JOB SUMMARY The Risk Management Specialist will monitor, develop, and implement a Risk Management Program for theMedical Center. Reports to: Dir Risk ManagementCommentsJOB REQUIREMENTS Minimum Education Bachelors in a health-related field - Preferred. Graduate of a School of Nursing preferred.
Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action. Licenses: Current license as an RN in New Mexico or compact license.
Claims Management and/or Risk Management certification preferred. In lieu of RN license, 3-5 years of claims/Risk Management experience in an acute care facility. Minimum Work Experience Three (3) years of experience as an RN or a combination of (3) years nursing/claims/ Risk Management experience required.
Design and coordinates a comprehensive risk management program.
Report Acts as a resource for current knowledge and appropriate methodology for effective risk management to the Medical Center and all departments. Reviews, coordinates and develops department risk management policies and procedures. Reviews, coordinates and develops the Medical Center's policies and procedures pertinent to risk management.
Maintains liaison with Medical Center administration, staff, Medical Staff and corporate representatives to assure that the lines of communication are kept open for feedback. Investigates, analyzes, documents, and recommends course of action on potentially compensable events, claims and litigation. Implements claim handling actions authorized by the Risk Management Committee, Administration and Corporate Risk Management.
Identifies risk reduction opportunities and recommends and implements risk reduction projects. Identifies staff education needs relevant to Risk Management. Provides education through presentations, development of educational material such as posters and handouts, and arranges for and coordinates education from outside sources such as tele conferences, speakers, etc...
Works cooperatively with Medical Center Administration, corporate representatives and staff to comply with state and federal regulatory requirements (i.e., NM Department of Health, CMS, EMTALA, SMDA, etc). Actively participates in Medical Center formal and ad hoc committees and work teams. Develops and maintains systems for regularly managing information relevant to the risk management program.
Communicates effectively and directly with external organizations (i.e. insurance representative, adjuster and attorneys.)