Regional Director of Risk and Compliance

Overview

The Regional Director of Risk and Compliance performs the functions of a Risk Manager, Compliance Officer, and HIPAA Privacy and Security Officer at the assigned regional level.

Responsibilities

Reporting Relationship:

The Regional Director of Risk and Compliance is part of the Office of Legal Affairs and reports to the Assistant Vice President of Risk and Patient Safety.

The Regional Director of Risk and Compliance reports indirectly to the Chief Compliance Officer for compliance related issues.

This position is stationed in the Hazard area and collaborates and communicates frequently with the Regional CMOs, CCEOs and administrative team, system directors, department heads, medical staff, and regulatory agencies.

Major Activities:

Lead and encourage respective region to a culture with a focus on the identification, communication, and resolution of risk, compliance and safety issues within the assigned region.

Oversees all activities related to patient safety and any resulting loss events which may lead to exposures to ARH and help limit the potential loss from those professional and general liability exposures within the assigned region within the assigned region.

Aid in development of programs to identify, analyze, monitor and remediate risk exposures.

Oversees and/or actively participates in the legal process at the direction of the Chief Legal Officer including investigation and documentation related to claims, potential claims, complaints (including employee complaints), or incidents within the assigned region.

Plans, develops and presents educational sessions with employees and providers regarding loss prevention and reduction techniques, insurance coverages and exclusions, medical record documentation, legal issues and the ARH Compliance Program within the assigned region.

Act as a liaison with patients/families and the care team for patient care concerns within the assigned region.

Act as a liaison with the Regional CMO and respective region regarding provider related risks.

Assist with the quality improvement programs within the assigned region.

Oversees and assists with peer review activities within the assigned region.

Oversees collection of data on assigned regional activities to monitor the performance of processes that involve risks, compliance or may result in sentinel events. Participates is proactive risk assessments to mitigate risks and promote patient safety within the assigned region.

Oversees and/or participates with investigation matters related to compliance, risk and any resulting corrective action with all departments, contracted vendors and others as appropriate within the assigned region.

Timely communicates any matter deemed potentially illegal, unethical or otherwise improper to the Assistant Vice President of Risk and Patient Safety and/or Chief Legal Officer.

Timely communicates all compliance related issues to Chief Compliance Officer.

Ensures the services in the region are compliant with applicable laws and regulations and implements system initiatives in that regard. Monitors effectiveness of processes that audit compliance of laws within the assigned region. 

Responds to, and acts as a liaison to the Office of Legal Affairs and the Compliance Department with respect to,   investigations or site-visits by regulatory agencies to facilities in the region including implementation of any corrective action plans.

Monitors the use and disclosure of, and addresses issues associated with the privacy and security of, individually identifiable health information and other patient medical data within the assigned region.

Assist ARH internal auditors concerning audits related to the assigned region.

Performs other duties as assigned.

Qualifications

EducationRequired: Bachelor of Science in Nursing or other health related fields.

Preferred: Master’s degree in Risk Management/Patient Safety or Nursing/Healthcare related field or CPHRM

Minimum Work ExperienceMinimum of two (2) years related experience

Required Skills, Knowledge, and AbilitiesStrong knowledge and understanding of regulatory health law and requirements of accrediting agencies.

Organized, persistent, and creative individual with strong communication skills.

Microsoft Office or related products.

Knowledge of electronic event reporting products and data management systems.

Knowledge of electronic medical records systems.

Able to function effectively, independently, and efficiently in a dynamic work environment.Must be accountable and willing to accept responsibility. Qualities of leadership and integrity are essential to the position.

Demonstrated organization, facilitation, communication (written and verbal), and presentation skills are required.