Job Description
Nestled between Burbank and Pasadena, Adventist Health Glendale is one of the area's leading healthcare providers. We are comprised of a 515-bed hospital, two urgent cares, home care services, comprehensive cardiology care and a vast scope of services located in the San Fernando Valley. We are committed to the development and empowerment of our nurses and have received Magnet designation from the American Nurses Credentialing Center. Glendale is known for its urban living, with easy access to dining, entertainment, shopping, amusement parks and outdoor recreation. Adventist Health Glendale is proud to be part of the thriving, diverse community since 1905.
Job Summary
Maintains responsibility for the direction and management of the risk department for multiple locations. Acts as principal advisor to both organizations in the areas of safety, risk management and regulatory affairs. Ensures compliance with various codes, laws, rules and regulations concerning patient care including those mandated by State/Federal agencies. Oversees incident reporting including investigation activities of Federal, State and local enforcement authorities. Supervises and directs the activities of various levels of assigned personnel using both professional and supervisory discretion and independent judgment.
Job Requirements
Education and Work Experience:
- Bachelor’s Degree or equivalent combination of education/related experience: Required
- Master's degree: Preferred
- Seven years' experience: Preferred
- Five years' leadership experience: Preferred
Licenses/Certifications
- Registered Nurse (RN) licensure in the state of practice: Required
Essential Functions
- Directs and coordinates safety initiatives with system leadership and medical staff for the organization. Initiates and oversees the development of a comprehensive safety program. Develops and enhances existing risk management programs consistent with established organizational philosophies and procedures. Oversees all risk management functions. Maintains a network of informational sources and experts, performs risk surveys, inspects patient care areas and reviews facilities to assess loss potential.
- Develops, coordinates and administers facility-wide systems for risk identification, investigation and reduction. Oversees the facility’s activities related to risk management to ensure patient/staff safety and minimize potential organizational financial losses. Participates in root cause analysis investigation and reports adverse drug/sentinel events to appropriate parties. Directs and ensures efficient/occurrence review and claim file management. Coordinates release of records in response to subpoenas, court orders and attorney requests. Ensures departmental support/participation in the Patient Safety process by evaluating individual files and trend data for compliance with regulatory requirements.
- Acts as site administrator for Claims Module (Potentially Compensable Event) and maintains legal case files. Investigates and reports potentially compensable events (PCEs) and asserted claims (demands for compensation, services or litigation) to the Trust pursuant to the corporate policy for reporting to the Trust. Provides investigation findings/information to claims staff including identity of location/site/clinic involved, identity (full name, job title) of involved parties, witnesses (how they are/were involved) etc., narrative description of the events, issues identified and recommendations for additional investigation. Investigates and responds (in writing) to requests from patients/visitors for compensation or payment for services, e.g., physical therapy, home health, specialist consultation, etc. Serves as primary contact for defense counsel and corporate claims staff. Facilitates/verifies discovery and requests for documents, information, interviews and depositions Obtains concurrence for settlement, trial, etc.
- Works with legal counsel to coordinate investigations, process and defend claims against the facility. Obtains/maintains records and documents and provides them to defense attorneys for preparation of testimony in pending litigation. Safeguards materials obtained or developed for root cause analysis to ensure documents/proceedings are protected from discovery. Initiates and monitors efforts to preserve evidence, i.e., surveillance video, equipment memory, etc., and/or litigation holds. Attends trial as site representative, coordinates litigation activities involving site interviews, depositions, witness preparation, etc. Approves payment for replacement of lost property after claim evaluation. Negotiates settlement of small claims within administrative authority and advises collection department of appropriate action for unpaid accounts involved in litigation.
- Performs other job-related duties as assigned.
Organizational Requirements
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.
About Us
Adventist Health is a faith-based, nonprofit, integrated health system serving more than 90 communities on the West Coast and Hawaii with over 400 sites of care, including 26 acute care facilities, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of 37,000 includes employees, physicians and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.
