SYSTEM DIRECTOR RISK MANAGEMENT

Position Overview:

The System Director of Risk Management is a key leadership role within Physicians Regional Healthcare System, responsible for overseeing the planning, directing, and implementation of risk management and facility compliance programs. This position ensures the healthcare system maintains compliance with all state, federal, and local regulations, while promoting a culture of safety and accountability for patients, employees, and physicians. The System Director is expected to remove obstacles, hire and develop the best employees, and set measurable goals to support the success of the organization. This individual will collaborate with various stakeholders, including CHS Corporate, to ensure optimal quality and risk management operations.

Key Responsibilities:

1. Risk Management System Design & Implementation:
• Develop, implement, and maintain an organization-wide risk management system that addresses risks related to patients, visitors, employees, products, and equipment.
• Investigate and analyze actual and potential risks, assessing the likelihood of legal actions and notifying appropriate hospital and corporate administrators.
• Collaborate with Human Resources to investigate allegations of sexual misconduct involving personnel with direct patient contact.
• Serve as a liaison between Physicians Regional Healthcare System and CHS for insurance issues and programs.
2. Incident Reporting & Patient Safety:
• Maintain computerized risk management and medication variance reporting systems.
• Review all incidents and medication variances for safety issues, patterns, and trends.
• Serve as the Patient Safety Officer or collaborate with the position to support safe patient outcomes.
• Ensure the identification, investigation, and necessary disclosure of Serious Safety Events (SSE) and Sentinel Events, including conducting Root Cause Analysis.
3. Reporting & Monitoring:
• Prepare monthly and quarterly reports for committees on risk-related occurrences, including tracking patient complaints and grievances.
• Interview patients and families when necessary to address complaints/grievances.
• Report risk management findings to committees, management, regulatory agencies, and the Board as required by regulations and corporate guidelines.
4. Claims & Litigation Management:
• Manage claims and litigation processes, including maintaining legal files, conducting investigations, reviewing charts, assisting defense counsel, and working with CHS claims management for settlements and mediation.
• Represent the hospital in legal proceedings as necessary.
5. Premium Credit Program:
• Oversee the premium credit program to achieve maximum credit.
6. Education & Staff Training:
• Educate staff and management on the risk management program, patient safety, ethics, and compliance, including during new employee orientation.
• Participate in the education program to enhance staff understanding of risk management, loss prevention, and regulatory compliance.
7. Regulatory & Compliance Oversight:
• Collaborate with key leadership to ensure compliance with state and federal regulatory agencies, accreditation requirements, and licensure mandates.
• Assist with regulatory surveys, including those by the Joint Commission and other state and federal bodies.

Qualifications:

Education:

• Bachelor’s degree in Nursing required.
• Relevant advanced certifications (e.g., CPHRM, CHC) are a plus.

Experience:

• 3-5 years of progressively responsible healthcare-related experience in Risk Management.
• 5 years of Acute care clinical experience required.
• Knowledge of healthcare law, risk, and claims management.

Licenses/Certifications:

• State of Florida licensure as a Registered Nurse required.
• Current Licensed Healthcare Risk Manager (LHRM) required.
• CPHRM (Certified Professional in Healthcare Risk Management) and/or CHC (Certified in Healthcare Compliance) required

Additional Skills & Abilities:

• Strong leadership skills with the ability to manage, motivate, and develop staff.
• In-depth understanding of risk management processes, including incident reporting, investigations, and litigation management.
• Excellent communication and interpersonal skills, capable of effectively collaborating with leadership, staff, patients, and external stakeholders.
• Ability to analyze and manage risk data, prepare detailed reports, and implement improvement plans.
• Demonstrated commitment to patient safety and regulatory compliance.

The System Director of Risk Management plays a critical role in ensuring the safety and well-being of patients, staff, and the healthcare system as a whole, while leading efforts to manage and mitigate risks within the organization.