Senior Risk Management Specialist

$74,734 - $127,546/Yr

University of Pittsburgh Medical Center - Pittsburgh, PA

Full-time - Senior

Pittsburgh, PA

Hospitals

About the position

The Senior Risk Management Specialist at UPMC Corporate is responsible for the systematic management of potential and actual claims, focusing on clinical data analysis to identify liability risks. This role involves developing loss prevention programs to enhance patient care quality while managing liability exposure. The position requires collaboration with hospital leadership and critical thinking skills to coordinate and manage various risk management projects. Initially, the role requires onsite work until training is completed, after which remote work may be possible.

Responsibilities

• Establish files on potentially compensable events and submit to the UHCIP as appropriate.
• Participate in determining level of liability exposure and setting of reserves.
• Identify specific needs of the office practices and develop Risk Management strategies to address those needs.
• Integrate ideas of community hospitals and facilitate ideas into the UHCIP.
• Establish an occurrence reporting system compatible with the current system, monitoring of occurrence reports and investigation of significant events.
• Present legal suit summaries at Professional Healthcare Provider Review Committee and participate in discussions as appropriate.
• Maintain awareness of current legislative activity affecting Risk Management by participating in local and national professional societies.
• Assimilate ideas and risk reduction strategies of UPMC Health System facilities into the Risk Management Program.
• Develop relationships within the management structure to facilitate investigation and feedback.
• Evaluate informational requests from department heads and coordinate with the Information Systems Coordinator necessary parameters to meet the request and facilitate report preparation.
• Develop a coordinated approach to patient and family complaints with the Patient Relations staff.
• Monitor occurrence-reporting system by analyzing and identifying trends and developing corrective action plans.
• Represent Risk Management on multi-disciplinary hospital committees and provide statistical information and reports as required or requested.
• Responsible for compliance with the provisions of the Safe Medical Device Act.
• Open and maintain legal files, complete and update Case Summary Worksheets on all assigned cases.
• Evaluate educational programs of UPMC Health System facilities and mobilize resources for developing specific programs.
• Review and evaluate potential and current claims with relevant internal departments and UHCIP claims investigator.
• Identify educational needs of the institution and develop specific educational programs for medical staff and others.
• Coordinate access to information or staff with outside legal counsel and insurance investigators.
• Serve as liaison between the Program and non-Faculty physicians.
• Act as a resource/consultant for staff and affiliates regarding professional liability issues.
• Conduct high quality in-depth multi-disciplinary investigations of occurrences presenting significant risks.
• Participate in Patient Safety Committees of designated areas.
• Coordinate Risk Management functions with multiple disciplines and other Risk Management Peers.
• Develop written material for distribution to hospital staff and present onsite educational programs.
• Establish a working relationship with staff of managed care organization and office site staff.
• Coordinate assigned professional liability legal suits with defense counsel.
• Gather information and requested documents to prepare draft Answers to Interrogatories and review prior to Director's review.
• Intervene at the request of UPMC Legal Services to provide information and guidance regarding subpoenas.

Requirements

• Bachelor of Science and a minimum of five years clinical or healthcare experience.
• Experience in data/trend analysis and report preparation is necessary.
• Skilled in both verbal and written communication.
• Demonstrates independence, leadership, and the ability to make sound decisions.
• Ability to handle very sensitive and confidential information.