Sr Risk Management Specialist at UPMC

Pittsburgh, Pennsylvania, United States -

Full Time

Start Date

Immediate

Expiry Date

13 Feb, 26

Salary

0.0

Posted On

15 Nov, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Risk Management, Clinical Data Analysis, Loss Prevention Programs, Critical Thinking, Collaboration, Data Analysis, Report Preparation, Root Cause Analysis, Healthcare Failure Modes, Verbal Communication, Written Communication, Leadership, Decision Making, Medical Legal Issues, Investigation, Corrective Action Plans

Industry

Hospitals and Health Care

Description

Purpose: Under the supervision of the Senior Manager, Corporate Risk Management, the function of the position is systematic management of potential as well as actual claims. Clinical data will by analyzed to determine areas of potential liability. Corrective actions will be developed with the assistance of clinical teams. The position will develop loss prevention programs in the area of professional liability to improve the quality of patient care while controlling liability exposure. This position requires critical thinking skills and the ability to provide direction. Must be able to collaborate with UPMC leadership in coordinating and managing individual projects. Responsibilities: Develop relationships within the management structure to facilitate investigation and feedback. Monitor occurrence reports, investigation, and resolution of significant events. Evaluate educational programs of UPMC Health System facilities and mobilize resources for developing specific programs to address the needs of the clinical and management staff. Establish a working relationship with staff of managed care organization and office site staff to facilitate integration of practice plans into the insurance program. Serve as liaison between Risk Management and non-Faculty physicians. Identify specific needs of the hospital and/or office practices and develop Risk Management strategies to address those needs and act as resource for physicians and staff regarding medical legal issues. Act as a resource/consultant for staff and affiliates for questions and concerns regarding professional liability issues. Provide twenty-four-hour day coverage according to the department on-call schedule. Monitor occurrence-reporting system by analyzing and identifying trends and developing corrective action plans in conjunction with appropriate management and staff. Conduct high quality in-depth multi-disciplinary investigations of occurrences, which present significant risks in the area of professional liability and share information with appropriate management and staff Bachelor of Science and a minimum of five years clinical or healthcare experience. Experience in data/trend analysis and report preparation is necessary. Experience completing and facilitating root cause analyses and healthcare failure modes and effects analyses. This position requires an individual who is skilled in both verbal and written communication and demonstrates independence, leadership and the ability to make sound decisions. This position involves the handling of very sensitive and confidential information. Licensure, Certifications, and Clearances: Pharmacist OR Registered Nurse (RN) Act 34 *Current licensure either in the state where the facility is located or, if the facility is in a state covered by the multistate Nursing Licensure Compact (NLC) agreement, a multistate license issued by a participating NLC state. Hires and current employees working on an out-of-state NLC license who later change their residency to the state where the facility is also located will have 60 days upon changing their residency to apply for licensure within that state. UPMC is an Equal Opportunity Employer/Disability/Veteran

Responsibilities

The Sr Risk Management Specialist will systematically manage potential and actual claims, analyze clinical data to identify liability areas, and develop loss prevention programs. The role involves collaboration with clinical teams and UPMC leadership to coordinate and manage projects effectively.