Metro Health (now the University of Michigan Health-West) is looking for Risk Management & Patient Relations Specialist

The Risk Management & Patient Relations Specialist assists in the facility's risk management activities, which include managing claims against the facility, administering the risk management program on a day-to-day basis, managing and analyzing risk management data, conducting risk management educational programs, complying with risk management related standards by the Healthcare Facilities Accreditation Program (HFAP) and other health law requirements, rules and regulations; all with the objective of maintaining patient safety, enhancing quality care, and minimizing loss to protect the assets of the organization. The Risk Management & Patient Relations Specialist may also be involved in the risk management activities of physician practice sites and other owned entities within the Metro Health system. The Risk Management & Patient Relations Specialist also serves as a liaison between patients, families/visitors, and the Hospital or office, helping to ensure patients and their families receive prompt assistance with any problems, concerns or special needs, and is responsible for all aspects of the patient complaint and grievance process in accordance with RM-25, Complaint and Grievance Policy, including but not limited to investigation and timely resolution of reported patient complaints and grievances.

Essential Functions and Responsibilities:

1. Claims Management and Incident Reporting:

• Participates in a direct referral system for hospital staff to report potential claims against the hospital through such input sources as medical records, business office, nursing, medical staff, patient complaints, etc.
• Investigates and analyzes actual and potential risks involving the Hospital and MHMG sites.
• Reports to CMS Regional Office appropriate occurrences involving patient deaths and restraints.
• Reports to the Compliance Officer any serious event involving reported or suspected non-compliance with governmental regulations, and/or actual or potential injury to patients, visitors or employees.
• Informs management of occurrences, issues, findings and risk management suggestions. Provides feedback in an effort to eliminate risks. Assists in designing risk management programs within their departments.
• Receives and reviews occurrence reports on a daily basis and determines appropriate follow-up action. Provides direction to staff and physicians for inputting data into the current risk management software program for tracking and trending. Reviews data to identify trends regarding occurrences and recommends corrective action as appropriate.

2. Legal:

• Works with outside legal counsel as directed on patient related matters, and /or claims investigations.
• Respond to police or other governmental inquiries as directed in the absence of the General Counsel or Compliance Officer.
• Works with Case Management and, where appropriate, outside counsel to facilitate guardianships for patients as needed.
• Accept service of subpoenas, search warrants, complaints, etc. in accordance with policy.
• Conducts research as needed on various health law requirements for policy development, implementing new processes or new systems and/or education.

3. Risk Management Consultation, Education, Intervention:

Assists in the development, maintenance, and use of the current risk management software program for incident reports, claims, complaints, peer review, etc.

Reviews medical records, conducts investigations and/or meets with physician leaders to address quality of care issues, physician issues, potential claims, and attorney/patient request for medical reco