Summary

Functions under the supervision of the Executive Director of Risk Management to support the mission, vision, and values of Wellstar Health System. This team member works to optimize patient safety, reduce the adverse consequences of accidental loss through protective risk management and education, train and update leaders on risk management matters and topics, and drive overall reduced clinical and operational claims. Collaborates with and supports the Executive Director and Risk Management and Legal Department leadership by providing information and data to facilitate decisions regarding insurance renewal and risk program financing. Responsible to regularly monitor and review Wellstar's online event reporting system for reporting, investigation, and filing of adverse events. Reviews incidents on receipt and conducts appropriate investigation, reporting, follow-up education, and knowledge sharing to prevent reoccurrence. Works collaboratively with Claim Managers to facilitate knowledge sharing and best practices for legal claim management.

Job description

Job Summary

Functions under the supervision of the Executive Director of Risk Management to support the mission, vision, and values of Wellstar Health System. This team member works to optimize patient safety, reduce the adverse consequences of accidental loss through protective risk management and education, train and update leaders on risk management matters and topics, and drive overall reduced clinical and operational claims. Collaborates with and supports the Executive Director and Risk Management and Legal Department leadership by providing information and data to facilitate decisions regarding insurance renewal and risk program financing. Responsible to regularly monitor and review Wellstar's online event reporting system for reporting, investigation, and filing of adverse events. Reviews incidents on receipt and conducts appropriate investigation, reporting, follow-up education, and knowledge sharing to prevent reoccurrence. Works collaboratively with Claim Managers to facilitate knowledge sharing and best practices for legal claim management.

Core Responsibilities and Essential Functions

Assists in the development and implementation of risk control plans to enhance patient safety, minimize risk exposures, and reduce losses.
Coordinates the clinical and operational risk management program.
Develops learning plan to educate Wellstar leaders on proactive risk management.
Reviews and analyzes all event reporting reports for risk management and quality of care concerns.
Conducts investigations into risk management matters.
Prepares various incident reports.
Maintains database of risk management matters and investigations.
Assists with peer review process and completion of safety solutions, in partnership with other departments and team members.
Identifies organizational risk trends through analysis of incident, incident letters, and reports.
Provides on-site support for regulatory investigations, reviews, and surveys.
Reviews Wellstar policies and team member training materials to ensure consistency with Wellstar's risk prevention strategies.
Stays informed about trends, best practices, and regulatory requirements related to clinical and operational risk management matters.
Provides rotating 24x7 on-call responsibility to field inquiries and support needs from Wellstar leaders on risk management and other concerns.
Conducts regular rounding with facility/medical group leadership.

Requirements

Minimum 2 years RN or clinician with at least two years clinical experience
Minimum 2 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
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
Bachelors Nursing-Preferred or Bachelors Other / Related Field
RN - Reg Nurse (Single State)-Preferred or RN-COMPACT - RN - Multi-state Compact-Preferred or CPHRM - Cert Prof Healthcare Risk Mgt-Preferred or LNCC - Legal Nurse Consultant Cert-Preferred

Company overview

Wellstar Health System is one of Georgia's largest and most comprehensive integrated healthcare systems, founded in 1993 and headquartered in Marietta, Georgia. As a non-profit health system, Wellstar operates with a mission to enhance the health and well-being of every person it serves through its PeopleCare approach. The system employs approximately 29,469 to 33,000 team members across multiple hospitals, health parks, medical offices, outpatient centers, pediatric centers, nursing facilities, and hospice and home care services. Wellstar is nationally recognized for operating Georgia's largest integrated trauma network and features the second-largest Emergency Department in the United States. The organization provides more than $1 billion annually in charity care and community programs, demonstrating its commitment to community health. Wellstar has earned numerous accolades including recognition on Fortune's 100 Best Companies to Work For, Best Workplaces in Health Care, and PEOPLE Companies that Care lists. The system embraces innovation through its venture firm Catalyst by Wellstar, which nurtures early-stage healthcare companies, and maintains academic partnerships with institutions like the Medical College of Georgia for caregiver training. With specialties spanning cardiovascular care, oncology, women's health, pediatrics, musculoskeletal services, and numerous other medical disciplines, Wellstar delivers comprehensive healthcare across all stages of life.