Clinical Risk Manager HYBRID

Discover Vanderbilt University Medical Center : Located in Nashville Tennessee and operating at a global crossroads of teaching discovery and patient care VUMC is a community ofindividuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued your knowledge expanded and your abilities challenged. Vanderbilt Health is committed to an environment where everyone has the chance to thrive and where your uniquenessis sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilts mission is to advance health and wellness through preeminent programs in patient care education and research.

Organization : RIM CRM

Job Summary : JOB SUMMARY

Investigate claims for medical appropriateness; analyze and process incident reports; provide training to nurses and other patient care staff in matters relating to Risk Management.

KEY RESPONSIBILITIES Assist claim manager and attorney by analyzing and investigating insurance claims and incident reports submitted to risk management. Review medical record; interview nurses physicians and other staff; obtain and read treatises; determine appropriate follow-up required. Conduct investigation and research to determine universitys potential liability regarding each significant incident. Compile incident report from medical procedural aspect and write report in format which can be assimilated by the hospital administrator legal staff and others in determining the universitys ultimate liability. Instruct nurses doctors and other patient care staff in matters relating to risk management issues; explain the incident reporting system and their legal responsibilities / liabilities. Manage all details of incident reporting system and data entry for risk managements computer system; verify data entry for accuracy and resolve problem areas. Serve as a resource person and consultant for various committees; attend meetings and enlist support and cooperation of medical staff for risk / management goals. Assist in resolving patient billing problems; review bills for appropriateness of treatment and corresponding charges; report on inaccurate or inappropriate charges. Perform other duties as CAPABILITIES

Our professional administrative functions include critical supporting roles in information technology and informatics finance administration legal and community affairs human resources communications and marketing development facilities and many more.

At our growing health system we support each other and encourage excellence among all who are part of our workforce. High-achieving employees stay at Vanderbilt Health for professional growth appreciation of benefits and a sense of community and purpose.

Core Accountabilities :

Organizational Impact : Delivers projects / assignments that have a direct impact on goals / objectives of the unit / department that the job is in. Problem Solving / Complexity of work : Conducts extensive analysis of situations or data to resolve numerous complex issues; may involve the input / work of others. Breadth of Knowledge : Has in-depth level of knowledge within a professional area and working knowledge of other areas. Team Interaction : May lead mid-sized projects; coaches and guides team members.

Core Capabilities :

Supporting Colleagues : - Develops Self and Others : Invests time energy and enthusiasm in developing self / others to help improve performance e and gain knowledge in new areas. - Builds and Maintains Relationships : Maintains regular contact with key colleagues and stakeholders using formal and informal opportunities to expand and strengthen relationships. - Communicates Effectively : Recognizes group interactions and modifies ones own communication style to suit different situations and audiences. Delivering Excellent Service : - Serves Others with Compassion : Seeks to understand current and future needs of relevant stakeholders and customizes services to better address them.- Solves Complex Problems : Approaches problems from different angles; Identifies new possibilities to interpret opportunities and develop concrete solutions. - Offers Meaningful Advice and Support : Provides ongoing support and coaching in a constructive manner to increase employees effectiveness. Ensuring High Quality : - Performs Excellent Work : Engages regularly in formal and informal dialogue about quality; directly addresses quality issues promptly. - Ensures Continuous Improvement : Applies various learning experiences by looking beyond symptoms to uncover underlying causes of problems and identifies ways to resolve them. - Fulfills Safety and Regulatory Requirements : Understands all aspects of providing a safe environment and performs routine safety checks to prevent safety hazards from occurring. Managing Resources Effectively : - Demonstrates Accountability : Demonstrates a sense of ownership focusing on and driving critical issues to closure.- Stewards Organizational Resources : Applies understanding of the departmental work to effectively manage resources for a department / area. - Makes Data Driven Decisions : Demonstrates strong understanding of the information or data to identify and elevate opportunities. Fostering Innovation : - Generates New Ideas : Proactively identifies new ideas / opportunities from multiple sources or methods to improve processes beyond conventional approaches. - Applies Technology : Demonstrates an enthusiasm for learning new technologies tools and procedures to address short-term challenges. - Adapts to Change : Views difficult situations and / or problems as opportunities for improvement; actively embraces change instead of emphasizing negative elements.

Position Qualifications :

Responsibilities :

Certifications :

Work Experience :

Relevant Work Experience

Experience Level : 7 years

Education : Bachelors

Vanderbilt Health is committed tofosteringan environment where everyone has the chance to thrive and is committed to the principles of equal opportunity. EOE / Vets / Disabled.

Required Experience :

Manager

Key Skills

Arm,Risk Management,Financial Services,Cybersecurity,COSO,PCI,Root cause Analysis,COBIT,NIST Standards,SOX,Information Security,RMF

Employment Type : Full-Time

Experience : years

Vacancy : 1