Self-insured Workers Compensation program.
• Assist with CDPHE, Joint Commission and CMS surveys.
• Collaborate with Law Enforcement and Security when a crime has been committed.

• Bachelor’s Degree:
  Bachelors of Science in Nursing
• Completion of an accredited Nursing Education Program satisfying Colorado State Board of Nursing licensing requirements for registered nurses.

• 1-3 years of professional nursing experience in an acute care setting.

• RN – Registered Nurse – DORA – Department of Regulatory Agencies

• Direct independent investigations of risk management matters, report results to stakeholders and assist in developing corrective action plans.
• Maintain current working knowledge of federal and state laws and regulations concerning health care risk management.
• Demonstrate good judgment, strong analytical skills and excellent interpersonal and writing skills. Highly self‑motivated with the ability to function independently and as part of a team in a fast‑paced environment with minimal supervision.

• Immunization records for MMR and varicella. Must have positive results; if negative, required to receive two MMR vaccinations with a 28‑day gap.
• TB test: options include TSPOT or QF TB Gold or 2‑step PPD. Provide latest documents (valid within 3 months).
• Annual physical exam.
• COVID vaccination required.

We are an equal opportunity employer with a diverse workforce.