Clinical Risk Nurse

The 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/Experience

• RN 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/Certificates

• RN with license in good standing in the State of Illinois.
• Greenbelt within 1st year of hire. If hired prior to 2026, Green Belt is due by July 1st, 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 Level

• HIPAA1