Risk Management Specialist, Grievances and Investigation – Risk Management – Full Time 8 Hour Days (Non-Union) (Exempt) – (Los Angeles, California, United States)

The Risk Management Specialist (Grievances and Investigation) provides departmental expertise in administering the centralized grievance process for the healthcare system, conducting and assessing ongoing root cause analysis and other investigation types, managing the source of information for grievances, developing and presenting targeted and timely reports, coordinating the Integrated Grievance and Concern Committee and its efforts in managing complex grievance concerns, developing and providing educational programs, and is an administrative lead in meeting preparation, auditing and regulatory quality control. This role may also collaborate with risk management projects and initiatives. This role is critical to the Office’s commitment to collaborative, data-driven risk management and risk mitigation services to the Keck Medicine system as a whole.

Essential Duties:

  • Grievance Process: Administers all aspects of the grievance process, including intake and documentation of grievances, develops and communicates responses towards patients and families to address grievances, ensures timely notification and accurate documentation, uses grievance process expertise to collaborate with faculty and staff to resolve grievances, oversees follow up communications with key stakeholders, and analyzes past grievances to identify trends that can lead to educational opportunities.
  • Investigations: Administers all activities of investigations through the Office of Integrated Risk Management. Ensures that investigations include all appropriate key stakeholders, policy timelines are adhered to, investigation expectations are clearly defined and enforced, plans of action are submitted to the appropriate committees for review, and facilitates communication with internal and external contacts.
  • Special Projects: Leads, organizes, and implements special projects for the Office of Integrated Risk Management
  • Data Management: Develops and presents targeted and timely reports, data base management, data analysis, and regular document/report generation. Enters data into the Risk Management System (RMS) or other pending RM software, as needed.
  • Education: Through trending and analysis, develops and provides focused educational training programs throughout the enterprise to reduce and mitigate patient grievances and other topics. Independently develops and prepares the tools, materials and presentations related to orientation, training and continuing education of faculty and staff.
  • Communication: Acquires, comprises, and communicates significant and sensitive information and data to appropriate members of the department. Leads communication efforts between the department and its customers, in collaboration with departmental staff.
  • Planning and Organization: Leads the coordination of grievance activities for the Office of Integrated Risk Management both internally (intradepartmental, interdepartmental and enterprise-wide), and externally (physicians, attorneys, regulatory agencies)
  • Committee Support: Facilitates the activities of the Integrated Grievance and Concern Committee and its efforts in managing complex grievance concerns.
  • Performs other duties as assigned.

Required Qualifications:

  • Req Bachelor’s Degree in Arts/Sciences (BA/BS) Degree in a related field.
  • Req 5 years Five years (5) experience in risk management, quality, performance improvement, patient relations, safety or other related healthcare position/setting
  • Req Proficient in Microsoft Office Suite

Preferred Qualifications:

  • Pref Master’s degree in Arts/Sciences (MA/MS) Degree in a related field.
  • Pref Knowledge of JCAHO, Title 22, and CMS regulations pertaining to healthcare
  • Pref Knowledge of principles, practices, processes, quality assessment, performance improvement functions, and legal concepts related to healthcare or related field.
  • Pref Certification – Job Relevant LEAN or Six Sigma Certification

Required Licenses/Certifications:

  • Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)

The annual base salary range for this position is $68,640.00 – $112,370.00. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.

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