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Director, Risk Management & Accreditation, Risk Management, Full-Time

Company: Adventist Health NW
Location: Sonora
Posted on: May 3, 2021

Job Description:

Adventist Health is more than an award-winning health system. We provide whole-person care to our communities and champion the greater good - from the operating room to the boardroom, we are driven by our unique passion to live God's love through health, wholeness and hope. From Oregon to Oahu, we have a calling to always do more. Now is your chance to apply your passion to our mission.

We're looking for someone to join our team as a Director, Risk Management who:

Maintains responsibility for the direction and management of the department. Acts as principal advisor to the organization in the areas of safety, risk management and regulatory affairs. Ensures compliance with various codes, laws, rules and regulations concerning patient care including those mandated by State/Federal agencies. Oversees incident reporting including investigation activities of Federal, State and local enforcement authorities. Supervises and directs the activities of various levels of assigned personnel using both professional and supervisory discretion and independent judgment.

Essential Functions:

  • Directs and coordinates safety initiatives with system leadership and medical staff for the organization. Initiates and oversees the development of a comprehensive safety program. Develops and enhances existing risk management programs consistent with established organizational philosophies and procedures. Oversees all risk management functions. Maintains a network of informational sources and experts, performs risk surveys, inspects patient care areas and reviews facilities to assess loss potential. Develops, coordinates and administers facility-wide systems for risk identification, investigation and reduction. Oversees the facility's activities related to risk management to ensure patient/staff safety and minimize potential organizational financial losses. Participates in root cause analysis investigation and reports adverse drug/sentinel events to appropriate parties. Directs and ensures efficient/occurrence review and claim file management. Coordinates release of records in response to subpoenas, court orders and attorney requests. Ensures departmental support/participation in the Patient Safety process by evaluating individual files and trend data for compliance with regulatory requirements.
  • Develops an annual Risk Management program, analyzes data and education programs. Participates in process of disclosure for medical errors. Handles all complaints and grievances, whether in person, by telephone or written correspondence. Reviews and evaluates organizational systems to prevent/reduce identifiable risk occurrences. Provides risk management information on medical/allied health staff to departments for use in the credentialing process. Provides in-service training to personnel, enhancing awareness of their role in reducing liability exposures. Risk Management / Liability Claims Liaison: Acts as Site Administrator for RADAR Claims Module (Potentially Compensable Event) and maintains legal case files. Investigates and reports potentially compensable events (PCEs) and asserted claims (demands for compensation, services or litigation) to the Trust pursuant to the corporate policy for reporting to the Trust. Provides investigation findings/information to claims staff including identity of location/site/clinic involved, identity (full name, job title) of involved parties, witnesses (how they are/were involved) etc., narrative description of the events, issues identified and recommendations for additional investigation. Investigates and responds (in writing) to requests from patients/visitors for compensation or payment for services, e.g., physical therapy, home health, specialist consultation, etc. Serves as primary contact for defense counsel and corporate claims staff. Facilitates/verifies discovery and requests for documents, information, interviews and depositions. Obtains concurrence for settlement, trial, etc. Works with legal counsel to coordinate investigations, process and defend claims against the facility. Obtains/maintains records and documents and provides them to defense attorneys for preparation of testimony in pending litigation. Safeguards materials obtained or developed for root cause analysis to ensure documents/proceedings are protected from discovery. Initiates and monitors efforts to preserve evidence, i.e., surveillance video, equipment memory, etc., and/or litigation holds.Attends trial as site representative, coordinates litigation activities involving site interviews, depositions, witness preparation, etc. Approves payment for replacement of lost property after claim evaluation. Negotiates settlement of small claims within administrative authority and advises collection department of appropriate action for unpaid accounts involved in litigation.
  • Performs other job-related duties as assigned.

You'll be successful with the following qualifications:

Education:

  • Bachelor's degree in business administration, hospital administration, law or equivalent combination of education/related experience: Required
  • Master's degree: Preferred

Work Experience:

  • Seven years technical experience: Preferred
  • Five years leadership experience: Preferred
  • Five years progressively responsible experience in hospital risk management: Preferred

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.

Keywords: Adventist Health NW, Modesto , Director, Risk Management & Accreditation, Risk Management, Full-Time, Other , Sonora, California

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