Job Summary: The position reports directly to the Director of Quality Improvement(DQI). Position usually requires frequent contact with patients and/or with professional and/or supportive personnel who provide patient care. Applicant must be able to deal effectively with a variety of people, work as a team member, exercise good judgment, and maintain a friendly and positive attitude at all time. Coordinate the processes involved in managing general liability and risk exposures for a healthcare facility and may be called on to: Investigate patient complaints and medical malpractice claims.
- Functions as the lead manager, coordinator, and point of contact for risk management policies and activities.
- Responsible for developing and implementing a systematic approach for managing and minimizing risk throughout the clinic.
- Manages the data needs and information flow for the program.
- Develops guidelines, recommendations, or implements process improvements to address high areas of vulnerability within the organization.
- Responsible for developing a systematic approach to assessing and improving organizational processes as well as ensuring the development of appropriate policies.
- Conducts reviews of policies, procedures, OSHA directives and guidelines to recommend changes and prioritization of performance improvement and risk management activities.
- Performs ongoing education to staff based on changes in the appropriate standards and requirement of medical/dental center processes.
- Works with the DQI and/or Chief Operations Officer (COO) and departments delegates to help provide risk management training, knowledge, and skills to clinical staff and other trainees.
- Implements, coordinates, and updates the organization risk management program.
- Conducts special assignments as delegated by the COO and may participate or lead organization committees, teams, etc., as a quality management representative.
- Performs a variety of duties related to managing potential risks and liabilities within their facility. This includes creating and implementing policies that improve both patient care and employee safety. Educating and training staff about potential risks is also a core responsibility of this job. Risk managers may also work with the health center's legal counsel in situations of medical malpractice or workers' compensation claims.
- Work daily with other staff to assess potential risks. They may take phone calls about patient complaints or accusations of abuse or negligence. Data is also collected and is accessed to identify problems or weaknesses in health center procedures. The health care risk manager must further draft and submit accident reports to the appropriate persons and agencies.
- Depending upon the circumstances, health care risk managers may report to the health center's legal counsel, quality director, or an executive officer such as the Chief Executive Officer or Chief Operation Officer.
- In addition, the position ensures that legal aspects of medical records practices, release of information, and health center responsibility for confidentiality and privacy are being met.
- Other work related duties as directed by the Director of Quality Improvement or COO. These additional duties can either be verbal or in writing.
- The intent of this job description is to provide a representative and level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform job-related tasks other than those specifically presented in this description.
Qualifications, Education, and Experience:
- EDUCATION: Bachelor's degree in a related field is required (e.g., health care administration, accounting, finance, insurance or law). Individual with no college degree will be evaluated on case to case basis. Each two years of related experience will be substituted for one year of college.
- EXPERIENCE: Must have at least 3 years of experience in a medical setting of which 1 year in a supervisory role.
- CERTIFICATION: American Society for Healthcare Risk Management affiliation preferred
- Knowledge is required of health center policies and procedures, as well as governmental regulations. Consequently, a nursing or other medical background is also good preparation for this job.
- Must have knowledge of:
- Registration procedure concepts
- ICD-9 and CPT Codes
- Payer Codes/ Sources
- Insurance Verification
- Basic supervisory/management skills
- Customer relations
- Program requirements: CHDP, Family Planning, Medi-Cal, Medi-Cal Managed Care, Medicare, HMOs, or PPOs, sliding fee scale, etc.
- Ability to work under pressure.
- Ability and willingness to train staff in customer service as well as protocols/ procedures in front office, billing and customer service.
- Ability to handle multi-functions.
- Promotes and believes in Omni’s mission statement.
- Ability to relate to the public regardless of ethnic, religious and economic status.
- Must be willing to work at any Omni Family Health location, other that the assigned site and be agreeable to work weekends, if so needed.
- Must demonstrate excellent telephone skills. Must demonstrate excellent communication skills with staff and clientele.
- Skills in using practice management software, spreadsheets and other computer software programs.
- Ability to organize and set priorities in order to function in a professional manner.
- Skills in meeting deadlines.
- Ability to communicate and maintain an effective working relationship with staff and providers
- Ability to operate independently, supervise personnel and train business unit personnel when necessary.
Responsible To: Director of Quality Improvement
Classification: Full Time Position, Exempt