Massachusetts Jobs

Opportunities with Reliant Medical Group, part of the Optum family of businesses. Join a community-based, multi-specialty, physician-led organization where you will work with talented peers on a common purpose: improving the quality, cost and experience of health care. Here, we focus on delivering the best patient care, rather than volume. Through innovation and superior care management, we support patients and your well-being as a team member. Join a team at the forefront of value-based care and discover the meaning behind Caring. Connecting. Growing together.

The Risk Manager provides day to day risk management and patient safety support across all Reliant Medical Group sites. Performs a variety of duties related to data input, analysis, trending and tracking of claims and risk management information. Serves a point of contact for all providers, managers and staff, handles all risk management issues, offering advice, coordinating investigations, ensuring follow-up and establishment of corrective action plans as needed.

Primary Responsibilities:

• Actively promotes the use of the electronic reporting Staff Safety Alert System for all adverse events, including near misses occurring organizational wide

• Reviews incident reports and enters appropriate information into the database to refer incidents to other involved departments and assures follow-up is complete and accurate for file closure

• Identifies incident reports to determine if reporting to outside parties is necessary (i.e., reporting to a regulatory agency, liability carrier, third party administrator, workers compensation carrier, FDA, etc.)

• Track and trends incident reports on a regular basis to identify safety issues and concerns throughout the organization

• Assists department managers in the identification of trends, timely resolution of incomplete, unresolved reported events and the development of meaningful action plans

• Provides guidance, advice, consultation and support to all providers, staff and leadership on risk management, legal and regulatory matters

• Conducts data analyses to assess performance improvement opportunities and measure these improvements within the organization

• Utilizes data and conducts research to find industry trends related to risk management while identifying and sharing best practices

• Actively serves on and participates in selected Reliant Medical Group Committees as assigned to promote the health and safety of our patients with high quality standard while addressing issues with risk management implications. Also, provides data to committees regarding risk management issues identified through the incident reporting process

• Prepares and maintains standardized PCE, claims, and suits files on the departments G drive

• Assists in the processing of documents for discovery as requested by the Manager of Risk Management and/or Director of Risk & Quality Management

• Reviews insurance carrier information reports such as open/closed claims, report and loss runs for accuracy and trends as necessary

• Develops patient warning and termination letters per the organizational policy and works with the providers, managers, and/or directors involved

• Works with clinical sites to plan, coordinate and evaluate corrective action plans recommended by the PCAR committee, the Manager of Risk Management and/or Director of Risk and Quality Management

• Collaborates with the Manager of Risk Management and Director of Risk and Quality Management to proactively identify risk reduction opportunities and to design and implement risk mitigation interventions

• Collects, evaluates and distributes relevant data concerning patient injuries; aggregate data summaries, monthly/quarterly trends; provides aggregate analysis of risk data and trending of losses, etc.

• Assists daily in the initiation of patient safety related strategies to ensure the delivery of high-quality care within the organization

• Identifies and reviews all PCEs, follows all recommending reporting requirements and hands off all incidents for a Quality Peer Review as identified

• Participates actively in the content planning, coordination of risk-related educational programs for physicians and support staff on concerning risk management issues such as informed consent, documentation, policies and procedures, etc.

• Presents risk management educational sessions to individual departments or groups to address trending topics of concern such as incident reporting; documentation concerns; regulatory requirements; informed consent, or other concerns identified through the incident reporting system

• Participates in Risk Management site visits which are conducted at all Reliant locations on a regular basis throughout the year

• Appropriately create or revise new or existing policies and procedures to reduce the frequency of future occurrences; recommends ways to minimize risks through system changes; reviews and revises facility policies as appropriate to maintain adherence to current standards and requirements

• Assist in the revision of and development of new department specific and organizational consent forms

• Conducts root cause analysis (RCA) and failure mode effects analysis (FMEA) as needed

• Complies with health and safety requirements and with regulatory agencies such as DPH, MDS, etc.

• Complies with established organizational policies, departmental policies, procedures, and objectives

• Enhances professional growth and development through educational programs, seminars, certifications, etc.

• Attends a variety of meetings, conferences, and seminars as required or directed

• Performs other similar and related duties as required or directed

• Other responsibilities as requested by the Manager, Risk Management and/or the Director of Risk and Quality Management

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Bachelor’s Degree in Business Administration, Healthcare or equivalent experience

• 3+ years of experience in Healthcare Risk Management

• 2+ years of Patient Safety experience

• Experience and basic command of Root Cause Analysis (RCA), FMEA and other risk management and quality improvement techniques

• Experience formulating data correlations to determine drivers of risk

• Experience conducing moderate level statistical analysis

• Experience communicating effectively and sensitively with clinicians in stressful situations

• Proficient in Microsoft Office Suite - Word, Excel, and PowerPoint

Required Qualifications:

• Experience with health and safety regulatory agencies such as DPH, MDS, etc.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.