Risk Management Consultant

Description : Job Summary :

The Risk Mgmt Consultant is responsible for providing a broad range of administrative, facilitation and technical support functions, specifically in the area of Risk Management, Safety Event Review, Quality Improvement and Patient Safety programs and initiatives Under general supervision, develops implements and monitors events within the event reporting system.

Develops and monitors performance indicators / metrics for patient safety and risk mgmt. principles. Collaborates with appropriate departments to collect, analyze and trend data from multiple reporting systems / sources to identify opportunities to improve patient safety and decrease clinical risk.

Develops and coordinates workgroups and to address priority issues identified. Acts as a resource throughout the Region for issues related to reported risk events.

Supports the various committees coordinated or chaired by the department, e.g., Service Quality Resource Management, Risk Management Oversight, Committee, Safety System Oversight Committee, and the Quality Oversight Committee .

Ensures organizations compliance with accreditation and licensing standards, laws and regulations, and internal requirements related to quality and patient safety.

Essential Responsibilities :

Risk Management Program Objectives : Assist in the planning and execution of short and long term Risk Mgmt, Quality & Patient Safety Program initiatives in alignment with organizational goals, as outlined in the annual Trilogy documents.

Assures Quality & Patient Safety work plans and projects include clear measurable goals and monitors results. Communicate trended program measurement outcomes to appropriate business owners to implements process improvements.

Investigation of safety event or contracted facility harm incidents : Investigate quality of care incidents and near misses according to the departments established process flows for investigating the following categories of events : TSPMG or affiliated Practitioner, KPHP nursing staff, Provider Organizations (hospital, ambulatory surgical center), continuing care vendors, (skilled nursing facility, home health agency, durable medical equipment contractor, transplant facility), Kaiser Permanente Ancillary Services or region-owned facilities.

At least quarterly, produce trended reports, and communicate a clearly developed analysis for actionable interventions by the department or key business owners.

Compliance with Accreditation and Program Office Reporting : Assure periodic reports required for accreditation or Program Office are submitted in a timely manner.

Coordinate the completion of the annual Trilogy documents in collaboration with the Director of Accreditation. Assure maintenance of process flow for investigating CMS Hospital Acquired Conditions (for possible Do No Bill Event) in collaboration with the Claims and Quality Assurance Appeals and Audit Department.

• Committee / Work Group Support : Support and participate in quality committees coordinated / facilitated by the department, including Service Quality Resources Management, Safety Systems Steering Committee, Continuing Care Quality Oversight and / or Peer Review Committees.
• Training / Surveys : Responsible for coordination Risk and Patient Safety training, including the use of Simulation / Team STEPPS, Conduct periodic Environment of Care survey in Kaiser Permanente-owned sites in collaboration with the regions Nursing Department.

Participate in annual NCQA mock accreditation survey. May support Failure Mode and Effects Analysis for newly internalized services.

Basic Qualifications : Experience

Minimum five (5) years experience working in a clinical setting or provider organization.

Education

• Bachelors Degree in Nursing or similar clinical discipline OR four (4) years of experience in a directly related field.
• High School Diploma or General Education Development (GED) required.

License, Certification, Registration

Professional in Healthcare Risk Management Certificate within 18 months of hire OR Professional in Patient Safety Certificate within 18 months of hire

Additional Requirements :

• Ability to enter data into a database in order to collect information for analysis.
• Proven ability to analyze clinical / utilization / satisfaction data, organize data into understandable graphic displays, produce reports with committee / work group discussion and develop action plans to improve processes.
• Demonstrated skill in facilitating committee meetings or work group meetings.
• Proficient utilization of Microsoft applications : Work, Excel, PowerPoint to support analysis and display of data for continuous quality improvement.
• Excellent communication and presentation skills.

Preferred Qualifications :

• Minimum two (2) years of health care quality experience in a medical health plan, provider organization, federal or state agency or health care consulting / contracting firm practicing the concepts of continuous quality improvement and monitoring.
• Masters degree in Public Health, Analytics, Healthcare Administration Business Administration or a related field.
30+ days ago