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Clinical Risk Nurse

Posted 4 days ago

springfield clinicSpringfield (IL)

SENIORITY

Mid

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About the role

Clinical Risk NurseThe Clinical Risk Nurse is responsible for receiving, investigating, documenting and summarizing all customer complaints and adverse clinical events directed to the Quality Management Department. Job Relationships Reports to the Risk Manager.
Principal Responsibilities:
  • Take all customer complaints directed to Quality Management Department.
  • Investigate complaints and prepare report including recommendations for resolution.
  • Prepare letters and account action worksheets for Director approval.
  • Maintain aggregate statistics for reporting complaints.
  • Prepare reports of complaints handled for Quality Management Committee. Assist in identification of cases for Committee review.
  • Identify trends and discuss with the Risk Manager and/or Director for reporting to Quality Management Committee.
  • Conduct special investigations/reviews as requested by Administration and/or Medical Directors for specified patient populations or conditions, procedures performed/utilized and prepare reports.
  • Conduct Ambulatory Surgery Center (ASC) chart audits and edits to ensure accuracy, completeness, and regulatory compliance.
  • Perform monthly site surveys at off-site locations to assess quality, compliance, and operational standards.
  • Conduct root cause analyses to identify underlying causes of quality, safety, or operational concerns
  • Design, perform, and evaluate quality studies related to risk management, patient safety, and process improvement initiatives
  • Comply with the Springfield Clinic incident reporting policy and procedures.
  • Adhere to all OSHA and Springfield Clinic training & accomplishments as required per policy.
  • Provide excellent customer service and adhere to SC Way customer service philosophy.
  • Perform other job duties as assigned.
  • Education/ExperienceRN BSN preferred.
  • Minimum of five (5) years' experience in a health care setting; medical office preferred.
  • Familiarity with EHR clinical products and experience in medical record review
  • Licenses/CertificatesRN with license in good standing in the State of Illinois.
  • Greenbelt within 1 st year of hire. If hired prior to 2026, Green Belt is due by July 1 st, 2027.
Knowledge, Skills and Abilities: Expertise with Microsoft Office products (Word, Excel, MS Access, MS Outlook).Customer oriented with pleasant telephone voice. Excellent organizational, verbal and written communication skills. Ability to solve problems and interpret clinic policy.
Working Environment: Office environment. Sitting for long periods/computer work. PHI/Privacy LevelHIPAA1

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