Clinical Risk Manager

Company: WellStar Health System
Location: Marietta
Posted on: January 12, 2021

Job Description:

At WellStar, we all share common goals. That's what makes us so successful - and such an integral part of our communities. We want the same things, for our organization, for our patients, and for our colleagues. As the--most integrated healthcare provider--in Georgia, this means we pride ourselves on investing in the communities that we serve. We continue to provide innovative care models, focused on improving quality and access to healthcare.Responsibilities Functions under the supervision of the Executive Director of Risk Management to support the broad vision and mission of WellStar Health System. Acts under the Executive Director of Risk Management to accomplish the department's mission to optimize patient and staff safety and reduce the adverse consequences of accidental loss through protective risk financing, effective loss prevention and successful claims management. Assists the Executive Director of RM in the establishment, direction and management of a structured HPL/GL insurance program for WellStar insured entities. Collaborates with and supports the Executive Director and leadership (AVP, EVP, Board) by providing information and data to facilitate decisions regarding insurance renewal and risk program financing. Utilizes and supports the CS STARS system for the reporting, investigation, and filing of adverse events. Reviews incidents on receipt and conducts appropriate follow-up. Actively assists in the investigation of risks identified through incident reporting and development/communication of corrective action recommendations to senior leadership. With Executive Director oversight, manages claims/lawsuits and monitors litigation involving assigned WellStar entities.Job Requirements:Required Minimum Education: Bachelor's degree required; BSN preferred. Required Minimum Experience: RN or clinician with at least two years clinical experience. Additionally, two years medical claims experience and/or risk management/quality assurance principles in the healthcare setting. Working knowledge of the medical/legal process, professional liability insurance, claims administration and insurance program management in healthcare. Required Minimum Certification: One of the following strongly preferred: Current GA licensure a registered nurse, Claims Adjuster, Certified Professional in Healthcare Risk Management or Certified Legal Nurse Consultant. Required Minimum Skills: Intermediate computer skills including Microsoft Word, Excel and PowerPoint. Must be self-motivating and capable of effectively communicating with physicians, patients, staff and attorneys. Ability to interface with all levels of the healthcare system and utilize discretion in handling confidential information.

Keywords: WellStar Health System, Marietta , Clinical Risk Manager, Executive , Marietta, Georgia