Responsible For: Risk Management within a Facility or Market Area
Under the direction of the Mercy Health Market Director of Risk & Insurance the Risk Manager (“Manager”) supports the goals of the Mercy Health Insurance & Risk Services Department within the Facility, and shares accountability for achieving program goals and objectives. The Manager assists with the enterprise wide risk management program for acute and non-acute care centers, physician practices and ancillary business entities when Mercy Health is the majority owner. Specific Risk Management responsibilities may include but are not be limited to:
- collect and analyze risk management data
- identify and minimize loss exposures in order to protect the assets of the Facility
- maintain a general knowledge of the Facility’s insurance programs
- conduct risk management educational programs
- comply with regulatory and accreditation standards
- manage retained losses through standardized processes
- works in conjunction with Mercy Health Claims Department and outside defense counsel in the defense of claims
- other duties as assigned
Under the supervision of the Director assists with loss prevention strategies and initiatives. These strategies include proactive risk activities such as risk assessments, educational programs, consultations and ensuring compliance with the multiple laws and regulations affecting patients, visitors, employees and the community we serve.
- Conducts risk management surveys and studies and responsible for implementing action plans to address risk exposures
- Participates in the event management process including initiating and participating in the Event Investigation Team; coaching leadership and physicians in the apology and disclosure process; attends the Root Cause Analysis; may assist with the early liability review process
- Adheres to Mercy Health policies regarding serious reportable events and sentinel events
- Contributes in establishing loss prevention initiatives related to non-clinical risk reduction and mitigation techniques by coordinating the commercial insurer’s recommendations for loss control
- Complies with various codes, laws, rules and regulations concerning patient care, including those mandated by state and federal agencies, incident reporting, also includes investigative activities with federal, state and local enforcement authorities
- Presents educational material to administration, medical staff, nursing personnel, and other department personnel on topics related to risk management
- Acts as a consultant and answers medical/legal inquiries of physicians, nurses and administrators regarding emergent patient care issues, insurance & claim questions
- Participate in Patient Safety WalkRounds, Collaboratives, and other patient safety activities
- Oversees the effective management of SafeCARE reporting and documentation. This includes analyzing trends and identifying reports that may indicate a significant event has occurred
- Takes “On call” responsibility related to risk management issues and adverse events as scheduled
Under the supervision of the Market Director performs the initial risk management investigation and if a claim is expected or received assists the Claims Managers and external defense counsel in the discovery process.
- Identifies and collects documents necessary to respond to interrogatories and requests for production of documents.
- Keeps Market Director apprised of significant claims and upcoming Trials
- Enters potential and actual claims in the Claim Data Base and maintains the investigation file according to the Risk Management Plan
The Risk Manager maintains a general knowledge of, and is familiar with, the facility’s coverage for professional liability, property and casualty loss, including CHP Insurance Ltd, risk insured retention, and coinsurance.
- Participates in the Facilities insurance programs by ensuring exposure data is maintained to facilitate renewal of the Mercy Health centralized insurance program
- Communicates any new exposures to avoid coverage gaps