Legal Services Clinical Risk Manager

Nationwide Children's HospitalColumbus, Ohio

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Job Description

Overview:

Job Description Summary:

Assists with the development, coordination, and maintenance of the Risk Management Program. Identifies, evaluates, and works to proactively mitigate risks and potential liability, develops loss prevention programs through the analysis of clinical data, and reinforces compliance with policies.

Job Description:

Essential Functions:

Performs surveillance, evaluates patient and employee safety risks, resolves concerns through daily time-sensitive calls, and conducts high quality investigations.
Evaluates all claims, makes recommendations, reviews compensable events, and determines the level of liability and setting reserves. Recommends approval or denial for reimbursement requests and manages the event reporting systems including, tracking and analyzing for trends of events and claims.
Maintains legal files, updates claim reporting system, and prepares applicable reports. Proactively reviews, assesses, and makes recommendations for changes to NCH systems to mitigate risks.
Ensures compliance with the provisions of the Safe Medical Device Act, participates in safety huddles, and develops a coordinated approach to patient and family complaints.
Analyzes legal documents, information, and reports in preparation for discovery, serves as liaison in coordination of litigation-related discussions, attends preparatory meetings for depositions, mediations, or trials, and prepares correspondence regarding claims and investigations.
Engages with leadership on risk management issues and trends, represents Legal Services on hospital task forces, and educates employees on various risk issues, including best practices in documentation.
Collaborates on safety initiatives including determining if an event is a Serious Safety Event (SSE). Maintains awareness of current healthcare risk management and legislative activities by participating in local and national professional societies.

Education Requirement:

Bachelor's Degree in relevant field, or equivalent experience, required.

Licensure Requirement:

Nursing License in the State of Ohio, required.

Certifications:

(not specified)

Skills:

Ability to review and analyze data for trends and present findings effectively and efficiently.
Excellent verbal and written communication skills.
Strong critical thinking, leadership, and independent decision-making skills.
Superior judgement and discretion in the handling of very sensitive and confidential information.
Proficient in word processing and spreadsheet applications.

Experience:

Five years of clinical pediatric experience, required.

Experience with electronic medical record and event reporting systems, required.

Physical Requirements:

OCCASIONALLY: Bend/twist, Biohazard waste, Blood and/or Bodily Fluids, Chemicals/Medications, Climb stairs/ladder, Cold Temperatures, Communicable Diseases and/or Pathogens, Driving motor vehicles (work required) *additional testing may be required, Electricity, Flexing/extending of neck, Fume /Gases /Vapors, Hand use: grasping, gripping, turning, Hot Temperatures, Lifting / Carrying: 0-10 lbs, Lifting / Carrying: 11-20 lbs, Lifting / Carrying: 21-40 lbs, Lifting / Carrying: 41-60 lbs, Lifting / Carrying: 61-100 lbs, Loud Noises, Machinery, Patient Equipment, Power Tools, Pushing / Pulling: 0-25 lbs, Pushing / Pulling: 100 lbs or greater with assistance, Pushing / Pulling: 26-40 lbs, Pushing / Pulling: 41-60 lbs, Pushing / Pulling: 61-100 lbs, Reaching above shoulder, Squat/kneel, Standing, Walking, Working at Heights, Working Outdoors

FREQUENTLY: (none specified)

CONTINUOUSLY: Audible speech, Color vision, Computer skills, Decision Making, Depth perception, Hearing acuity, Interpreting Data, Peripheral vision, Problem solving, Repetitive hand/arm use, Seeing – Far/near, Sitting

Additional Physical Requirements performed but not listed above:

"The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"