Clinical Risk Manager/ Quality Coordinator

JOB DESCRIPTION

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Position: Clinical Risk Manager

Reports to: Chief Nursing Officer 

Department: Administration 

Status: Full-time/Exempt

Classification: Permanent

EEO Code: Professional

DEPAUL COMMUNITY HEALTH CORE VALUES:

• Service of the Poor – Employee demonstrates generosity of spirit, especially for persons most in need
• Reverence – Employee demonstrates respect and compassion for the dignity and diversity of life
• Integrity – Employee inspires trust through personal leadership
• Wisdom – Employee integrates excellence and stewardship into execution of job duties
• Creativity – Employee demonstrates courageous innovation
• Dedication – Employee affirms the hope and joy of the Daughters of Charity mission

GENERAL JOB DESCRIPTION

The Director/Coordinator Quality and Risk Management (QM/RM) works in partnership with the Chief Nursing Officer and reports directly to the Chief Medical Officer with matrixed accountability to the Chief Operating Officer. This position is responsible for the Coordination of Quality Improvement program and Risk Management. The Quality Management will be responsible for training, feedback and interventions with access and clinical teams to provide the highest quality care, outcomes, and satisfaction of all active patients.

“The clinical risk manager manages the operation of the organization-wide risk management and patient safety programs and provides guidance to clinical staff. The risk manager develops and maintains systems within the organization to detect, monitor, prevent, organize, measure, investigate, report, and manage patient adverse events, incident reports, and other indicators of potential patient harm. The organization’s key aims in this area are to be on the leading edge of improving health outcomes and service, increasing patient safety, and reducing error in healthcare processes. This position will be vital to accomplishing these objectives.”

 DUTIES & RESPONSIBILITES

Management of Quality Improvement program

Work with leadership team to develop and implement health care plan for UDS measures required by HRSA, as well as other key measures of quality, access, or satisfaction that may be chosen by organization

Develop and implement training program for both clinical and support staff on the tools used in the Quality Improvement program, in conjunction with Ascension Health’s Aim4Excellence program and other resources that may become available.

Work with information systems to provide teams with reliable actionable feedback and data on their historical performance by organization, team, and individual on identified measures; 

Work with organizational and site-specific teams to optimize workflow to achieve identified goals, as well as secondary process measures that may be needed to assure adherence to the model.

Key Interventions:

• Oversees outreach to patients who are overdue for preventive services and chronic illness care.
• Provides maintenance of CDS functions in EMR [alerts, order sets, workflows] to ensure that gaps are closed during visits.

Collaborates with Integrated Care Team to ensure that each member is empowered to provide highest level of care to patient

The clinical risk manager is responsible for promoting the development and implementation of the facility risk management program including the following:

1. Proactively evaluate areas of organizational risk based on internal assessment and external benchmarking and implement strategies and policies that promote patient and staff safety.
2. Promote the occurrence reporting process including trending and reporting of results, identification of problem-prone areas, and facilitation of prevention initiatives.
3. Direct the investigation of all potentially compensable events (preventable adverse events).
4. Lead the review of serious incidents requiring root-cause analysis or failure mode and effects analysis. Disseminate lessons learned and process improvement plans.
5. Meet regularly with leadership to provide detailed reports on all serious incidents and risk-related issues.
6. Respond to sentinel events and other serious incidents and provide advice on the management and reporting of such events to administrative and clinical leadership and staff.
7. Conduct immediate/appropriate response to any serious occurrence/complaint representing actual or potential patient, visitor, or associate injury. Monitor and take subsequent actions to ensure learning, compliance, and documentation 
8. Analyze all statistical reports and advisories that identify risk management and patient safety patterns and trends for leadership.

1. Keep up to date with new and revised state and federal regulations and statutes related to patient care. Review and evaluate related policies and procedures and recommend revisions as needed. Create new policies for approval, as needed.
2. Actively participate in a variety of committees as assigned.
3. Annually evaluate risk management and patient safety program for improvement opportunities.
4. Prepare Annual Risk Management report for submission to executive leadership, board committees and full board. 

PHYSICAL DEMANDS

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. This is largely a sedentary role, filing is required and some lifting, twisting, standing, bending will occur. 90% of work will require some sort of physical activity to be performed. Employee will be required to travel from time to time and must be willing to travel to various clinic work locations as events dictate

WORK ENVIRONMENT

This job operates in a professional office environment. According to the special event type, some work may be performed outside with varying temperatures.

MINIMUM QUALIFICATIONS

Required: bachelor’s Degree in a relevant field of study
 Five years in healthcare operations/ administration

PREFERRED QUALIFICATIONS

SPECIAL KNOWLEDGE, SKILLS, ABILITIES, TRAINING, OR SPECIAL LICENSES/CERTIFICATIONS NEEDED TO PERFORM YOUR JOB:

• Ability to work effectively with DCHC business colleagues, as well as with various types of clinicians, including physicians, nurses, and nurse practitioners in the field
• Ability to work effectively remotely
• Demonstrated success leading through influence and working in a matrixed environment
• Proactive, self-motivated and takes initiative; thinks two steps ahead and can effectively think through implications of key decisions
• Strategic thinker willing to solve complex problems
• Must be able to perform at a high level in a professional environment
• Meticulous attention to detail and strong organizational skills
• Demonstrated ability to communicate ideas clearly and concisely to leadership
• Demonstrated ability to prioritize and balance multiple priorities and projects
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Qualifications

• High-energy, organized, persistent, and creative individual with strong communications, interpersonal, and systems thinking skills.
• Proven management ability and experience including a thorough understanding of quality improvement (QI) processes, tools, and techniques; quality measurement and reporting; root cause analysis and preventive risk management strategies; accrediting bodies’ standards; and state and federal regulations. 
• Bachelor’s degree required with master’s preparation and risk management certification highly desirable. Clinical background desirable.
• Experience with standard Microsoft Office or related products required and experience in database management and systems development desired. 
• Knowledge of risk information management systems (RIMS).
• CPHQ Preferred

Ability to function effectively, independently, and efficiently in a stressful and dynamic work environment.