Associate Risk Manager

University of Texas MD Anderson Cancer Center; Houston (TX); Remote; USD 85,000 - 128,000; Full time

Job summary

An established industry player is seeking an Associate Risk Manager to support its Risk Management program. This remote position demands expertise in reviewing complex claims, particularly in medical malpractice, and requires a Bachelor's degree in Nursing. The role involves providing guidance on patient care risk management, conducting thorough investigations, and preparing detailed reports. The ideal candidate will have substantial nursing experience and a passion for enhancing patient safety. Join a collaborative team dedicated to improving healthcare outcomes and making a significant impact in a dynamic environment.

Benefits

Relocation Assistance

Flexible Work Hours

Remote Work Option

Qualifications

• Bachelor's degree in Nursing or higher required.
• Five years of nursing experience preferred.

Responsibilities

• Review and analyze claims against MD Anderson resources.
• Conduct investigations and prepare comprehensive summaries.
• Assist in developing and implementing risk assessments.

Skills

Risk Management

Medical Record Review

Claims Analysis

Negotiation

Data Management

Education

Bachelor's degree in Nursing

Bachelor's of Science in Nursing (BSN)

Tools

Computerized Claims Database

Data Management Tools

Job description

The Associate Risk Manager will provide support to the Director, Risk Management and others in the operation of MD Anderson's Risk Management program, with an emphasis on potential and actual claims for injury or medical negligence, medical record review, analysis and summary, and allegations of property damage or loss.

The ideal candidate will have a Bachelor's degree in Nursing or higher, and five years of nursing experience.

Schedule is Monday - Friday with rotating On-Call schedule.

This role is a remote position within the State of Texas only. All remote positions are required to report to campus for business related needs as they arise.

KEY FUNCTIONS

Risk Management/Legal Professional

1) Reviewing incoming reports that assert claims against MD Anderson resources or against an MD Anderson employee, officer, or agent. This includes the review of highly complex claims, with a particular focus on medical malpractice claims, and the following actions:

1. Providing leadership, direction, advice, and guidance to healthcare teams and hospital leadership on patient care risk management issues that affect the safety and quality of patient care.
2. Conducting reviews of reported claims, incidents, and problems within at least 24 hours of receipt.
3. Identifying key information for incorporation into a computerized claims database and identifying a priority rating for each case.
4. Where necessary, promptly initiating, completing, or coordinating thorough investigations with the use of written correspondence, telephone communications, and electronic messages, and by traveling to all areas of the campus to inspect site, equipment, or other pertinent materials and then recording findings.

Legal Resource

1) Conducting detailed reviews of records, with a special focus on medical records, and also including billing records, project files, consultant reports, witness statements and other correspondence, and then identifying relevant risk issues and preparing comprehensive, detailed summaries of those items.

1. Resolving or participating in resolution of actual or potential risk issues, including:
2. Negotiating settlements with the claimant or with the claimant's representative where authority to do so has been specifically delegated by the Dir, Risk Management.
3. Providing appropriate information to MD Anderson's designated negotiator or legal representative.
4. Resolving and assisting to resolve a variety of risk issues, including patient care and billing issues.
5. Reporting issues and/or demands to the appropriate individual(s) with authority to resolve them.

<2) Investigating risk issues and clarifying the chronology of events. Also identifying key events, witnesses and/or participants involved in risk issues.

1. Develops risk management timelines for litigation cases to assist litigation section attorneys on claims filed against the institution.

<3) Developing, maintaining, and updating physical and electronic files on risk issues.

1. Creating and refining data management tools to assist in reporting metrics.
2. Filing or designating the retention location of all documents, reports, and correspondence, equipment, photographs, graphs, sketches, notes, or other data maintained in the Associate Risk Manager's files.
3. Periodically (at least every 30 days) reviewing all assigned, open files, monitoring activity and potential for resolution.

<4) Identifying sections of patient medical records to be sent to UT Office of General Counsel (OGC) in medical negligence claims and lawsuits, utilizing OGC guidelines.

5) Preparing reports required by the Safe Medical Device Act for review by the Dir, Risk Management within required time frames.

Legal Support

1) Assists the Dir, Risk Management as needed by:

1. Developing and implementing risk assessments;
2. Overseeing and directing the institutional risk management program through strategic and tactical planning.
3. Conducting in-service educational presentations throughout MD Anderson;
4. Preparing special reports.

<2) Participate, manage, and attend trainings on the Institutional/ Risk Management on-call schedule.

1. Participates in providing for 24-hour coverage to assess and document potential liability claims daily, including weekends and holidays.

<3) Leads special projects supporting the overall strategic vision and business operations of the risk management program.

<4) Assesses current trends and forecasts in healthcare risk management through review of relevant literature and educational opportunities.

<5) Actively participates on Institutional 2-STOP committee which includes thorough investigations of threats made against patients and employees.

<6) Independently analyzes and assists in the awareness of accreditation, regulatory, and safety standards to mitigate risk.

<7) Reviews reports submitted through the institutional incident reporting system and collaborates with Performance Improvement on facilities root cause analysis as needed.

<8) Actively assists with the supervision of support staff for the risk management & patient care and healthcare operation section, this includes hiring, orientation, and education of these members.

<9) Assists in institutional policy and procedure development.

1. Reviews institutional policies and serves as risk management representative on committees that develop policies and procedures related to safety of patients.

<10) Performing other duties, as needed, to assist the Risk Management and Legal Services departments in providing timely and effective services to a large academic health care institution.

Other

Perform other duties as assigned and required.

EDUCATION

Required: Bachelor's degree.

Preferred: Bachelor's of Science in Nursing (BSN) or higher.

EXPERIENCE

Required: Two years of experience in hospital or clinical environment.

Preferred: Five years of nursing experience.

It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law.

Additional Information

• Requisition ID: 173159
• Employment Status: Full-Time
• Employee Status: Regular
• Work Week: Days
• Minimum Salary: US Dollar (USD) 85,000
• Midpoint Salary: US Dollar (USD) 106,500
• Maximum Salary : US Dollar (USD) 128,000
• FLSA: exempt and not eligible for overtime pay
• Fund Type: Hard
• Work Location: Remote (within Texas only)
• Pivotal Position: Yes
• Referral Bonus Available?: No
• Relocation Assistance Available?: Yes
• Science Jobs: No

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