Position Details

Department: PCH-MAIN | Risk Management
Category: Legal/Risk/Reg Compliance
Location: Phoenix
Posting #: 531737
Date Posted: 10/14/2020
Employee Type: Regular

Position Summary

Posting Note: ** Please note that this position is located in Phoenix, AZ. Relocation Assistance is available for out of state candidates.

The Risk Program Manager collaborates with senior leaders and key stakeholders or experts, (e.g., Clinical Operations, Patient Safety, Supply Chain, Legal, and Regulatory Services), throughout PCH to develop system-wide responses to risk issues that impact specific groups or the entire organization with policies/procedures, guidelines, tools, forms, and education/training. In addition, this position serves as a liaison between patients, families, and all hospital departments, facilitating conflict management and complaint resolution to achieve optimal communication between patients and healthcare team.

PCH Values

  • Family-Centered care that focuses on the need of the child first and values the family as an important member of the care team
  • Excellence in clinical care, service and communication
  • Collaborative within our institution and with others who share our mission and goals
  • Leadership that set the standard for pediatric health care today and innovations of the future
  • Accountability to our patients, community and each other for providing the best in the most cost-effective way.

Position Duties

  1. I. Develops risk mitigation strategies based on analysis of relevant data (e.g. claims, complaints/grievances, Serious Reportable Events, and risk assessments). Investigates and analyzes potential and actual professional liability exposures in the organization; evaluate the extent and elements of exposure and recommend appropriate actions for risk mitigation
    • a.Works in conjunction with the Quality Management and operational leaders in the investigation of potential or actual events/concerns. Participates in root cause analysis (RCA), Failure Mode and Effects Analysis (FMEA), or risk mitigation and investigation strategies.
    • b.Supports the Risk Management and Quality Management teams in error prevention efforts by investigating and analyzing events and trends, and communicates findings to appropriate departments/staff.
    • c.Develops processes and benchmarks to monitor the effectiveness of risk mitigation strategies.
    • d.Collaborates with Risk Management and Quality Management staff in developing periodic in-services, teleconferences, face-to face meetings and work groups regarding health care risk management and related topics.
    • e.Performs risk assessments and audits in various clinical settings and coordinates development of clinical loss prevention plans for PCH based on event or claims analysis. Assumes an active role in on-boarding newly acquired practices and mitigating potential liabilities using risk assessment tools.
    • f.Assists Quality Management in gathering information requested by regulatory agencies, in regards to complaints/grievances, and event investigations. Assists Quality Management in the identification of policies/procedures, and other information that identifies and supports organizational efforts in response to regulatory investigations.
  2. II. Under the direction of Risk Management Leadership and PCH Counsel, investigate and analyze potential and actual professional liability exposures in the organization; evaluate the extent and elements of exposure and recommend appropriate actions for risk mitigation.
    • a. Ensures the quality of legal services for HPL lawsuits and the efficient use of funds
    • allocated for legal expenses by directing the activities of outside defense counsel,
    • performing internal audits of defense legal services and continually evaluating
    • strategic alternatives and opportunities for early mediation/resolution of claims and
    • litigation.
    • b. Serves as a liaison between Counsel, other business units and external contacts to
    • coordinate and expedite legal matters to ensure discovery and other related documents
    • are prepared and executed accurately and in a timely manner. Coordinates activities
    • related to meetings, depositions, mediations, and other legal activities and ensures the
    • litigation calendar is up to date.
    • c. In conjunction with the Risk Management Director, will keep PCH Risk Management Leadership and General Counsel regularly apprised of all significant developments in claims and litigation matters. Such leaders shall be consulted sufficiently in advance of the date by which any significant decision must be made regarding a particular matter. This includes obtaining settlement authority and discussing any other discovery or public relations topics.
    • d. Collaborates in the completion of notifications and financial recommendations needed for compliance with tracking and insurer requirements, including excess insurance carrier notifications, reserve recommendations, and any federal, state, or entity reporting requirements (including SMDA, MMSEA Section 111, DataBank, etc.) as necessary.
    • e. Provides oversight and maintains the accuracy and integrity of documentation in the Risk Management System (RMIS). Ensures that the claims/litigation files and other documentation are organized, clear, concise, and timely updated.
  3. Works with clinical leaders to manage complex or unresolved complaints and grievances.
    • a.Researches medical records, policies and procedures to gather information required for the resolution of complaints/grievances.
    • b.Supports operational leaders in implementing and sustaining patient experience improvement initiatives. Is a key partner is supporting the culture of patient and family centered care.
    • c.Initiates rounding on patients and staff and prioritizes focused re-visits to improve the patient and family experience.
    • d.Works with clinical leaders to ensure a written response to grievances in accordance with applicable policies and regulations.
  4. IV. Provides on-call assistance for emergent/urgent risk management issues.
  5. Performs miscellaneous job related duties as requested.

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Position Qualifications

Please review the following qualifications and specify whether you meet each of the requirements listed.
Do you meet this requirement?
1. Bachelor of Science in Nursing (BSN) or a related field. Required
Do you meet this requirement?
1. Three(3) or more years of experience in one (1) or more of the following fields: Registered Nurse, Respiratory Therapist, or other clinical professional field, Required
2. Three(3) or more years of experience in Risk Management, Quality Improvement, or other loss prevention techniques and operations. Required
3. Possess project management skills as well as strong verbal and written communication skills. Ability to effectively listen, present, discuss, report, and explain trends and patterns. Required
4. Must possess high level of interpersonal diplomacy, finesse and negotiation ability to influence a wide variety of stakeholders, many of whom have responsibilities and interest that are distinct form those of Risk Management. Required
5. Possess a comprehensive knowledge of healthcare Risk Management and loss prevention techniques and operations. Preferred
6. Proficient in data analysis, statistics, risk evaluation, interviewing skills, investigation skills, and medical terminology. Preferred
Do you meet this requirement?
1. Certifications- ARM and/or CPHRM Preferred
Do you meet this requirement?
Special Skills
1. Requires significant use of personal computer, phone and general office equipment and databases. Required
2. Must be proficient in the use of Microsoft Office products (Word, Excel, Power Point). Medium to expert level of expertise using various types of office software (claims database) and electronic medical records. Required
Physical Requirements & Occupational Exposure/Risk Potential
1. Physical Requirement - Climbing Frequently
2. Physical Requirement - Feeling (sensing textures and temperatures) Frequently
3. Physical Requirement - Fine Motor Skills (pinching, gripping, etc) Frequently
4. Physical Requirement - Hearing Constantly
5. Physical Requirement - Pushing/pulling Occasionally
6. Physical Requirement - Reaching Frequently
7. Physical Requirement - Sitting Constantly
8. Physical Requirement - Standing Constantly
9. Physical Requirement - Stooping/crouching/kneeling/crawling Frequently
10. Physical Requirement - Talking Constantly
11. Physical Requirement - Tasting/smelling Occasionally
12. Physical Requirement - Walking Constantly
13. Physical Requirement - Near Vision Constantly
14. Physical Requirement - Far Vision Constantly
15. Physical Requirement - Color Discrimination Occasionally
16. Physical Requirement - Use of keyboard, mouse and/or computer equipment Constantly
17. Occupational Exposure/Risk Potential - Inside office environment Applicable
18. Occupational Exposure/Risk Potential - Outdoor weather conditions Applicable
19. Occupational Exposure/Risk Potential - Extreme temperatures Applicable
20. Occupational Exposure/Risk Potential - Confined areas Applicable
21. Occupational Exposure/Risk Potential - High places Applicable
22. Occupational Exposure/Risk Potential - Extreme noise levels Applicable
23. Occupational Exposure/Risk Potential - Airborne communicable diseases Applicable
24. Occupational Exposure/Risk Potential - Bloodborne pathogens or bodily fluid Applicable
25. Occupational Exposure/Risk Potential - Fumes or airborne particles Applicable
26. Occupational Exposure/Risk Potential - Hazardous materials exposure Applicable
27. Occupational Exposure/Risk Potential - Radiation exposure Applicable
28. Occupational Exposure/Risk Potential - Toxic or caustic chemicals Applicable
I have reviewed the qualifications, physical requirements and occupational exposure/risk potential for this position and wish to apply