Coordinates and oversees the hospital staff’s quality monitoring processes as well as departmental QA/PI implementation and improvements. Evaluates activities within the risk management function. Provide basic and complex preventive risk management assessment of processes, procedures, and programs. This role may assume supervisory responsibility for staff during special projects. This role is also designated as the management representative that has the responsibility and authority for ensuring that the requirements of the Quality Management System are implemented and maintained. This role ensures the effectiveness of the quality management system for the hospital. This individual ensures processes are in place for internal audits and management review to ensure corrective and preventive actions are carried out and are measured for effectiveness.
Essential Functions/Major Responsibilities:
Investigate and analyze potential and actual professional liability and general liability exposures within the hospital; evaluate the extent and elements of exposure and recommend appropriate actions for risk mitigation.
Recommend resolution of claims; complete negotiation of resolution within authority granted.
Coordinates and is accountable for ensuring successful survey and accreditation processes to include DNV and ensures ongoing compliance with regulations.
Review process and outcome of medical care by comparing actual care of individual patients with criteria of care established by medical staff; Review information in medical record; obtain and review information from patient, physician and other participants in the care of patient; determine whether care of patient is an exception to established criteria for the diagnoses and problems that apply to that patient.
Manages and facilitates the Quality Assessment and Performance Improvement Committee.
Co-manages MSPI Committee.
Co-chairs the Policy and Forms Committee
Investigate, evaluate and document pre-litigation occurrences and claims; Acts as liaison with outside counsel and insurance carriers, working together with Safety and Security Officer.
Develops policies and procedures for loss prevention and risk control.
Provides assistance and guidance to departments regarding liability, risk issues and contract administration.
May be requested to participate in review of hospital contracts for insurance requirements and transference of risk.
Provides education to staff regarding quality, ISO, regulatory requirements, and risk management issues
Develops and executes projects to improve compliance with identified quality issues.
Attends and participates in department and hospital meetings.
Conducts routine and periodic education for hospital departments related to billing, documentation, and patient care.
Other duties and responsibilities as assigned/required.
Specific Job Skills:
Proficient with Microsoft office suite.
Strong knowledge of insurance market and products.
Ability to read and interpret business, professional and technical journals.
Ability to write reports and correspondence.
Ability to give formal & informal presentations, occasionally in front of large groups that include the general public.
Ability to actively listen, facilitate resolution and negotiate agreements.
Ability and willingness to participate in process improvement projects and provide input for resolution.
Ability to handle sensitive information in a confidential manner.
Ability to understand and apply intermediate mathematical concepts such as probability, basic statistical analysis and ratios.
Ability to deal with problems involving several concrete and/or abstract ideas.
Flexibility with assigned tasks, as they change to meet hospital needs
Education and/or Experience:
Bachelor’s degree in risk management or other related field; Colorado State Registered Nurse License; three years related experience.
Pikes Peak Regional Hospital and Surgery Center is located just outside the “City Above the Clouds,” Woodland Park, Colorado. This new, state-of-the-art community hospital offers the latest in innovative technology with highly trained and committed individuals serving a pristine mountain community. Featuring 15, all private rooms with a view of America’s Mountain, Pikes Peak Regional Hospital trul...y provides a higher level of healthcare.
Digital mammography along with MRI, 16-slice CT, X-ray, C-arm fluoroscopy and ultrasound imaging.
Level IV trauma with fully equipped rooms, separate patient walk-in and ambulance entrances plus a helicopter transport pad. Telemedicine equipment for assessing stroke patients is also on site.
Family Medical Care
An outpatient medical clinic open to patients of all ages, from newborns to adults. Staffed with three board certified family practice physicians and a nurse practitioner to serve all primary care needs as well as acute, chronic and preventative care. Sports medicine and women’s health emphasis. Services include an in-office laboratory. SAME DAY APPOINTMENTS AVAILABLE at 686-0878! In-office lab and allergy testing also avaiable.
Services include trauma and fracture care, total joint replacement of the hip and knee, arthroscopic and reconstructive surgery of the knee, shoulder and elbow, sport related injuries, arthroscopic ACL reconstruction, shoulder rotator cuff repair plus general hand surgery including Carpal Tunnel Release and Trigger Finger Release.
Outpatient Infusion & Injections
Antibiotic, antiemetic and antihistamine therapy, biologicals, hydration and electrolyte therapy, steroid therapy, rheumatoid arthritis treatments, therapeutic phlebotomy and blood transfusions.
Comprehensive treatments, including physical, occupational, hand and speech therapy, as well as sports medicine.
Pulmonary Function Testing
The PFT Lab offers complete testing on an outpatient basis so patients can be evaluated at higher altitude for lung dysfunction.
Special Care Unit
A Special Care Unit for more medically complex cases such as diabetes, cardiovascular disease and respiratory problems.
Uniquely designed to provide maximum patient and family comfort, the surgical services department offers general, laparoscopic, trauma and vascular surgery, along with gynecologic, minimally invasive, orthopedic, ophthalmologic, plastic surgery, pain management and endoscopy services.
Offering the latest in technology, PPRH is now home to Remote Presence Robotics. Patients with symptoms arriving at our ER can be assessed in a metter of minutes by neurologists specializing in stroke using telemedicine equipment. The specialist connects via the Internet, and appears on camera at the bedside of the patient, much like video conferencing, to interact with family members and clinical staff in the room.
The Transition Care program and its multi-disciplinary team helps patients move from acute to skilled rehabilitation while still in a hospital setting.