Providence Health & Services Manager Risk Management South Bay Community in San Pedro, California
Providence is calling a Manager Risk Management South Bay Community (Full-Time/Day Shift) to Providence Little Company of Mary Medical Center in San Pedro, CA.
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We are seeking a Manager Risk Management South Bay Community who will provide day to day operational leadership for risk management, privacy, and compliance issues across the South Bay Community. The Clinical Risk Manager may be primarily located at one of the acute ministries within the South Bay (San Pedro or Torrance) but will be expected to work throughout the continuum of the South Bay Community in addition to supporting any assigned regional departments in the service area. Analyzes risk management data, leads facility wide projects, prepares claims files (med mal, auto, property and general liability insurance), works with claims and legal counsel in case management, assists in determining claims causation, provides education to the facility relating to risk, regulatory compliance, and supports compliance with applicable regulatory agencies and the Joint Commission.
The manager will work very closely with the other South Bay Clinical Risk Manager(s) and Risk Specialist(s) ensuring risk management functions are consistent, effective, and efficient while collectively ensuring best practices are being used for the South Bay Community.
The South Bay Community consists of two general acute care hospitals, two post-acute skilled nursing facilities, acute rehab, acute and outpatient psych, chemical dependency recovery and several affiliated off-site locations.
On a rotating basis with other risk management designated individuals, provide 24x7 call coverage for the South Bay Community and other assigned areas which may include physically being present at the facility during off-hours, weekends, and/or holidays.
In this position you will:
Development and maintenance of appropriate and necessary departmental policies, procedures, objectives, and activities relating to improving organization performance.
Directs the work of the risk specialist(s) to ensure department needs and expectations are being met.
Provides investigative support for all activities regarding actual or alleged Medical Center liability (not including Workers' Compensation) relative to patients, employees, physicians, and visitors. Ensures Executive Director is kept apprised of status of discovery and investigations.
Ensures appropriate executive leadership, in conjunction with the Executive Director, are kept apprised of status of litigation, and, when needed, obtain authorization for payment of monies to settle claims.
May be required to attend legal proceedings as a representative on behalf of the organization in conjunction with legal counsel.
Act as a liaison, on behalf of the Executive Director, between respective PSJH enterprise risk management, integrity, compliance, privacy, and/or legal departments.
May act as a delegate of the Executive Director at internal and external meetings.
Coordinates insurance new/renewal activities and submits the required documentation.
Provides support for regulatory agency survey and reporting activities, including CDPH, DMH, DHS, CMS, FDA and the Joint Commission in collaboration with the regulatory program manager(s).
Coordinates mandatory and statutory reporting to licensing, accrediting, and other governmental bodies under the direction of the Executive Director. This may include, but not limited to, sentinel events, health & safety code reportable events, unusual occurrences, and workplace violence reporting, etc.
Prepares and submits appropriate facility licensing documentation in collaboration with the regulatory program manager(s).
Completes “pre-surveys” ensuring facility compliance. Inspections may include internal and external facility inspections. (roof, grounds, basement, etc.).
Provides investigative and other support for event analysis (Root Cause Analysis, Intense Analysis, Failure Mode Effect Analysis).
Coordinates facility-wide communication of lessons learned and improvements from event analysis (RCA, IA, and FMEA) in collaboration with regulatory and/or patient safety program manager(s).
Under the supervision of the Executive Director, acts as facility Super User of Unusual Occurrence Report system, assigning permission levels to managers/others, reviewing and analyzing UOR submissions, and prepares quarterly summaries of UOR data for Leadership and committee support.
Works to reduce facility risks and promotes patient safety.
Participates in hospital/medical staff committee meetings and Medical Center as required. Attends and serves on professional/civic service organizations as hospital representative.
Interacts with legal counsel and insurance claims representatives. Collaborates to determine event causation, claim worth, mediation, completion of discovery and interrogatories.
Manage the claims process for those actions that are not covered under the self-insured trust.
Responds to high risk complaints and grievances.
Coordinates Physicain Peer Review:
Performs case findings per Interdisciplinary/Departmental Specific, Medical Staff Indicators for peer review in collaboration with the quality department.
Assigns peer review cases to appropriate Medical Staff reviewers and monitors progression of case through committees until completion.
Maintains database of peer review records and develops and designs reports and queries to support committee needs.
Prepares summaries of peer review data for the Executive Director, Clinical Risk Manager(s), Leadership, Medical Staff, Board, and other committees as necessary.
Keeps Clinical Risk Manager(s), Executive Director, Chief Medical Officer and Medical Staff Officers apprised of status of peer review cases and any issues that may exist.
Attends hospital and medical staff committee meetings as required.
Enhances professional growth and development through participation in educational programs, professional affiliations, current literature, in-service meetings, and workshops.
Willingly performs other related duties outside immediate work area as assigned or required.
Required qualifications for this position includes:
Knowledge of national healthcare trends, multi-disciplinary professional practice models, information systems, quality management, and customer service needs.
Knowledge of the fundamentals of risk management, privacy, compliance, patient safety and/or performance improvement.
Knowledge of regulatory requirement, state and federal laws.
Work efficiently and effectively in a matrix structured environment.
Must possess strong presentation and interpersonal skills that display a presence of relevant knowledge in a wide range of settings.
Must possess skills and understanding of hospital clinical healthcare operations and quality data management.
Quality and Safety skills.
Driving improvement skills.
Patient Experience skills.
Risk Assessment skills.
Conflict Resolution skills.
Staff Development skills.
Efficiently problem solve, while dealing with a diverse set of systems and individuals.
Ability to interact effectively with physicians, patients and employees at all levels of the organizational hierarchy.
Ability to maintain good working relationships, both inter- and intra-departmentally.
Ability to manage sensitive and confidential issues.
Ability to respond to multiple duties simultaneously.
Ability to meet strict deadlines.
Preferred qualifications for this position includes:
Bachelor's Degree in Science or Nursing or equivalent educ/experience
Current California Registered Nurse License, or equivalent or higher level licensure
Certified Professional in Healthcare Risk Management (CPHRM)
5 years Acute care experience
Hospital operations experience
About the hospital you will serve:
Providence Little Company of Mary Medical Center San Pedro is a 259-bed nonprofit hospital that has served the Harbor and greater South Bay communities since 1925. Our Medical Center offers a comprehensive array of medical and surgical services each distinguished by innovation, quality and excellence in its respective area. We received the CHART “Certificate of Excellence” for receiving superior or above average results across the majority of outcomes and process measures publicly reported by CHART. We ranked in the top 21 among more than 240 hospitals throughout the state compared by California Healthcare Foundation, and were the first location in the South Bay to carry the Gold Seal of Approval® from The Joint Commission for Primary Stroke Centers. As a member of Providence, we are continually driven by the caring tradition of our heritage – the foundation of our Mission and core values – to embrace compassion, dignity, justice, excellence and integrity. Providence today celebrates unprecedented growth, recognition for top quality health care, a vibrant employee culture where new ideas are encouraged and a drive to help the underprivileged - all with an eye toward the future.
We offer comprehensive, best-in-class benefits to our caregivers. For more information, visit
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Non-Clinical Lead/Supervisor/Manager
Location: California-San Pedro
Req ID: 316017