Buscar empleo: 170 ofertas de trabajo de claims en San Diego, California (septiembre 2025)

AMN Healthcare

Director, Risk Management & Patient Safety

hace 11 días

San Diego

Position: Director, Risk Management & Patient Safety What You'll Do: The Director, Risk Management & Patient Safety reports to the General Counsel and works closely with the Medical Staff, Nursing and Ancillary leadership to provide expertise, oversight and leadership of Enterprise Risk Management (ERM) and patient safety according to the goals as set by the organization. Provides leadership and influence with the development, planning, coordination and administration of a systematic risk management and patient safety program designed to promote high reliability, culture of safety and reduce organizational risk and injury. Analyzes clinical risk management data and develops and conducts clinical risk educational programs in compliance with clinical risk management related standards established by DNV, CDPH and other regulatory agencies. Oversees Enterprise Risk Management program and analysis. Supports change through promoting patient safety, enhancing quality care and minimizing loss to protect the assets of the organization. Supports process improvement with multidisciplinary teams to achieve the organization’s mission and vision and values for the highest level of safety and efficient patient care. EXPERIENCE/QUALIFICATIONS: • 5-7 years nursing experience in a hospital or clinical environment and 1-3 years progressive healthcare leadership in nursing or other related field required., • 5-10 years Risk Management and/or Patient Safety experience required., • Knowledge and experience with risk management principles, patient safety, lean and quality management-performance improvement methods required., • Ability to effectively utilize a variety of computerized software applications including Excel, Word, etc., • BSN degree in Nursing required, • Current licensure with the California Board of Registered Nursing required, • CPHRM or equivalent certification preferred., • Must successfully complete and maintain LA City Fire Card certification at the time of hire or within the first 30 days of employment DUTIES AND RESPONSIBILITIES: • Develops and manages an effective risk management (RM) and patient safety (PS) program for hospital operations, departments and services; and utilizes a high degree of judgement, prioritization, problem solving, and decision-making to complete a comprehensive review of quality-of-care incidents., • Evaluates potential and/or actual patient harm clinical incidents to ensure a multi-disciplinary, risk-based approach is taken to effectively learn from unanticipated outcomes, patient safety events, sentinel events, and medical errors; and leads the root cause analyses (RCA) process to identify opportunities for improvement and eliminate deficiencies that may adversely affect patients, visitors and employees; conducts Failure, Mode, Effects Analysis (FMEA); deploys lean tools to streamline processes; and collaborates with Safety, EOC and Emergency Management on hazard vulnerability assessments., • Develops and revises RM, PS and other organizational plans, policies and procedure process when needed and as requested., • Recommend and facilitate change within the organization to improve patient safety based on identified risks., • Functions as organizational Patient Safety Officer., • Leads the claims management function; partners with outside counsel and third-party administrators for claims reviews, discovery and coordinates interviews, site visits and depositions and to provide clinical knowledge and assistance throughout the litigations process; and attendance at depositions, mediation and trials may be required., • Works with Patient Financial Services (PFS) team regarding billing procedures on pertinent patient incidents and General Counsel to recommend write-off or discount charges deemed necessary to proactively mitigate claim potential., • Maintains regulatory knowledge specific to EMTALA, consents, restraint use, CDPH-reportable adverse events, and other Federal and State patient safety requirements, programs and/or initiatives; and provides education to the organization regarding regulations., • Responds to state inspections and regulatory audits and reviews., • Owns the analysis and investigation of incident reports and maintains oversight of the incident reporting system. Performs statistical analysis and creates reports on trending of events and leads the proactive assessment and develops mitigation and sustainable strategies for clinical risk vulnerabilities., • Reports trended data and mitigation actions to the appropriate committees, departments and individuals., • Educates and assists other managers and directors in proactively assessing their areas of responsibility for exposures to loss and unsafe processes and conditions., • Leads timely investigation, communication and documentation of errors or serious events in accordance with legal requirements and/or accreditation standards., • Conducts annual proactive risk assessments to identify opportunities to improve reliability in processes and reduce risk and provides education to the Board of Directors and the Quality & Patient Safety Committee of the Board., • Coordinates Enterprise Risk Management orientation and continuing education and training programs for providers, management and staff to enhance awareness of their role in high reliability, just culture, patient safety, risk reduction and event reporting., • Participates in Patient Safety Teams and other committees as needed to communicate findings, recommendations, actions and results., • Provides clinical risk management information on medical and allied health staff to Medical Staff Services for use in the reappointment and/or credentialing process., • Manages and responds to patient complaints and grievances., • Collaborates with Quality Department staff in matters related to regulatory compliance, policy planning and implementation., • Stays abreast of health care risk management and patient safety related legislation, guidelines and/or accreditation standards and advises the organization on developments which may affect patient safety and ERM., • Assesses the ongoing culture of safety and leads actions to strengthen the culture., • Demonstrates excellent communication/interpersonal skills; ability to problem solve, analyze situation, think critically, give constructive feedback and supervise and team with other., • Reviews and meets ongoing competency requirements of the role to maintain the skills, knowledge and abilities to perform, within scope, role specific functions., • Any other risk management and patient safety related duties as may be assigned from time to time by the General Counsel. Why You'll Love Working Here: • Supportive Environment: We prioritize teamwork, professional growth, and a positive work culture., • Impactful Work: Your role will directly contribute to the smooth operation of our organization., • Professional Development: We offer continuous learning and advancement opportunities to help you grow in your career.

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