Clinical Risk Manager

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015. Position Summary The Clinical Risk Manager drives optimization of patient safety, reduction of risk of harm, and ensures regulatory adherence for all health center departments and sites. Performs detailed analyses of individual incidents and trends, creates tactics and tools to mitigate recurrent adverse events and partners with Delivery System (DS) leadership to implement change to improve patient care outcomes and experience. Serves as a subject matter expert on all relevant clinical state policy and ensures DS Clinical Policies and Procedures are up-to-date and compliant with regulatory guidance. This position also oversees staff in the data collection and reporting activities for external quality programs deemed of interest by senior leadership. Job Description

PRIMARY DUTIES AND RESPONSIBILITIES

Employees are expected to work consistently to demonstrate the mission, vision, and core values of the organization. Develops and drives policy, protocols and procedures required to support quality assurance and regulatory compliance as determined by state law or leadership at Martin's Point Ensures adherence to all applicable State laws by remaining up to date on relevant and new standards or requirements Disseminates knowledge of policy and procedure, working with practice leaders to support staff education on quality assurance and regulatory related issues Owns the development and improvement of Martins Point's internal event reporting system in partnership with IT Fosters a "culture of safety" to ensure staff feel safe reporting adverse and near-miss events Conducts Root Cause Analysis for clinical adverse event trends and high-risk events; develops action plans to reduce risk of recurrence; follows the progress of these action plans to completion with all assigned parties Provides quarterly and annual reports of trended incidents with recommendations to DS Senior Leadership, and on request to the Executive Management Team Recommends and develops selected case reviews, in consultation with the VP of Clinical Integration, and leads Peer Review of the highest risk clinical adverse events with the goal to improve quality and safety of care as well as internal processes; follows the progress of these action plans to completion with all assigned parties Manages, in partnership with Practice Leadership and Practice Quality Steering, high priority clinical quality and safety improvement projects, and develops supporting policy, communication, and job aids Provides support and guidance to Compliance and Legal Affairs for all clinically related matters Creates and delivers New Provider Onboarding activities related to clinical risk, patient safety education, and best practices Provides ad hoc consultation to front line providers and Practice Medical Directors on request Remains abreast of CMS Medicare and Medicaid quality performance programs; raising attention re. program changes, new opportunities, and performance barriers Manages

NCQA PCMH

Recognition certification process across the Delivery System, to include a broad understanding of the theoretical framework, standards, and guidelines, eligibility, application, and documentation processes Manages

MIPS MACRA

submission and compliance efforts across the Delivery System in coordination with the Clinical Informatics Team Performs other duties as requested by leadership team

POSITION QUALIFICATIONS

There are additional competencies linked to individual contributor, provider, and leadership roles. Please consult with your leader to discuss additional competencies that are relevant to your position. Education Bachelor's degree in nursing required Master's degree in nursing, Business, or Health Care Management preferred Licensure/certification Current, unrestricted Registered Nurse licensure in Maine American Society for Healthcare Risk Management (ASHRM) Certified Professional in Healthcare Risk Management (CPHRM) required upon hire or completed within first year Experience 5+ years of nursing experience required with experience in risk mitigation and quality assurance, quality and safety improvement, and regulatory readiness activities Knowledge Maintains broad knowledge of industry trends and developments Skills Competence with computers and business applications: Microsoft Outlook, Excel, Word, and Power Point Abilities Superb critical thinking and analytical skills and ability to identify root causes of problems Strong interpersonal skills and able to build strategic relationships across organization Ability to gather, interpret and present data to teams, senior leadership, and external partners Systems thinker who can contribute to strategic and tactical planning, developing, and supporting implementation of creative solutions Possess ability to interpret and simplify communications of regulatory standards, and remain up to date on changes to requirements Proactive approach and able to work independently, highly organized Excellent written and oral communication skills, able to discuss negative events with others in a supportive and non-punitive manner Ability to build collaborative relationships with multi-disciplinary teams supporting the achievement of objectives, without direct authority Inspire others toward the goal of continuous quality and safety improvement Manage multiple competing demands, able to prioritize and make sound decisions This position is not eligible for immigration sponsorship. We are an equal opportunity/affirmative action employer. Martin's Point complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact jobinquiries@martinspoint.org Do you have a question about careers at Martin's Point Health Care?

Contact us at:

jobinquiries@martinspoint.org Martin's Point Health Care is a progressive, not-for-profit organization providing care and coverage to the people of Maine and beyond. The organization operates six primary care health care centers in Maine and New Hampshire, accepting most major insurance plans. Martin's Point also administers two health plans: Generations Advantage (Medicare Advantage plans available throughout Maine), and the US Family Health Plan (TRICARE Prime® plan for active-duty and retired military families in Maine, New Hampshire, Vermont, upstate New York, northern and western Pennsylvania, and northeastern and central Ohio). For more information, visit https://careers.martinspoint.org.