The primary duty of System Director Risk Management is to confer with physicians and health care facilities regarding the potential risks of medical treatments.Reporting to the System VP of Quality and Safety and working within the confines of regulatory compliance, this manager uses proactive measures to strengthen a safety culture and create a safe environment for quality patient care.
§Bachelor's Degree in clinical field, Healthcare Administration, or related field; graduate degree preferred
§Certified Professional in Healthcare Risk Management (CPHRM) -- to be obtained within two years of hire
§Lean experience desired.
§Excellent interpersonal skills required.Demonstrated ability to communicate effectively with physicians, nurses, other health care professionals, insurance representatives and attorneys.High degree of accuracy and mental awareness.Ability to make accurate independent decisions
§Excellent verbal, written, and presentation skills are necessary.Computer database and word processing skills required.Must be able to collect, synthesize and interpret large amounts of data related to risk management and patient safety
§Exceptional problem-solving skill. Excellent customer service orientation skills necessary in order to deal effectively with various levels of hospital personnel, outside customers, and community groups.
§Requires independent judgment and action skills.Must maintain high level of confidentiality and ability to prioritize multiple tasks/activities.Strong organizational skills and the ability to concentrate while being subject to multiple interruptions and changing work priorities.
§Comfort in handling challenging situations that may involve adverse outcomes
§Ability to maintain a calm, professional demeanor under pressure
§Knowledgeable of CMS, Joint Commission, and other regulatory requirements
§Reports to the to the System VP of Quality and Safety
§Also has accountability to the President MHC, CMO MHC & VP Legal Affairs
§Works in close collaboration with local and entity Vice Presidents of Medical Affairs and Medical Staff Services, quality, safety and risk leaders, Infection Prevention Managers, Accreditation Compliance Managers, Directors Safety and Security, Director Corporate Compliance, and the Director of Organizational Quality & Patient Safety
§Works directly with patients, families, and appropriate staff to resolve concerns /complaints and maintain positive relationships
§Performs functions of the Patient Liaison as needed to meet departmental goals and customer service requirements.
Has responsibility for the following areas at MMC:
§Clinical Risk Management
§Patient Liaison Department
1.Supports the Mission, Vision and Values of Munson Healthcare
2.Embraces and supports the Performance Improvement philosophy of Munson Healthcare.
3.Promotes personal and patient safety.
4.Uses effective customer service/interpersonal skills at all times.
§Provides consultation related to potentially compensable events, policy/procedures, care standards, patient rights, incidents and claims, documentation requirements, regulatory agency standards, reporting requirements, complaint management, etc.
§Advises staff, Medical Staff, and administrators regarding disclosure, assisting the process as appropriate system-wide.
§Evaluates the litigation potential of incidents and adverse outcomes occurring within MHC hospitals, clinics, offices, and properties in collaboration with Claims Coordinator.
§Prepares and conducts educational programs for MHC entities' medical, nursing, and support staff on risk management topics, including disclosure.
§Minimizes severity of losses through methods such as claims investigation and early identification and management of events.
§Identifies potential risks related to local and system policies, practices, and situations that could result in patient harm and/or financial loss and advises staff, employees, and Medical Staff in assessing, resolving, and preventing risk
§Reports significant incidents of risk and concerning trends to the System VP of Quality and Patient Safety, VP Legal Affairs, the Claims & Risk Coordinator, and appropriate Administrator(s)
§Responds to patient and visitor claim demands with primary responsibility for MMC and as a resource for system entities.
6.Coordinates/leads Complaints/Grievances Committee. Provides risk management support to entity Board Quality Committees, Quality and Patient Safety Councils, Serious Safety Event Committees, and others as requested; reports Risk Management Program activities to the MHC Board at designated intervals for the purpose of reviewing and evaluating the activities.
7.Participates in activities of various hospital or medical staff committees, CQI teams/work groups, Munson Health Care affiliates, or community organizations to promote attainment of Risk Management Program objective.
8.Coordinates and presents information regarding the Risk Management Program to surveyors for CMS, TJC, MHAIC, OSHA, MDHHS, and other regulatory agencies.Assists other departments/subsidiaries/affiliates to meet compliance requirements.
9.Maintains a working knowledge of applicable Federal, State, and local laws and regulations, the Corporate Compliance Program, Code of Ethics, SMDA, EMTALA, and patient safety, as well as other policies and procedures, in order to ensure compliance. Assists in the development of local and system policies and procedures for compliance and promoting patient safety.
10.Maintains awareness of legislative activities, court decisions, regulatory agency requirements, and risk management trends via membership and communication with state and national risk management associations in order to assure proactive preparation and facilitate compliance in a timely manner.
11.Complies with MHC Claims Management Policies and agreements for claim management.
12.Actively preserves the confidentiality of claims files and patient and corporate protected information.Knows and coaches others on compliance with HIPAA, Patient Safety Evaluation System, Patient Safety Work Product, peer review, attorney/client work product, and other applicable regulations and laws.
13.Actively supports programs that strengthen a safety culture and create a safe environment for quality patient care.
14.Supports the functions of the Patient Liaison Department when necessary with primary
responsibility at MMC.
15.Communicates with all levels of staff within the department and hospitals, including outside agencies, to ensure prompt and proper exchange of information and resolution of issues.
16.Attends court/litigation proceedings including settlement/mediation, trials as needed.
17.Uses computer applications (PowerChart, Word, Excel, Powerpoint, RL Solutions, Outlook, Morrisey, etc.) efficiently and effectively.
18.Performs other duties and responsibilities as assigned.