CORPORATE CLINICAL RISK MANAGER RN Job at Nexus Health Systems Ltd in Houston

POSITION SUMMARY:
The Corporate Clinical Risk Manager (CRM) is responsible for overseeing the day-to-day administration of the Risk Management program at all Nexus facilities. The CRM assumes direct responsibility for incident investigation, analysis, documentation, reporting, and identifying areas of liability. The CRM acts as a consultant to leaders and members of the medical staff, including training local leaders in triage, analysis, documentation, and reporting standards. The CRM professional maintains positive and supportive relationships at all levels of the organization.

JOB SPECIFIC RESPONSIBILITIES:
 Implements a comprehensive risk management program within the health system. Assess potential risks to health and safety of patients and employees using a high degree of judgement, prioritization, problem solving, and decision-making to complete a comprehensive review of quality of care incidents.
 Evaluates actual and potential harm of reports, and ensures inter-disciplinary approach is taken to effectively learn from unanticipated outcomes, patient safety events, sentinel events, and medical errors.
 Performs medical record reviews, relating findings with accepted standards of medical and nursing practice.
 Oversees all system-wide clinical risk activities associated with the delivery of care upon admission, during care and treatment and upon discharge and recommends strategies to reduce liability to providers, staff, and patients.
 Assists in preparing corrective or preventive actions, prepares trainings as needed, and also oversees the complaint and grievance process at all Nexus facilities.
 Assists in the preparation of general and professional liability insurance as needed, including assisting in certificates of insurance where applicable.
 Takes initiative to organize and conduct audits or other data analysis reviews to establish training or metrics in risk reduction. Conducts audits where applicable to ensure compliance with local, state, and federal regulations and minimum standards or safety.
 Investigates adverse events or incidents as lead or as a collaborator to identify the cause and recommend corrective solutions. Communicates findings and strategies in with respective leaders in a meaningful and collaborative way.
 Serves as the subject matter expert (SME) for DNV, CARF, Joint Commission, and RTC Minimum Standards as it pertains to safety and effectiveness.
 Prepares or amends policies pertaining to risk and patient safety in order to enhance effectiveness of NHS programming and safety.
 Receives assignments and sets work priorities, organizing tasks to meet deadlines.
 Prepares professional reports and trainings involving risk management activities and effectively presents information to audiences of varying backgrounds and education.
 Responds to risk-related inquiries and issues from staff, patients, and other regulatory bodies.
 Serves as a member on various committees involving peer review, safety or quality to offer input and provide consultation on risk identification and reduction strategies.
 Reviews legal complaints or other legal requests and coordinates with external counsel when appropriate and attends depositions as necessary. Conducts facility accreditation tracer activities, garnering participation, providing feedback and recommending changes.
 Assists in survey preparation activities when indicated.
 Maintains current knowledge of healthcare risk management and sources accreditation information from authoritative bodies relevant to local, state, and federal changes to regulatory standards, accreditation or other emerging requirements.
 Attends meetings and represents the Compliance & Quality Department of NHS in a professional manner.
 Performs other duties which may be required of the facility or organization from time to time.

POSITION QUALIFICATIONS:

EDUCATION:
 Bachelor’s degree in Nursing required
 Masters in Nursing preferred.

EXPERIENCE:
 Minimum of 3-7 years of recent healthcare risk management experience, preferably pediatric acute care, long term care, or rehab setting.
 Demonstrated experience analyzing incident reports and leading investigations or regulatory inquiries
 Experience managing PDCA projects involving cross-departmental teams and working in a matrix structure is preferred.
 A strong understanding of the principles of a Quality Management System (QMS) is required.

LICENSURE/CERTIFICATION:
 Unencumbered Registered Nurse (R.N.) license in the State of Texas is required
 Basic Life Support (BLS) is required
 CPPS or CPHRM required, or within 12 months of hire.

KNOWLEDGE, SKILLS and ABILITIES:

 Advanced knowledge of MS Office Suite and cloud-based platforms required.
 Advanced knowledge navigating and interpreting a medical record.
 Extensive knowledge of health care standards, including, but not limited to CMS, JC, DNV and CARF.
 Excellent project management skills, presentations, and use of audit tools and tracers.
 Able to work independently, with strong critical thinking skills and set priorities.
 Working knowledge of pediatric care and complex sub-specialties, such as Prader Willi Syndrome, Autism, and other complex pediatric behavioral conditions is a plus.
 Advanced verbal and written communication skills necessary to effectively collaborate in a team environment and make meaningful contributions to projects and assignments.