RN Clinical Risk Management and Claims Coordinator
Location: Sebring, Florida
Internal Number: 22018198
All the benefits and perks you need for you and your family:
Benefits from Day One
Paid Days Off from Day One
Student Loan Repayment Program
Whole Person Wellbeing Resources
Mental Health Resources and Support
Debt-free Education (Certifications and Degrees without out-of-pocket tuition expense)
Nursing Clinical Ladder Program
Team Based Nursing Model
Our promise to you:
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Schedule:Full Time, Part-Time, PRN
Location: 40100 US-27, Davenport, FL 33837
The community you’ll be caring for: AdventHealth Heart of Florida
AdventHealth Heart of Florida is a licensed 193-bed acute care hospital, coupled with outpatient services including imaging, rehab, lab and wound care, that has been serving the community for over 50 years.
As a part of the AdventHealth network patients will have greater access to a wide range of innovative therapies, new research, leading-edge technology and an extensive team of medical specialists.
High-quality care that has been recognized by the Joint Commission, the American Heart Association and the American Diabetes Association.
Located in Davenport, FL., which is close to major destinations, like Busch Gardens, Legoland, and Walt Disney World, without being located in the central hub of tourism.
The role you’ll contribute:
The Clinical Risk Management Coordinator (CRMC) is responsible for the risk management program for the assigned areas. This position is responsible for working in collaboration with the clinical team to ensure adherence to all federal regulations and hospital policies. This position engages in activities which contribute to a safer environment for patients, employees, and visitors. These activities promote customer service, minimize liability risk for the Hospital and proactively identify areas for improvement. The CRMC will systematically investigate clinical incidents/ accidents/ events that could lead to patient harm and/or financial loss and ensures all risk management activities, including the internal event report system and patient grievance process are in compliance with FL State Statute 395.0197. The CRMC will identify areas of risk and facilitate risk mitigation/safety strategies including the Root Cause Analysis and Response. The focus of this position is on review, investigation and response of incidents that include general/premises liability, medical liability, regulatory investigations and other potentially compensable events including lost or damaged belongings incidents, providing timely communication and submission of required documents to support legal defense response. The CRMC also acts as the internal system administrator for the voluntary event reporting system.
The value you’ll bring to the team:
Responsible for the management of the internal event report system for assigned area, in compliance with Florida Statute 395.0197 including identification and reporting of adverse events.
Reviews reported events to assure data completeness and accuracy and initiates event follow up with appropriate Directors and Managers within 3 days of event report.
Identifies, investigates, and reports on Sentinel Events/Never Events and facilitates Root Cause Analyses according to the RCA2 HFACS method.
Investigates premises liability and medical malpractice claims working with the Director of Risk Management and the corporate Claims Manager to achieve the appropriate outcome.
Identifies potentially compensable events (PCE) and converts events over to the claims systems according to established guidelines in a timely manner.
The expertise and experiences you’ll need to succeed:
Florida Registered Nurse License or other commensurate clinical licensure/certification.
Associate degree in business or healthcare related field
3-5 years clinical experience in healthcare related field
Bachelors’ Degree in healthcare related field.
2 years’ experience in Health Care Risk Management which includes claims management/litigation prevention
Experience in process improvement/patient safety
Certification in Healthcare Risk Management (CPHRM) or Associate in Risk Management Designation (ARM)or Certified Professional Patient Safety (CPPS)
At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. Our more than 80,000 skilled and compassionate caregivers in hospitals, physician practices, outpatient clinics, urgent care centers, skilled nursing facilities, home health agencies and hospice centers are committed to providing individualized, wholistic care.