Consultor de Gestão de Riscos III

Job Summary: Maintains risk management programs by independently conducting standard and nonstandard audits and analyses to evaluate risk management programs. Contributes to reports and specialized data analysis for professional liability cases, risk management trends and issues, significant events, and near misses. Collaborates across functions (e.g., claim management, legal, patient safety, clinical quality) to monitor and identify risks and threats. Independently applies protocols in rapid response and situation management for minor to moderate incidents. Independently provides consultative services for clinical and non-clinical staff on a range of risk management issues. Complies with State and Federal laws, regulations, patient rights, and professional ethics. Essential Responsibilities: • Pursues effective relationships with others by proactively providing resources, information, advice, and expertise with coworkers and members. Listens to, seeks, and addresses performance feedback; provides mentoring to team members. Pursues self-development; creates plans and takes action to capitalize on strengths and develop weaknesses; influences others through technical explanations and examples. Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; helps others adapt to new tasks and processes. Supports and responds to the needs of others to support a business outcome. • Completes work assignments autonomously by applying up-to-date expertise in subject area to generate creative solutions; ensures all procedures and policies are followed; leverages an understanding of data and resources to support projects or initiatives. Collaborates cross-functionally to solve business problems; escalates issues or risks as appropriate; communicates progress and information. Supports, identifies, and monitors priorities, deadlines, and expectations. Identifies, speaks up, and implements ways to address improvement opportunities for team. • Ensures compliance by: complying with State and Federal laws, regulations, patient rights, and professional ethics; upholding Kaiser Permanentes policies and procedures and applicable federal and state laws and regulations; serving as a liaison to assist other departments in complying with standard and nonstandard accreditation and regulatory risk management requirements (e.g., policies and procedures, legal claims manager), identifying and recommending solutions; preparing for and participating in standard and nonstandard regulatory audits and related projects (e.g., annual audits, accrediting bodies); and learning about changes to laws, regulations, codes, policies, and standards as they apply to risk management. • Engages in Risk Management consulting by: independently providing consultative services for clinical and non-clinical staff on a range of risk management issues; implementing communications, outreach, and education as part of a comprehensive response plan to mitigate risk; and providing support as requested by participating in committees related to risk management activities. • Engages in documentation, analysis, and reporting by: using sophisticated risk management data sources to conduct standard and nonstandard tasks; following guidelines, independently, to document professional liability cases, risk management trends and issues, significant events, and near misses; collaborating on the development and production of reports on scheduled cadence to senior leadership, Board committees, and regulators; contributing to reports and specialized data analysis for professional liability cases, risk management trends and issues, significant events, and near misses; independently conducting standard analyses to identify trends and facilitate improvements; utilizing reports and analyses to develop recommendations and action plans for standard and nonstandard issues; interpreting and applying broad guidelines to research risk exposure data and prepare underwriting submissions in the areas of insured risks, including general and professional liability and independently consulting on certificates of insurance, indemnification letters, and credentialing responses as they relate to insured risks, including general and professional liability programs; and investigating, analyzing, and resolving potentially compensable events, compensable events, and regulatory investigations. • Conducts Risk Management education and training by: implementing and assisting in the development of risk management-related training programs, conducting training for providers, staff, and/or external audiences as needed; actively seeking training and development on risk management best practices and integrating learning and feedback into daily work tasks and strategies; and measuring the impact and monitoring sustainability of education and training. • Responds to Risk Management incidents by: independently applying protocols in rapid response and situation management for minor to moderate incidents; independently gathering information and conducting investigations and helping to determine impact and appropriate actions; applying knowledge and judgment to act as a liaison to resolve and/or mitigate standard and nonstandard incidents, escalating complex incidents with unusual conditions or factors; determining root cause(s) and suggesting incremental improvements and corrective actions to prevent recurrence; and independently facilitating organizational awareness and handling of day-to-day clinical risk issues. • Maintains Risk Management programs by: independently implementing integrated, locally-relevant and/or enterprise-wide risk reduction and prevention programs; independently conducting standard and nonstandard audits and analyses to evaluate Risk Management programs; and making some recommendations to enhance existing programs based on analyses and observations. • Engages in threat monitoring and risk prevention by: collaborating across functions (e.g., claim management, legal, patient safety, clinical quality) to monitor and identify risks and threats; implementing plans for analyzing, validating, and interpreting new and ongoing risks and threats; independently supporting technical consulting and analytical support to a comprehensive risk financing program preserving corporate assets in order to reduce the impact of financial loss in the areas of property, casualty, workers compensation, general liability, and professional liability; independently implementing action plans to address identified problems; independently reviewing and analyzing high-level product safety risks; independently preparing initial processing and receipt of clinical / safety events; and providing risk management expertise to support the reduction of preventable errors in health care delivery.