Clinical Risk Manager

The best thing about this role

Are you looking to make a difference by improving the health of our patients? Here you will find an innovative culture that is patient-focused and dedicated to making a difference. We are committed to helping the population we serve, and our communities, achieve optimum health and enjoy the best quality of life possible.

Under the minimal supervision of the Director of Patient Safety & Risk Management, the Clinical Risk Manager provides consultation and expertise for regulatory requirements promulgated by the New York State Department of Health and CMS and Joint Commission. Uses professional judgment and advanced knowledge in risk management issues to serve as a support for the organization.

The Risk Manager is responsible for the administration of the institutional systems to comply with regulatory reporting initiatives including the New York State Patient Occurrence Tracking and Reporting System (NYPORTS). Responsible for the information gathering, data analysis, investigation, and response to Sentinel Events, and NYPORTS events and applies the appropriate and current root cause analysis methodology to the investigative process. Investigates all near-miss events.

Independently performs follow-up as needed to assure recommended reviews and investigation inquiries regarding quality-of-care issues. Tracks and trends NYPORTS quality outcomes and makes recommendations as needed.

Responsible for the coordination of clinical reviews as needed. Works closely with departments to recommend and implement system improvements as a result of the RCA and investigative process actions. Responsible for monitoring the sustainability of actions. Assists the Director with maintaining a Culture of Safety. Serves as a knowledgeable resource for risk issues, and legal and regulatory matters. Reviews, investigates, and analyzes Medication Variance Reports for trends, safety, and liability issues for the organization.

Prepares quarterly and annual reports for various committees including the Board of Trustees Performance Improvement Committee, Board of Trustees, and Annual Safety Report with analysis of trends.

Acts as a consultant to providers and staff members on all risk management issues. Represents Risk Management on a number of different teams including Medication Safety, Emergency Preparedness, Morbidity & Mortality, and Risk Reduction Committees (falls, medication errors, pressure ulcers, DVT, etc) as well as other committees as assigned. Participates in special studies and other duties as assigned.

• Timely investigation, analysis, and reporting all NYPORTS, ensuring that the regulatory requirements are met for root cause analysis, database tracking and generating data for the Director of Patient Safety & Risk Management, other departments, clinical chiefs, and the Medical Director and the Board of Trustees.
• Maintains current knowledge of the reporting requirements promulgated by the New York State Department of Health (NYSDOH and OMH). Disseminates new information, regulations, policies and procedures to key administrative personnel within the healthcare organization, evidenced by review of submitted materials.
• Applies the NYPORTS criteria to ensure proper reporting and follow up (RCA). Alerts the Department Director of any events requiring immediate attention, as evidenced by direct observation.
• Works collaboratively with the Director of Patient Safety & Risk Management and other designated department staff to identify and track events, which are related to NYPORTS and EMTALA, other appropriate entities, as evidenced by review of daily work.
• Responsible for the oversight of corrective action plans to NYPORTS/ EMTALA and/or NYSDOH/OMH/ CMS findings as evidenced by direct observation.
• Evaluates trends and patterns related to the NYPORTS program and makes recommendations for improvement, as evidenced by review of reports and recommendations.
• Review incident reports promptly and ensure investigative findings are complete as appropriate relative to the significance of the event.
• Track and trends incident reports to identify safety issues and concerns throughout the organization
• Make recommendations for Root Cause Analysis and Failure Mode Effect Analysis on safety issues and noted trends
• Communicate in a timely manner significant safety event findings.
• Crosswalk incident reports and issues reported in the daily safety huddle to assure accuracy of report and determine time line for which investigation should be completed.
• Reports and presents relevant findings to organizational leadership; keeps organizational leadership and malpractice carriers informed of issues.
• Completes reports, with analysis, for the Board of Trustee meetings, Performance Improvement Board Meetings, Quality Management Council, Safety Action Council, the annual report and the annual Safety Report.
• Performs chart reviews as required 100% of the time, as evidenced by direct observation.
• Attends assigned morbidity and mortality…