Risk Management Director

Summary

The Risk Director assesses, plans, implements, and directs the Risk Management activities of the organization. The Risk Director works collaboratively with peers in leadership across the organization to mitigate risk and identify opportunities to prevent harms. This will include operational, clinical, strategic (or reputational), financial, workforce, legal and regulatory, technology (including information technology), and facilities or grounds/property risks. The Risk Director must be familiar with all state and federal compliance regulations and standards.

Essential Duties and Responsibilities

The duties and responsibilities described below represent general, expected tasks to be performed; other tasks may be assigned.

• Investigate patient complaints, potential adverse events, and reported medical malpractice claims in collaboration with peers in operations, quality, and compliance departments as necessary.
• Review medical records for various possible liability issues.
• Demonstrate a commitment to flexible work scheduling when necessary to ensure patient care.
• Identify and evaluate risks to reduce injury to patients, staff members, and visitors within the organization.
• Work proactively and reactively to either prevent incidents or to minimize the damages following an event.
• Design, implement, and maintain organizational systems for claims management and occurrence reporting with the goal of reducing claims, occurrences, and the associated liability.
• Serve as the Administrator and maintain and utilize the event reporting system to track and trend potential areas of risk and to identify patient safety concerns.
• Develop system-wide risk management objectives through effective collaboration with organizational leaders.
• Design risk management strategies, with the assistance of the respective department leaders. Establish and implement procedures to decrease risk and liability of organization.
• Follow trends in the risk management industry, and collect and analyze risk management data as required, to advise executive team of new developments in liability or risk.
• Review claims or potential claims related to professional and general liability, analyze actual and potential risk, assess liability and probability of legal action, and collaborate with legal counsel.
• Assist in processing summons and complaints served on present and previous employees.
• Interact with executive team and legal counsel to respond to claims or issues to facilitate settlement at an early stage.
• Work to resolve complaints/issues to mitigate professional liability claims.
• May negotiate settlement of small claims within administrative authority. 
• Provide follow-up and take appropriate steps to ensure risks are minimized on all identified regulatory/insurance survey reports recommendations/deficiencies.
• Receive and manage information on event occurrences; review for potential liability; ensure immediate investigation and follow-up of serious occurrences and sentinel events with participation at the level appropriate to the event.
• Plan and coordinate the organization’s insurance coverage against liability and casualty loss, budgeting for payment of deductibles, risk retention, coinsurance.
• Participate with management in reviews of insurance coverage and related issues.
• Collaborate with insurance carriers regarding claims, applications, and on-going communication.
• Aid in gathering information regarding claims or claims history.
• Coordinate with hospital legal counsel to coordinate the investigation, processing, and defense of claims against the hospital.
• Assist with professional liability and hospital liability questions presented by hospital staff and medical staff.
• Present in-services and routine orientation for employees and medical staff regarding healthcare risk management and related subjects to enhance awareness of their role in reducing liability exposures and for reporting occurrences.

Supervisory Responsibilities

Reports to:  Chief Medical Officer

Supervises: This job has no supervisory responsibilities

Responsibilities:

• Assists in the development) of the department budget.
• Analyzes costs and develops processes or initiates to assure compliance with budgetary constraints.  Reviews monthly departmental department budget reports and provides justification for budget variances.
• Provides guidance and professional and technical development for team members.
• Conducts regularly scheduled meetings to communicate issues regarding on-going work issues, new developments, and overall effectiveness.
• Develops job competencies for staff members, conducts evaluations in a timely manner and ensures evaluations are fair and consistent and that performance expectations are communicated.
• Responsible for the appropriate orientation, development, and training of staff members
• Performs conflict resolution, problem solving and initiates progressive disciplinary action when necessary.
• Develops and implements department policies and procedures as necessary.
• Develops. Reviews, and revises organizational policies as required.  Plays a key role in the implementation of such policies.

Qualifications

To perform this job successfully, and individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Excellent verbal and written communication skills.
• Proficiency in planning, coordinating, and implementing patient and staff safety procedures.
• Good judgment and decision-making abilities.
• Strong interpersonal, organizational and customer service skills.
• Ability to work independently and as part of a team.
• Interest in continuous learning and a commitment to staying informed on regulatory changes.
• Talent for leading and facilitating group and team meetings.
• Attention to detail and analytical skills.
• Comfort in handling challenging situations that may involve adverse outcomes.
• Ability to maintain a calm, professional demeanor under pressure.

Education and Experience

Minimum Required Education: Master of Science in Nursing (MSN)

Preferred Education: Juris Doctor (JD)

Experience: Minimum of 5 years of progressive risk management experience required.

Certificates, Licenses, Registrations:

Must be RN with current license in the state of Virginia or a compact state.  Currently licensed attorney for the state of Virginia preferred.