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OhioHealth · 19 hours ago

Sr. Risk Consultant (RN)

RIVERSIDE METHODIST HOSPITAL

Full-time

Onsite

Senior Level

OhioHealth is a health system that believes in a lifelong partnership for wellness and sickness. The Senior Risk Consultant RN is responsible for risk assessment, analysis, prevention, and education activities to minimize losses and protect corporate assets, while engaging in patient complaint management and litigation support.

Health Care

Responsibilities

Meets with patients, families, visitors, as well as clinical, ancillary, & administrative staff, and physicians, to assist/consult with, or take a lead role as indicated, in confronting and managing serious patient and visitor complaints & grievances, typically alleging substandard, or inappropriate professional care and treatment ; investigates the validity of the complaint/claim, analyzes medical records, interviews associates as indicated, negotiates and manages resolution of complaints and claims while balancing corporate interests and service recovery ; consults with the Risk Manager for case management, and settlement authority in negotiating and settling patient claims

Analyzes all UORs & miscellaneous hospital reports on-line UORs, Attorney Requests for Medical Records, Quality variance reports, et c and identifies those having professional liability claim potential; initiates follow-up and/or investigative activities where indicated; reports significant findings to the Risk Manager, Legal, and Safety & Quality leadership; monitors for and reports significant UOR trends to

Monitors for and generates dedicated reports of Safety incidents; notifies designated management/ leadership personnel of significant findings; actively participates in follow-up and investigation of incidents, participates in all Safety Event meetings/Root Cause Analyses; participates in Disclosure discussions with patients & families as requested by Hospital Safety & Quality leadership; completes clinical chart reviews and presents case summary at monthly Reserves meeting for significant/serious incidents

Functions as the hospital/division liaison in assisting the General Counsel, in-house counsel, and external trial counsel with litigation-related activities; carries a litigation case load as assigned by the Legal department; completes clinical chart reviews and presents to the General Counsel for Reserving purposes; collaborates with and/or manages all requests for assistance from in-house counsel and external trial counsel in assisting with completion of interrogatories and production of documents requests, and other legal discovery activities as necessary; coordinates meetings between associates and trial counsel, schedules depositions of associates; attends/participates in litigation-related meetings & trial activities as delegated

Reviews, investigates, & analyzes general liability incidents & claims to determine the nature and extent of any hospital exposure/liability; in collaboration with the Risk Manager, Systems Director, and/or the General Counsel, for claims within the self-insured retention, is given authority to negotiate & settle claims; functions as the on-site insurance contact to capture data & submit claim reports for multiple other lines of casualty insurance coverage, i. e Property damage, fleet/auto accidents, pollution/contamination incidents; Assists the Risk Manager and Systems Director with data collection for the Corporations annual insurance renewal process; continually monitors the environment to identify issues having insurance coverage/ adverse exposure implications

Represents the Risk Management department at a wide variety of committee meetings including but not limited to, Safety, Security, Quality, Patient Safety, & Ethics and Compliance, and as a member of specialized task forces for the purpose of contributing perspectives/recommendations on Risk Exposure, Risk Reduction, and Risk Prevention

Ensures the delivery of both proactive and reactive Risk Management education and training to a wide variety of hospital & ambulatory audiences and venues, inclusive of clinical, medical, ancillary/support services, &administrative personnel; Takes an active role in developing customized Risk Management in-services/presentation materials; may be engaged as a public speaker at professional organization seminars, and at academic centers, and /or to provide shadowing experiences for students