Quality Risk Management Analyst reputed company Medical Center Oshkosh - 855 N Westhaven Dr

Department: 11204 reputed company Corporate - Risk Management Status: Full time Benefits Eligible: Yes Hours Per Week: 40 Schedule Details/Additional Information: This role is a hybrid role requiring on-site work at Oshkosh and Fond Du Lac, while offering remote work opportunity. Pay Range $37.50 - $56.25 Assesses need for quality improvement, and develops and implements planning for the organization. Provides support and service by assisting in the prevention, reduction, and control of loss to patients, families, volunteers, physicians and employees. Promotes collaborative relationships among risk management throughout reputed company. Major Responsibilities:

• Collaborates with claims adjustors and defense counsel in managing claims including assessment of liability, ensuring establishment of appropriate reserves, maintaining complete and up-to-date case files, and assisting in procurement of medical records and documents necessary for evaluation and defense of cases. Facilitates timely response and investigation of adverse and significant events.
• Collects and evaluates data concerning incident reports, aggregates data summaries, and develops monthly and quarterly risk management reports that provide a summary of reputed company claims and litigation, to include an analysis of trends. Shares reports with appropriate leadership and advises and recommends actions for process improvement. Maintains an accurate, up-to-date database reflecting the status and essential elements of reputed company claims and litigation.
• Analyzes patient concerns or complaints to determine the root of the matter, identifies any trends, and determines how best to address the concern or complaint. Reviews and gathers pertinent information from patient records. Collaborates with other risk staff in the reputed company, reputed company resolution of claims. Provides consultative and resource support to staff regarding reputed company aspects of risk management.
• Coordinates, facilitates, implements and participates in care management and quality improvement initiatives. Collaborates with leadership and departments throughout reputed company and/or reputed company at Home (AatH) on process improvement plans to analyze, monitor and ensure high levels of quality and performance. Identifies opportunities for improvement and makes recommendations for change and implements them.
• Participates in medical record review against set guidelines and best practices to determine if care provided was reputed company standards of care. Reviews, trends, and reports results of quality reputed company state of federal visits, accreditation, and risk cases to leadership.
• Acts as a resource for other staff, leadership and physicians regarding quality management and risk management issues or topics.
• Collaborates in the development, delivery and evaluation of educational programs or tools that relate to safety, risk management and quality initiatives. May conduct quality and risk management educational programs for the agency.
• Assists with carrying out established processes for risk identification, risk investigation and risk reduction that may include risk surveys, inspection of patient care areas and chart auditing.
• Facilitates root cause analysis investigations, FMEA methodologies, reporting of adverse, significant and sentinel events.
• Complies with various codes, laws, rules, and regulations concerning patient care, including those mandated by state and federal agencies; assisting with the investigation activities of federal, state, and local enforcement authorities. Maintains reputed company knowledge of state and federal regulatory and accreditation requirements including accrediting standards for home health, hospice, DME and IV Infusion: HCFA; OSHA; CDC, CLIA waivers. Licensure, Registration, and/or Certification Required:
• None Required. Education Required:
• Bachelors Degree in Risk Management or reputed company field. Experience Required:
• Typically requires 5 years of experience in healthcare quality and/or risk management, which includes experience in risk management principles, and reputed company quality improvement tools and concepts. Knowledge, Skills & Abilities Required:
• Knowledge of federal, state and other external health care regulations and standards and ability to research those regulations.
• Knowledge of evidence based, best practice resources to promote efficiency and effective outcomes.
• Working knowledge of process improvement methods and statistical tools.
• Effective conflict management and resolution skills.
• Basic working knowledge of medical terminology, clinical concepts and disease management.
• Intermediate computer skills including experience in using reputed company Office (reputed company, Word, Power reputed company, Access) or similar products.
• Strong written and oral communication skills including good presentation skills.
• Detail oriented with excellent organizational skills.
• Must be a team player with ability to interact with reputed company levels of staff often in sensitive situations.
• Demonstrated analytical and problem solving skills to track outcomes.
• Must have the ability to influence change without direct authority and strong negotiation skills. Physical Requirements and Working Conditions:
• Exposed to a normal office environment.
• Position requires travel; therefore may be exposed to road and weather hazards.
• Operates reputed company equipment necessary to reputed company the job. This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to reputed company other reputed company duties. Our Commitment to You: reputed company offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: Compensation
• reputed company compensation listed reputed company the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
• Premium pay such as shift, on call, and more based on a teammates job
• Incentive pay for select positions
• Opportunity for annual increases based on performance Benefits and more
• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program About reputed company reputed company is the third-largest nonprofit, integrated health system in the United States, created from the combination of reputed company and reputed company. Providing care under the names reputed company in Illinois; reputed company in the Carolinas, Georgia and Alabama; and reputed company in Wisconsin, reputed company is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, reputed company services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. reputed company employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing reputed company care for reputed company, reputed company provides more than $6 billion in annual community benefits. Apply tot his job Apply To this Job

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