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Organization:SHSO-Sutter Health System Office-ValleyPosition Overview:Collaborates with system and affiliate risk management leaders and other stakeholders, providing consultation and expertise to develop and support a comprehensive system-wide risk management program that focuses on proactive risk management and loss prevention. Manages and analyzes risk, loss and related claims activity for assigned affiliates. Evaluates system program and risk mitigation action plans, identifies risk exposure and improvement opportunities, and recommends policy and practice modifications. Analyzes and develops guidance for implementing requirements of new legislative, regulatory and case law mandates.Job Description :These Principal Accountabilities, Requirements and Qualifications are not exhaustive, but are merely the most descriptive of the current job. Management reserves the right to revise the job description or require that other tasks be performed when the circumstances of the job change (for example, emergencies, staff changes, workload, or technical development).JOB ACCOUNTABILITIESRISK MANAGEMENT: Collaborates with system and affiliate risk management leaders and other stakeholders to develop a comprehensive system-wide risk management program focused on proactive risk management and loss prevention. Evaluates program and risk mitigation action plans, identifies risk exposure and improvement opportunities, and recommends policy and practice modifications. Conducts in-depth and on-site review of affiliates’ risk programs and provides comprehensive recommendations. Assesses and provides consultative support through site visits, regulatory and liability assessment surveys, contract and policy reviews and risk identification, resolution and evaluation processes. Investigates, creates and implements system-wide patient safety focused shared learning alerts program.CLAIMS MANAGEMENT: Reviews and evaluates potentially compensable professional, general and miscellaneous liability events, and works with third-party administrators in developing liability assessments and claims resolution. Directs and obtains preliminary investigative information to enable liability assessment, provides guidance to affiliates for loss control activities, and assesses for appropriate insurance coverage on submitted claims Produces analysis of claims for coding data and directs the disposition of litigation and claims. Provides guidance for affiliate’s response to legal service received and small claims court litigation.RISK ASSESSMENT: Identifies and assesses existing and potential risk exposure for the system, and identifies areas of loss through reports of trended claims activity. Provides analysis of potential risk associated with prospective affiliations, programs, and contracts via site visits, program review, and interviews. Develops and conducts system-wide in-depth reviews of high-risk practices (liability surveys) and affiliate compliance with legislative, licensure and accreditation standards, providing a detailed summary report of survey findings with recommendations and supportive materials for reduction of high-risk conditions or non-compliant practices. Monitors and re-evaluates affiliates’ programs and claim status to measure progress towards resolution of potential loss exposure.RESCUE, GUIDANCE, & EDUCATION: Responds to complex and urgent requests, and provides advice and guidance on high risk events, patient safety and issues related to scope of practice, regulatory and privacy. Serves as a resource to affiliate, facilitating and assisting with depositions and providing support and guidance to affiliate leadership in achieving program goals and objectives. Provides education and training to risk management leaders on the timely reporting of liability and litigation responsibilities, including claims management program. Analyzes and develops guidance for implementing requirements of new legislative, regulatory and case law mandates. Develops and presents educational programs, provides support for orientation programs, conducts research on a variety of issues, and authors and publishes articles.PERFORMANCE MANAGEMENT & CONTINUOUS IMPROVEMENT: Seeks and responds to regular performance feedback. Supports and assists the team when necessary. Contributes ideas and actions toward continuous improvement of processes and workflows. Recognizes and communicates potential issues to appropriate leader.EDUCATIONEquivalent experience will be accepted in lieu of the required degree or diploma.Bachelor's: Risk Management, Insurance, Finance, Business Administration, Healthcare Administration or related field or equivalent education/experienceCERTIFICATION & LICENSURECPHRM-Certified Professional Healthcare Risk ManagementARM-Associate in Risk ManagementPREFERRED EXPERIENCE AS TYPICALLY ACQUIRED IN:8 years experience in healthcare risk management.8 years experience developing and/or implementing healthcare risk management programs or services.8 years experience managing healthcare related liability claims.8 years experience with conducting investigations related to patient/employee safety and/or liability claims.SKILLS AND KNOWLEDGEWorking knowledge of relevant laws, regulations, and industry standards related to healthcare risk management.Working knowledge of risk management process, best practices and methods used to limit exposure to liability and risk, including identification and control methods, loss reduction and prevention activities, risk financing and claims management.Knowledge of relevant healthcare privacy standards, laws and regulations.Critical thinking and analytical skills with a keen attention to details.Ability to identify and assess situations/issues presenting an existing or potential risk exposure.Investigative and interviewing skills to obtain the necessary information to draw logical conclusions.Organization skills to effectively manage and/or re-prioritize activities and projects to meet deadlines wihle maintaining a high degree of responsiveness.Customer service focus in all decisions and actions.Ability to communicate through verbal and written means.Ability to interact and maintain effective working relationships with those contacted in the performance of required duties.Ability to work effectively in a dynamic and fast-paced environment with changing business priorities.Ability to maintain and work discreetly with confidential information.Ability to maintain and work discreetly with confidential information.Ability to use essential applications and/or databases associated with the role’s duties and responsibilities.PHYSICAL ACTIVITIES AND REQUIREMENTSSee required physical demands, mental components, visual activities & working conditions at the following link:Job Shift :DaysSchedule :Full TimeShift Hours:8Days of the Week:Friday, Monday, Thursday, Tuesday, WednesdayWeekend Requirements:Saturday, SundayBenefits:YesUnions:NoThis position is work from home eligible.Position Status:ExemptWeekly Hours:40Employee Status:RegularNumber of Openings:1Sutter Health Affiliates are equal opportunity employers EOE/M/F/Disability/Veterans.All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin (including possession of a driver's license issued to individuals who did not present proof of authorized presence in the U.S.), age, medical condition, physical or mental disability, military or protected veteran status, political affiliation, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical condition, genetic information or any other characteristic made unlawful by local, state, or federal law, ordinance or regulation. External hires must pass a background check/drug screening. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state, and local laws, including but not limited to the San Francisco Fair Chance Ordinance.
Full-time- ID: #44335864
- State: California Roseville 95661 Roseville USA
- City: Roseville
- Salary: USD TBD TBD
- Showed: 2022-07-24
- Deadline: 2022-09-22
- Category: Et cetera