Market Operations Manager – Utilization Management
CareSource
Clinical Risk Manager
House + Home Loans
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteJob Level
SeniorLead
About the role
- Oversee patient safety, environment of care and risk management programs to ensure that patients receive the highest quality of care
- Guide site leadership in development of site-based safety programs that adhere to environment of care and OSHA standards
- Review and analyze reports of adverse events, near misses and concerns related to clinical risk and collaborate with departments and site leadership to develop responsive programs
- Conduct Root Cause Analysis (RCAs) on sentinel events and serious patient safety events as directed by the CMO or CRO
- Support the Director of Compliance in executing and implementing the annual compliance and risk work plan
- Develop and maintain policies and provide education related to implementation and revision
- Conduct internal audits in high-risk areas to assess quality of controls and prepare timely written reports of investigations and audits
- Serve as the organization’s Safety Officer and guide site teams on development and maintenance of environment of care and safety programs
- Assist Director of Compliance in coordinating Safety Committee activities
- Facilitate hazardous vulnerability assessments and annual emergency management and preparedness exercises
- Prepare reports and presentations; collaborate with cross-disciplinary teams and site leadership
Requirements
- Nursing degree from an accredited school of nursing
- Current RN license to practice nursing in the state of Texas
- Minimum 5 years clinical experience
- Minimum 3 years healthcare risk management experience
- Preferred: Risk management, quality improvement, or legal nurse consulting experience
- Knowledgeable of TJC, CMS, TDSHS, OSHA, HRSA and other applicable state and federal regulatory requirements governing federally qualified health care centers and ambulatory care
- Strong written and verbal presentation skills with attention to sensitive, confidential matters
- Strong interpersonal skills and ability to build effective collaborative relationships
- Ability to lead, train and facilitate cross‐disciplinary teams
- Ability to think critically, problem solve, make independent decisions, and handle multiple projects simultaneously
- Competent with data management and analysis
