Risk Management Specialist
Medical Mutual Liability Insurance Society of Maryland Hunt Valley, Maryland
If you have an interest in improving healthcare quality and providing risk management consultative services, Medical Mutual is seeking a motivated, organized individual to join its Risk Management team.
- Assists in the development and presentation of accredited risk management programs and materials including live, computer-based, and web-based programs
- Communicates directly with Insureds and their staff to provide risk management issues of varying complexity, including matters related to health care practice compliance, safety and security protocols, including information security, and current risk management trends
- Presents risk management strategies at continuing education programs or other healthcare-related group programs/presentations
- Participates in projects as assigned to achieve corporate and departmental business goals
- Bachelor’s degree required
- 1-3 years’ experience in a health-related, insurance, or legal field
- Experience in healthcare risk management, medical quality assurance, or medical malpractice claims handling preferred
- Excellent verbal, writing, and presentation skills
- Functions comfortably with Microsoft Office and able to learn new technologies and software as required
- A valid driver’s license required
- Occasional travel required
- Ability to prioritize and work independently and in a team environment
- Ability to work in company’s office in Hunt Valley, Maryland
Medical Mutual Liability Insurance Society of Maryland, a physician-owned medical malpractice liability insurance carrier, is headquartered in Hunt Valley, Maryland. Excellent benefit package includes health and dental insurance, 401k plan, vacation, and sick leave.
Email resume and cover letter: firstname.lastname@example.org
Senior Risk Manager
Kaiser Permanente Rockville Maryland
Collaborates and develops a proactive risk management program to prevent or minimize losses in KPMAS Region. Manages, organizes, and assists with the implementation of the Regional Risk Management Program and related activities. Provides basic and complex preventive risk management assessment of processes, procedures, and programs, including education, consultation, and liaison activities. Initiates, coordinates, and manages all investigational and evaluation activities associated with professional and general liability occurrences. Identifies and manages actual or potential sources of financial loss arising from injury to the person, property, or reputation of KPMAS. Actively monitors Medical Device/Equipment Recalls and develops and coordinates response efforts. Functions as a key member of the Threat Management team. Acts to provide fair and equitable solutions to member disputes, suggesting dispute resolution processes for addressing and managing conflict, and determines appropriate reimbursements/payments under program guidelines. Serves to improve patient safety and enhance relations, build trust, and acts as a trusted information resource, facilitator, consultant and practitioner.
- Plans and organizes the development of effective methods for reporting of occurrences and near-misses by provider and staff through various sources, including medical records, outside medical settings such as hospitals,medical centers, security, quality management, etc.
- Plans and organizes the development and maintenance of a risk management database to facilitate trending and preparation of risk management analyses identifying opportunities for improvement, improvement actions taken, and follow-up to evaluate compliance and efficacy.
- Provide consultation, advice, resolution for medical/legal issues in a manner consistent with applicable KPMAS policies, State and Federal laws, regulations, patient rights and professional ethics. Provides risk management expertise to support the reduction of preventable errors in health care delivery.
- Conducts thorough and timely PCE investigations. Collaborates with Director and other leaders to implement Early Resolution with members and/or their representatives as indicated. Collaborates with Regional Claims Manager for successful management and disposition of pre-suit claims. Serves as a departmental resource for these processes.
- Investigates and analyzes actual and potential risks on a proactive and preventive basis; develops and maintains a mechanism to receive and disseminate safety alerts; and works with biomedical engineering to investigate reports of product and equipment problems to determine appropriate response and coordination of medical device tracking and reporting efforts.
- Coordinates Significant Event reporting. Works with departments to complete root cause analysis and implement corrective actions when needed. Collaborates with physicians and departments to develop strategies when communicating with members after adverse events.
- Assesses the need for risk management related education and coordinates the development, completion and evaluation of these programs with the appropriate departments such as new employee orientation, infection control, etc.
- Monitors new practices to identify additional risk and assist departments in minimizing and avoiding liability.
- Develops educational and training programs for providers and staff regarding risk trends and avoidance. Develops methods to monitor the impact of this training.
- Develops structures to keep the organization in compliance with accreditation standards, federal and state laws and regulations, and KPs internal requirements related to risk management. Communicates findings and risk prevention strategies to regional providers and staff.
- Assists other KP departments in complying with accreditation and regulatory risk management standards,i.e.policies and procedures, legal claims manager, etc.
- Coordinates the implementation of rapid response mechanisms and situation management procedures for onsite patient and/or member issues.
- Partners with other departments such as Quality Management, Patient Safety, Operations, Customer Service Call Center, Member Services, EH&S, and Security in the identification and response to risk threats.
- As part of the Threat Management Team, responsible for receiving, validating, interpreting, responding to, and managing threats. Develop intervention plans that protects KP and its members and addresses and mitigates conflicts that precipitated the threat. Document the threat assessment process allowing for confidentiality in accordance with privacy requirements and other KP policies. Conduct an after-action review/debrief process.
- Develops and maintains a mechanism to receive and disseminate safety alerts, medical device/equipment recalls, and coordinate appropriate tracking, response, and reporting efforts.
- Requires Risk Manager on-call duties
- Other Duties as assigned
- Minimum five (5) years of direct experience in the direction, management and analysis of patient safety/risk management data, quality, and patient safety in health care/managed care fields required.
- Minimum five (5) years of clinical healthcare experience
- Minimum three (3) years of experience with federal and state laws and regulations
- Minimum three (3) years of experience with early resolution, mediation, or dispute resolution
- Bachelors degree in nursing or other health related field required.
License, Certification, Registration
- This job requires credentials from multiple states. Credentials from the primary work state are required before hire. Additional Credentials from the secondary work state(s) are required post hire.Registered Nurse License (Maryland) within 6 months of hire AND Registered Nurse License (Virginia) within 6 months of hire
- Compact License: Registered Nurse within 6 months of hire
- Registered Nurse License (District of Columbia) within 6 months of hire
- Professional in Healthcare Risk Management Certificate within 6 months of hire
- Proficient in computer applications including Microsoft Office Suite required.
- Strong interpersonal skills, with good verbal and written communication skills required.
- Skills in problem-solving and collaboration with other professions/ disciplines required.
- Skill and experience in organizational change management required.
- Demonstrated leadership skills required.
- Knowledge of legal issues and State and Federal Laws
- Knowledge of compliance and accreditation standards
- Data management and interpretation, effective communication skills
- Strong assessment and analytical skills necessary.
- Early Resolution, mediation, or Ombudsman experience preferred.
- Experience with Threat Management or patient/customer negotiation strategies preferred.
- Masters degree in related field preferred.
- Knowledge of Kaiser Permanente preferred.
- Advanced Proficiency with MIDAS+ reporting system preferred.
- Completed coursework in Early Resolution or Mediation preferred.
Primary Location: Maryland, Rockville, Rockville Regional Offices
- Scheduled Weekly Hours: 40
- Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri
- Working Hours Start: 08:00 AM
- Working Hours End: 05:00 PM
- Job Schedule: Full-time
- Job Type: Standard
- Employee Status: Regular Employee
- Group/Union Affiliation: NUE-MAS-01|NUE|Non Union Employee
- Job Level: Individual Contributor
- Department: Regional Office – Rgnl Risk Management – 1808
- Travel: Yes, 25 % of the Time
Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.
Risk Manager I
UM BMWC and UM Shore Regional Health Baltimore, MD
The Risk Manager I will support UM BWMC and UM Shore Regional Health. Work location will vary between the hospitals and 250 W. Pratt St in downtown Baltimore as needed.
Performs the investigation of adverse events, near misses, and potential claims and suits and actively participates in developing and implementing loss prevention methodologies and patient safety initiatives in certain designated areas or entities. This includes gathering and analyzing data and preparing reports as well as keeping the management informed about significant developments; and other duties as assigned.
EDUCATION and/or EXPERIENCE
- Bachelor’s degree or in clinical health care with Master’s preferred
- Three to five years nursing and/or other clinical experience required in special care units, ICU’s, ER, Shock Trauma, etc. Other clinical experience may be acceptable such as chronic or rehab care based on assigned areas or responsibility
- Previous experience in risk management, patient safety or quality assurance preferred
- Paralegal knowledge also an asset
MedStar Harbor Hospital 3001 S Hanover St, Baltimore, MD 21225
- Coordinates the review and investigation of occurrences and potentially compensable events. Assists legal counsel in the preparation of defense for liability suits. Assists in maintaining a hospital-wide awareness of patient and associate safety, risk management, and quality review.
- Bachelor’s degree in Business or healthcare field.
- 2 years risk management experience in hospital or insurance field. Nursing background a plus.
- No special certification, registration or license required.
Knowledge, Skills & Abilities
- Verbal and written communication skills. Basic computer skills preferred.
Primary Duties and Responsibilities
- Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards and safety standards. Complies with governmental and accreditation regulations.
- Coordinates a patient complaint system to centralize the data collection and maintenance of information.
- Defines and activates reporting procedures to facilitate the notification to administration of all significant patient, visitor, or product incidents.
- Develops internal controls to reduce financial losses associated with claims, decreasing the number, frequency, and severity of claims.
- Ensures effective patient and family communications related to patient care and safety problems to enhance the hospital’s community relations image and consumer confidence.
- Ensures that quality standards are maintained related to all incidents through review, analysis, and follow-up studies to improve patient care.
- Establishes an effective patient and visitor incident reporting system with specific reporting and guidelines in high-risk departments, specialties, and other departments.
- Identifies and corrects potential risks in an effort to reduce and prevent potential injuries or losses. Participates in risk identification and control programs.
- Participates in meetings and on committees and represents the department and hospital in community outreach efforts as required.
- Performs other duties as assigned.
- Prepares and presents risk management educational programs.
- Provides necessary statistical reports and other related information as required by hospital and medical staff. Prepares, reviews, and maintains claim files.