We are recruiting for a mission-driven Senior Clinical Risk Manager to join our team!
We're with you for life's journey. At Denver Health, purpose isn't just something we believe in-it's something we live every day, for life's journey.
Our Values
Respect | Belonging | Accountability | Transparency
Department
Risk Management
Job SummaryThe Senior Clinical Risk Manager supports Denver Health's system-wide risk management program by identifying, investigating, and mitigating clinical and operational risks across all care settings. This role leads investigation and reporting of significant health events, collaborates with clinical and operational leaders to reduce harm, and ensures compliance with regulatory and insurance requirements. The position develops and maintains risk reduction strategies, policies, and educational programs, analyzes trends, and provides critical guidance regarding potentially compensable events and patient safety concerns. The Senior Clinical Risk Manager works closely with senior leadership, participates in organizational committees, supports regulatory reporting, and provides rotating, reoccurring 24/7 on-call support for urgent risk/safety/legal concerns.Essential Functions:
Provide rotating, recurring 24/7 on-call support, including after hours and weekends, across all Denver Health entities to address clinical, operational, and legal concerns. Serve as subject matter expert and trusted advisor, especially to high-risk care units such as L&D, ED, OB/ED, BH, MICU/SICU, PDUC, and peri-op/surgical services, delivering guidance on navigating time-sensitive complex matters such as patient disclosures, informed consent, custody arrangements/decision making, patient care management issues, patient safety concerns, crisis management, risk mitigation, and liability exposure. This often may involve close collaboration with in-house attorneys on legal/risk/care related questions - serving as a liaison and understanding when to further escalate situations. (35%)
Independently investigate and determine if significant occurrences meet elements for a state reportable event to CDPHE and/or meet the Joint Commission criteria for a sentinel event or near miss. For sentinel events, direct the Root Cause Analysis (RCA) process to ensure compliance with CMS Conditions of Participation by performing timely and thorough investigations, interviewing key clinical staff, and leading/facilitating multiple meetings with clinical staff and senior leadership to identify system contributions and vulnerabilities. Submit required reports and actions items when applicable, and collaborate with Patient Safety, Quality and Excellence to develop risk reduction initiatives and enhance patient safety following the RCA. (20%)
Under the quality management privilege and at the direction of in-house legal counsel, conduct early investigations into all potentially compensable events to evaluate standard of care (professional standards, statutes, regulations, hospital and department policies and guidelines) and liability exposure, and facilitate individual claim reporting to professional liability insurance carriers to ensure appropriate coverage. Undertake clinical review and prepare detailed timeline of care, maintain appropriate case files and documentation, and prepare critical communications and reports for internal and external partners. In conjunction with Deputy General Counsel and Claims Manager, review and respond to CGIA notices of claim, patient concerns, and summons and complaints. Confer directly and independently with claimants, attorneys, experts, employed clinical providers, insurance brokers and carriers, and other stakeholders to assess, defend and/or facilitate resolution of a claim. Participate in early resolution, mediations, settlements and/or trial, and ensure compliance with state and federal reporting obligations. (20%)
Routinely lead or partner with other leaderson system-wide committees and initiatives that strengthen risk prevention and patient safety and mitigate institutional risk. This includes, but is not limited to, regular involvement with the Patient Advocate and Quality teams to assist with reviewing, drafting and responding to patient grievances and identifying matters to transfer to Risk Management/Claims/Legal for potential early resolution; facilitating the health system's controlled substance and drug diversion program; representing Risk Management on various Committees, including the Ethics Committee, Controlled Substance Diversion Committee, ACS Threat Group, and the Nursing Executive Committee; responding to and investigating issues of workplace violence and assessing related reporting obligations, and responding to confidential ethical and legal issues reported through Risk Management or Compliance.(15%)
Conduct various @types of risk assessments to identify, evaluate and propose risk reduction strategies. Assess high-harm events and claims trend data to reduce economic impact and improve patient outcomes. Design and deliver system-wide presentations and education on clinical risk management, documentation best practices, patient disclosures, statutory and regulatory compliance, legal interactions, risk mitigation, and patient safety topics. (5%)
Develop, draft, edit, and review policies and procedures, and participate in system or department-wide implementation and education. (5%)
Education:
Bachelor's Degree Required
Work Experience:
4-6 years Professional clinical experience required. Required and
4-6 years of relevant healthcare risk management experience. Required
Licenses:
RN-Registered Nurse - DORA - Department of Regulatory Agencies Required or
PHA-Licensed Pharmacist - DORA - Department of Regulatory Agencies Required or
PT-Physical Therapist - DORA - Department of Regulatory Agencies Required or
OT-Occupational Therapist - DORA - Department of Regulatory Agencies Required or
RTL-Respiratory Therapy License - DORA - Department of Regulatory Agencies Required or
MD- Physician - DORA - Department of Regulatory Agencies Required or
NP-Nurse Practitioner - DORA - Department of Regulatory Agencies Required or
PA- Physician Assistant - DORA - Department of Regulatory Agencies Required
CPHRM-Certified Professional in Healthcare Risk Management - ASHRM - American Society for Health Care Risk Management preferred
Knowledge, Skills and Abilities:
Demonstrate knowledge and competency in all areas of responsibility as described within the Job Description.
Direct critical independent investigations of legal and risk matters with considerable empathy, sensitivity, objectivity and effectiveness, report results and analysis to stakeholders, including senior leadership.
Develop effective working relationships with management and stakeholders throughout the organization.
Promotes positive interpersonal relationships with fellow employees, physicians, patients and visitors.
Maintain a current working knowledge of federal and state laws and regulations concerning health care risk management.
Educate and train others on risk management principles.
Demonstrate good judgment, strong analytical and critical thinking skills.
Ability to assess and evaluate risk to develop and maintain effective risk control processes.
Highly self-motivated with the ability to function independently and as part of a team in a fast-paced environment with minimal to no supervision and direction.
Complex problem-solving and decision-making skills.Excellent communication skills, including writing, facilitation and presentation.
Strong organizational, prioritization, and project management capabilities.
Demonstrates support for the mission and values of Denver Health.
Ensure confidentiality of patient infor
