Overview
Essential Responsibilties:
• Facilitate quarterly Risk Management and Safety Committee meetings
• May participate as consultant for employee disciplinary matters involving policy violations as needed
• Lead agency wide enterprise risk management efforts in following areas (a) Applicable standards of health care risk management; (b) Applicable federal, state, and local health and safety laws and rules, including competency validation, credentialing and privileging requirements; (c) General risk management administration, including claims and insurance management, confidentiality and release of information, and event investigation, root-cause analysis, and follow up; (d) Patient care, including reporting and management of adverse and near misses and trend analysis of events, near misses, and claims; (e) Medical/dental care, including implementing performance improvement strategies to mitigate risk ; (f) Accident prevention, and event investigation, rootcause analysis; (h) All functional areas in organization, as outlined in the Risk Management Plan.
• Institutes and maintains an effective compliance communication program for the organization, including promoting use of the Compliance Hotline, heightened awareness of Standards of Conduct and HIPAA rules, understanding of new and existing compliance issues and related policies and procedures
• Ensure all HRSA guidelines are adhered to on an ongoing basis
• Coordinate with Leadership and managers to collaboratively conduct an annual risk assessment.
• Conduct quarterly risk assessments.
• Maintain system to detect, prevent, report, manage and mitigate areas of risk and vulnerabilities.
• Create, modify, and implement policies
• Develop executive summaries of risk management activities, for Board review.
• Identify and prepare case studies for quarterly Root Cause Analysis
• Manage risk management and safety policies and procedures.
• Facilitate risk awareness (organization of risk awareness sessions, preparation of packages for new employees, assessment/testing of employees’ knowledge etc.)
• Support the tracking and reporting of risk incidents, corrective action plans, root cause analysis, etc.
• Research and maintain trending data on Risk Management issues and medical and dental standards of care identified through incident report and patient grievances.
• Lead efforts to ensure compliance with medical practice standards to manage and minimize risk.
• Recommend and implement changes in potential and known risk exposures to address procedures and practices that are not compliant with industry regulations.
• Assure maintenance of compliance and risk management intranet resources
• Identifies training needs of organization and recommends training subjects to Compliance Officer
• Develop and maintain rapport and positive relationships with providers.
• Assists with the maintenance and revisions to the incident reporting system.
• Develop and provide Risk Management orientation and other educational services for personnel regarding risk issues as required by state statute.
• Other duties as assigned.
Qualifications:
Education: Bachelor’s degree in healthcare administration, public health, risk management or related field required or equivalent experience. Master’s degree in healthcare administration, nursing, public health, or a related field strongly preferred.
Knowledge, Skills and Abilities:
• Intermediate-level overall computer skills and advanced knowledge in Microsoft Office applications – particularly Excel.
• Proven ability to maintain a high degree of discretion, integrity, and sensitivity to confidentiality and privacy.
• Advanced training/knowledge in QI/QA processes and healthcare compliance.
• Demonstrated understanding of data collection, data validation, and data reporting processes.
• Proven ability to manage a high work-volume with changing priorities, and frequent interruptions.
• High level of attention to detail.
• Proven ability to work independently and maintain self-motivation.
• Strong organizational, problem solving and analytical skills.
• Ability to work as part of an interdisciplinary team, and to deal effectively with diverse individuals at all levels of the organization and with external partners.
• Excellent written and verbal communication skills.
• Proven skill preparing and maintaining records, writing reports, and responding to correspondence.
Experience:
• Experience working in a health care setting including experience working with electronic health record system strongly preferred.
• 2-4 years of healthcare industry experience, with a thorough understanding of provider relations, clinical metrics, claims/encounters and analytics
• Demonstrated commitment to high quality health care for low income, ethnically diverse populations.
• Proven project management skills.
• Risk Management experience preferred.
• Ability to communicate effectively, both verbally and in writing.
• Able to maintain confidentiality of sensitive information.
• Experience as a Quality Utilization Management reviewer beneficial.
• Knowledge of clinical, negligence and/or insurance, risk management principles preferred.
• Knowledge of California Statutes pertaining to Risk Management and Patient Safety, medical malpractice, medical standards of care, HIPAA, etc.
• Able to relate cooperatively and constructively with internal and external customers.
• Ability to identify potential risk/quality issues and to analyze and prepare reports.
• Ability to interpret, adapt and react calmly under stressful situations
SITE/HOURS: 40 hours per week, Monday – Friday. Office at Administrative location in Oakland, CA. Travel to nearby clinics in Alameda, Contra Costa and Solano sites is required.