Hospital Clinical Risk Navigator

Memorial Hermann; Houston (TX); On-site; USD 90,000 - 130,000; Full time

Job summary

Memorial Hermann is seeking a clinical risk management professional to oversee a portfolio of hospital-based claims, perform investigations, and assess liability and standard of care. You will educate staff, collaborate with risk managers, and coordinate with outside counsel and providers to mitigate risk.

The role requires nursing background, CP HRM certification or plan to obtain, and 5+ years in clinical hospital settings with 3+ years in risk management.

Qualifications

• Bachelor's Degree in Nursing preferred.
• CPHRM designation or obtain within three years of placement.
• Minimum five years of progressive clinical experience in a hospital setting.
• Minimum three years of risk management in hospital-based environment or as nurse paralegal in a law firm.
• Skilled in clinical education curriculum development and delivery.
• Ability to work collaboratively with health professionals at all levels to achieve established goals.
• Computer proficiency.
• Demonstrated interpersonal, organizational, and communication skills.

Responsibilities

• Manage a portfolio of claims as assigned.
• Conduct claims investigation, medical records review and timeline development; evaluate liability and standard of care.
• Resolve claims through communications with claimants, families and counsel within authority.
• Act as liaison between outside counsel and the organization through discovery and resolution.
• Represent the organization at mediations or trials as needed.
• Provide backup coverage for risk management issues and on-call duties.
• Provide clinical risk management counsel to facility-based Risk Managers.
• Monitor clinical claims trends to support loss prevention recommendations.
• Participate in enterprise clinical risk assessments to prioritize risk management initiatives.
• Interface with insurance and loss prevention for mitigation activities.
• Collaborate with loss prevention, quality and patient safety to develop education initiatives.
• Serve as a clinical risk management educational resource with needs assessments and curriculum delivery.
• Ensure safe care and adherence to Memorial Hermann policies within budget and productivity standards.
• Promote professional growth; act as preceptor and mentor.
• Demonstrate commitment to compassionate, personalized patient experiences.
• Other duties as assigned.

Skills

Clinical education curriculum

Collaborative work

Computer proficiency

Interpersonal skills

Education

Nursing degree preferred

Tools

RMIS

Variance reporting system

Job description

Memorial Hermann is seeking a clinical risk management professional to oversee a portfolio of hospital-based claims, perform investigations, and assess liability and standard of care. You will educate staff, collaborate with risk managers, and coordinate with outside counsel and providers to mitigate risk.

The role requires nursing background, CP HRM certification or plan to obtain, and 5+ years in clinical hospital settings with 3+ years in risk management.