As a reminder this writer works as a field base case manager of an insurance company; who provides medical management of occupational hazard claims. The employer’s introduction to the explanation of a risk management program varies from the usual approach. This writer’s employer’s approach to the acknowledgement of their risk management program is illustrated via their quality management program. The scope and content of the QM program are designed to continuously monitor, evaluate and improve the quality and safety of clinical care and service provided to enrollees. (Aetna, 2013). Likewise, the following steps are also a part of the administrative process of mitigating risk.
The employer’s plan of carrying out the approach to risk management as follows:
The identification of risk; which entails the documentation of key corporate and tactical drivers. Secondly, the clarification of restructuring protocols to the organization. Likewise the fortitude of introductory organizational and program risks.
The valuation and ranking of risk; including the conveyance of risk assessment to assess the consequence of the obligatory compliance measures that must be implemented. Following the risk management teams’ assessment using the Knowledge Areas defined in PMI’s PMBOK® Guide, such as Projec...
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...consistency in quality management. Likewise, for case managers’ functioning in this role the important aspects of risk management is the safe guarding and accuracy of documentation, compliances and timely contact or reporting. The new hire should be adequately educated in the above so that they’re protected (person/license) in addition to becoming informed of institutional compliances to maintain patient and organizational safety.
Risk exploration and risk managing are the groundwork of safety compliance efforts. It is a continuing process that will offer comprehensive understanding of the risks to both the corporate/ human capital aspects of a business and give depth to the measures set in place to manage said variances. Completing timely and sequined compliance will safeguard the concealment, obtainability and veracity against any judiciously projected variances.
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