Program Manager, Risk

Job Summary :

Under the direction of the Regional Director, establishes, monitors and coordinates a comprehensive program of clinical and enterprise risk management functions that includes, but is not limited to risk identification, analysis, investigation, mitigation, prevention, control, education and consultation. Leads enterprise risk management activities and patient safety efforts at all acute and ambulatory care facilities for the Northwest region. Acts as a change agent to facilitate risk control and prevention through surveillance, education and participation in system / process re-design efforts.

Essential Responsibilities :

• Provide basic and complex preventive risk management assessment of processes, procedures, and programs, including in-service education, consultation, liaison activities and on-call emergency assistance to clinicians, managers and staff members. Minimize clinical, operational, financial and strategic risks through rounding in assigned KPNW facilities at least annually. Responsible for the implementation of risk management activities on a day-to-day basis to further the organizations overall enterprise risk goals.
• Collaborate with Quality, Patient Safety, Compliance and Operational departments to assist with Comprehensive System Analysis (CSA) for serious adverse and / or sentinel events and / or pro-active risk assessment. Participate in policy development and guidance to mitigate and prevent risks.
• Conduct periodic trend analysis of data sources to identify and communicate themes and high-risk processes / programs to key stakeholders and leadership teams as priority areas of focus. Act as a change agent to facilitate and influence risk reduction efforts with multidisciplinary improvement teams to develop system redesign in decreasing organizational risk. Monitor the progress and success of recommended actions and escalate challenges / barriers to senior leaders as appropriate.
• Partner with Program Manager for Claims Resolution and support the Professional & Public Liability (PPL) team with investigatory activities of adverse events involving serious harm or death that include, but not limited to conducting chart review, writing clinical summaries, triaging, and prioritizing events for Risk Management physician review. Consult with Risk Management physician to determine liability assessment and Potentially Compensable Event (PCE) designation and / or referral for quality review. Identify events for potential early resolution and collaborates with the Health Care Mediator who initiates contact with patient and family utilizing appropriate communication skills.
• Participate in the development and implementation of specific department goals and tactics consistent with the organizations strategic plan. Participate in improvement projects aligned with goals, tactics, and strategic plan. Ensure full and sustained implementation of process improvements. Other duties as assigned.
• Serve on regional / national committees and task forces to address specific issues and / or represent the department as assigned.
• Team with the Workplace Safety / Threat Management departments for Health Plan and Northwest Permanente Medical Group to address care plans for patients exhibiting unwanted or disruptive behaviors.
• Review and respond to Risk Escalations from Member Relations, including allegations of negligence, quality of care concerns, and allegations of abuse.
• Collaborate with Compliance and Quality & Patient Safety to investigate and respond to allegations of abuse, mistreatment, and discrimination.
• Assist physicians, managers, and executive leaders to investigate and respond to threats of litigation, allegations of negligence, and quality of care concerns.

Basic Qualifications :

Experience

Education

License, Certification, Registration

Additional Requirements :

Preferred Qualifications :

Strong project management skills or certification in Lean Sigma.< /