Risk Manager - Hybrid in Worcester, MA

UnitedHealth Group•Worcester, MA

3d•Hybrid

About The Position

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. Under the direction of the Senior Manager, Risk Management, Optum Massachusetts. The Risk Manager provides day-to-day risk management and patient safety support across the organization, to create and sustain a culture of safety. The Risk Manager functions as an expert in matters of patient safety, event reporting, analysis and education. Assists all employees with the review of the safety events; analyzes trends in safety event reporting, conducts event reporting investigations and completes Root Cause Analysis, as needed. Assists in the design and implementation of strategies to increase and improve event reporting to identify system related issues that adversely affect patient safety. The Risk Managers primary responsibilities include but is not limited to, daily management of the electronic safety event reporting system (RLDatix), performs a variety of duties related to data input, analysis, trending and tracking claims and risk management information. This position follows a hybrid schedule with two in-office days per week.

Requirements

3+ years of healthcare experience
EMR experience
Ability to review and synthesize data and present data and strategy to a large group of diverse individuals
Demonstrated ability to conduct moderate level statistical analysis
Proficiency with Microsoft Office software((Microsoft Word, Excel, PowerPoint and Access)
Ability to travel up 10%25 within MA
Driver’s license and access to reliable transportation

Nice To Haves

3+ years of healthcare risk management experience
Healthcare risk and quality improvement and patient safety experience
Epic experience
Electronic event reporting experience
Basic command of RCA, FMEA and other risk management and quality improvement techniques
Demonstrated ability to formulate data correlations to determine drivers of healthcare risk

Responsibilities

Establish and lead an atmosphere of Just Culture
Serves as a point of contact for all providers, managers and staff, handling all risk management issues, offering advice, and coordinating investigations
Utilizes the web‑based safety event reporting system (RLDatix) to regularly review and triage safety events for appropriate site and department follow‑up and resolution
Verifies initial event data, reviews for escalated criteria, charts and documents that need to be escalated
Reviews all documentation of the department and site level reviews, assesses preventability and severity For event closures, codes events according to the Optum national required standards
Monitors, analyzes and evaluates data to identify safety event trends and researches problem areas identified
Interacts and consults with department and site leadership to gain an understanding of factors that affect the data and possible sources of variation
Provides recommendations in the planning of a systematic organization‑wide approach to continuous patient safety improvement
Works with clinical sites to plan, coordinate and evaluate corrective action plans recommended by internal committee, the Senior Manager Risk Management and or the Director Risk and Quality Management
Collects, evaluates and distributes relevant data concerning patient injuries aggregate data summaries monthly quarterly trends provides aggregate analysis of risk data and trending of losses etc
Assists daily in the initiation of patient safety related strategies to ensure the delivery of high‑quality care within the organization
Identifies and reviews all PCEs follows all recommended reporting requirements and hands off all incidents for a Quality Peer Review as identified
Complies with health and safety requirements and with regulatory agencies such as DPH MSDS BORIM BORIN FDA etc
Complies with established organizational policies departmental policies procedures and objectives
Collaborates with the Senior Manager Risk Management and the Director Risk and Quality Management to proactively identify risk reduction opportunities and to design and implement risk mitigation interventions
Facilitates Root Cause Analyses and supports multidisciplinary teams to address identified vulnerabilities within the system of care
Designs and presents effective patient safety education programs and performance improvement projects for staff and clinicians based on the needs of the site as needed to educate provide awareness influence and enhance a culture of safety in the ambulatory setting
Participate in Risk Management site visits
Analyzes trends in safety metric performance and identifies opportunities for improvement
Participates in internal organizational meetings representing the Risk Management Department
Appropriately create or revise new or existing policies and procedures to reduce the frequency of future occurrences recommends ways to minimize risks through system changes reviews and revises facility policies as appropriate to maintain adherence to current standards and requirements
Assist in the revision of and development of new department specific and organizational consent forms
Enhances professional growth and development through educational programs seminars certifications etc
Attends a variety of meetings conferences and seminars as required or directed
Regularly exercises independent judgment and decision making on allocation of time and resources to perform job duties
Performs other duties as assigned by Senior Manager Risk Management and or the Director Risk and Quality Management