This position provides leadership and direction for Risk Management within the CHRISTUS Physicians Group (CPG) which includes primary care and other specialty clinics, and urgent care centers. In collaboration with the CPG Director of Quality, Chief Nurse and CPG Leadership, Responsible for supporting a culture consistent with the CHRISTUS Mission, Core Values and Code of Ethics by planning, designing, implementing and maintaining the CPG risk management program, policies, and procedures. This position will lead initiatives in order to foster a culture of safety, where sound risk management practices are implemented. As risk manager, this position facilitates the identification and reporting of events that exposes CPG to liability and risk, and leads efforts to address and reduce organizational risks.
Function as CPG Risk Manager responsible for Risk Management of clinics, urgent care centers and potentially other practice sites acquired ambulatory practice sites.
Builds and manages a standardized variance reporting program
Enter events into a tracking data base to assist CHRISTUS Claims Management Section of the Legal Department in resolving claims and to monitor trends
Work with CPG Director of Quality or Designee to manage clinical practice variance and drive patient safety, including conducting investigations, implementing process improvements, building sustainable structure, writing and implementing policy/procedure guidance.
Prepare Quarterly Risk event reporting for CPG Quality Board
Track and notify CPG Compliance team of complaints against providers
Work with CPG Medical Director and Physician Leaders and Legal Department to investigate and resolve medical practice issues
Work effectively when required with CPG Legal Advisor to resolve issues, define new structure, formulate and implement new policies, forms or procedures
Timely reporting of potentially compensable events including professional and general liability, employment, physician credentialing disputes and breach of contract claims.
Communicate with known or potentially injured parties and/or their representative to facilitate satisfactory resolution of concerns and complaints.
Immediately notify the CHRISTUS Claims Management Section of the Legal Department upon receipt of an attorney assertion, petition, complaint, Medical Review Panel complaint, or subpoena.
Report any event that is believed to be a sentinel event to the System Clinical Loss Prevention Manager. Gather all information necessary to evaluate potential claims. Secure medical records and documents.
Work with the CHRISTUS Regional Claims Managers to complete the factual investigation and interviews of pertinent associates/witnesses.
Preserve all evidence pertaining to potential or asserted claims in a locked and secured place. Maintain log of evidence.
Manage a timely response to requests for document collection during the discovery phase of litigation; monitor claims to ensure compliance with all discovery demands and timetables.
Facilitate and coordinate attorney requests for scheduling associate interviews, depositions, and witness preparation for trial. Use event, claim and suit information to initiate or support facility or CPG safety, quality, and loss control programs.
Serves on appropriate facility committees and maintains appropriate organizational links to ensure appropriate loss prevention efforts in the facility.
Coordinate facility representation at trial. Attend trials, if necessary, and provides trial updates to facility leadership.
Responsible for performance management, hiring, and termination of associates under organizational structure
Bachelor's degree required.
Graduation from an accredited school of nursing
Strong interpersonal skills, including the ability to interact effectively across multidisciplinary teams including Physicians, Nurses, Medical practice staff, Corporate Leaders, Board Members and Patients, and regional CPG associates.
Ability to work autonomously, making independent decisions as necessary.
Effective skills in driving effective, sustainable change across large groups both through virtual and face to face methods.
Flexible, creative and motivated by challenges.
Ability to initiate, coordinate and follow multiple projects, tracking and reporting data through to completion.
Excellent analytical, written and oral communication skills.
Excellent spreadsheet, internet, Power Point and word processing skills.
Ability to work in a rapidly changing and stressful environment.
Experience working with physician practices and procedures as well as laws, regulations, and guidelines pertaining to healthcare.
Other duties as reasonable and necessary.
Minimum of 5 years RN experience.
Health care clinical risk management or clinical quality experience.
RN licensure in Texas required
Certified Professional in Healthcare Risk Manager (CPHRM) or Associate of Risk Management (ARM) certification preferred
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.