Catholic Health Initiatives Risk Analyst in BURIEN, Washington

Risk Analyst

Description

CHI Franciscan Health has exciting and rewarding careers with competitive salaries and benefits. We are a family of hospitals, health care services, and medical providers delivering compassionate care to people throughout the South Puget Sound. We are part of Catholic Health Initiatives, one of the largest not-for-profit health care systems in the country.

Our mission is to deliver high quality care that meets our patients' medical needs while providing emotional and spiritual support to patients and their families. We believe this three-part approach — physical, emotional, and spiritual — is essential to healing the whole person. Come join our team!

Job Summary:

This job is responsible for providing professional support for the Franciscan Health System (FHS) strategic clinical risk management program which is focused on enhancing patient safety and quality of care and mitigating/minimizing financial loss through risk detection, evaluation, prevention, reduction and resolution. An incumbent researches bills/non-billable events relating to hospital-acquired conditions/sentinel events and participates, under the direction of hospital-based Risk Managers, in the investigation of claims and potential claims.

Work also includes: 1) supporting litigation and insurance processes; 2) researching regulatory requirements and best practices to facilitate implementation of risk strategies/programs to improve patient outcomes and liability risk reduction; 3) analyzing risk-related data to identify trends, differences from benchmark quality data and gaps in standards/processes, and 4) monitors department compliance with corrective action plans.

Work requires knowledge of risk, legal and/or patient safety processes and terminology, and of the objectives of the risk management and/or regulatory/safety functions sufficient to carry out most responsibilities independently. An incumbent uses initiative in carrying out the recurrent work, handling problems and deviations in accordance with established procedures, accepted practice and/or requirements. Guidelines for conducting the work are general, requiring the exercise of independent judgment in determining the most efficient and effective way to achieve desired objectives and in recommending alternative options to billing situations requiring interpretation of complex regulations.

Essential Duties :

  • Investigates incidents of hospital-acquired conditions, sentinel events and other incidents involving errors or omissions in the delivery of patient care to identify/clarify non-billable events and coordinate the bill-split process.

  • Reviews and analyzes IRIS incident reports to identify opportunities to improve the delivery of safe patient care; develops reports and presentations as directed by Risk Managers.

  • Maintains database of sentinel events; updates department action plans designed to implement procedural changes and remedial actions to facilitate performance improvements and avoid recurrence of adverse events.

  • Researches applicable regulatory requirements and best practices on a regular basis to facilitate the development/implementation of risk strategies/programs to achieve better patient outcomes and liability risk reduction; participates in the implementation, documentation, evaluation and follow-up of risk reduction initiatives/programs/tools; monitors ongoing compliance with loss prevention programs.

  • Gathers information and completes formal documentation in support of claims, litigation and insurance processes; supports data collection relating to the CHI clinical risk management incentive plan.

Additional Responsibilities:

  • Adheres to and exhibits our Core Values of Reverence, Integrity, Compassion and Excellence.

Qualifications

Education/Experience :

  • Bachelor’s degree in business administration, healthcare administration, or other related field that demonstrates the attainment of the requisite job knowledge skills/abilities and two years of related work experience (including exposure to legal and medical terminology). Paralegal experience is preferred.

  • Or any equivalent combination of education and experience which provides the required knowledge, skills and abilities to perform the essential functions of the position.

License/Certification:

  • Certified Professional in Healthcare Risk Management (CPHRM0) through the American Hospital Association (AHA) is preferred.

Job Risk Management

Primary Location WASHINGTON-BURIEN-HIGHLINE MEDICAL CENTER

Daily Schedule day shift

Scheduled Hours per 2-week Pay Period 80

Weekends Required None

Req ID: 2017-R0116220