System Director of Risk Management
2 days ago
The System Director of Risk Management is responsible for developing, implementing, and overseeing the organization’s risk management strategies, including its professional liability and patient safety programs. This position ensures compliance with all regulatory requirements, manages insurance programs, mitigates risk exposures, and supports efforts to enhance patient safety across the system. As the leader of the Risk Management Department, this role supervises the Clinical Risk Manager and Patient Relations Specialists ensuring all patient grievances and complaints are managed appropriately.
Qualifications:
- Juris Doctor (JD) or Master’s in Healthcare Administration, Nursing, or a related field
- Certified Professional in Healthcare Risk Management (CPHRM) or obtain certification within one (1) year of hire
- Seven (7) years of experience in healthcare risk management or a related legal/clinical role, strong understanding of healthcare regulations, compliance standards, and risk management best practices (e.g., root cause analysis, failure mode effect analysis), and familiarity with regulatory standards (e.g., DNV-GL, CMS)
- Two (2) years of prior management experience, preferably in a healthcare setting
- Preferred: Bachelor of Science in Nursing (BSN) or a similar clinical degree
Essential Job Functions:
- Lead the development, implementation, and management of the organization's Risk Management Plan and Enterprise Risk Management Program, ensuring full alignment with regulatory standards such as DNV-GL and CMS to promote patient safety and organizational compliance.
- Oversee the organization’s professional liability and general liability insurance programs, working closely with insurance advisors and brokers to manage risk exposure for employed physicians, advanced practice clinicians, and the healthcare system as a whole.
- Investigate, document, and assess potential and actual liability risks, including claims management.
- Collaborate with legal counsel to handle litigation and work with external stakeholders such as insurers, defense attorneys, and mediators to protect the organization’s assets.
- Supervise the Clinical Risk Manager and Patient Relations Specialists, ensuring effective management of day-to-day patient complaints and grievances.
- Conduct training for physicians, advanced practice clinicians, nurses and other clinical staff, and medical/allied health students regarding risk management strategies, appropriate documentation in medical records, disclosure conversations with family members and other risk and claims management topics.
- Design and implement programs and strategies to minimize or eliminate risk exposures. Analyze data and reports to the Executive Team on a regular basis regarding the Risk Management program, trends, and current issues.
- Under the direction of the Chief Legal Counsel, oversee the handling of claims, communication with patients and or families, documentation, evaluation, and patient bill holds. Work with leadership regarding decisions to waive bills in connection with a risk event or an adverse event.
- Maintain a strong understanding of healthcare regulations and standards, ensuring compliance with accrediting agencies. Keep abreast of changes in healthcare law, tort reform, and relevant legislation to inform risk management practices.
- Responsible for developing and maintaining a strong positive working relationship with Medical Group and Medical Staff leadership, including Chief Medical Officer, Medical Group President, Chief of Staff and other clinical leaders (i.e., Chief Nursing Officer), regarding all aspects of claims and litigation management, keeping them fully informed regarding the status of claims or suits.
- Foster a culture of safety and proactive risk management by promoting strong internal and external communication.
- Provide regular presentations and reports to senior leadership on significant cases, risk management trends, and the effectiveness of implemented safety and loss prevention programs.
Knowledge, Skills and Abilities:
- Strong interpersonal, verbal and written communication skills
- Creativity, problem analysis and decision making
- Exercises tact, discretion, sensitivity and maintains confidentiality
- Detail oriented, organizational skills and the ability to prioritize
- Standard office equipment and computer applications; MS Office, EMR, internet applications etc.
Schedule Requirements:
This role requires regular and sustained attendance. The position may necessitate working beyond a standard 40-hour workweek, including weekends and after-hours shifts. On-call work may be required to respond promptly to organizational, patient, or employee needs.
Physical Requirements:
- Lifting (Rarely – 30 pounds): Exerting force occasionally and/or using a negligible amount of force to lift, carry, push, pull, or otherwise move objects or people.
- Sit (Continuously): Maintaining a sitting posture for extended periods may include adjusting body position to prevent discomfort or strain.
- Stand (Occasionally): Maintaining a standing posture for extended periods may include adjusting body position to prevent discomfort or strain.
- Walk (Occasionally): Walking and moving around within the work area requires good balance and coordination.
- Climb (Rarely): Ascending or descending ladders, stairs, scaffolding, ramps, poles, and the like using feet and legs; may also use hands and arms.
- Twist/Bend/Stoop/Kneel (Occasionally): Twisting, bending, stooping, and kneeling require flexibility and a wide range of motion in the spine and joints.
- Reach Above Shoulder Level (Occasionally): Lifting, carrying, pushing, or pulling objects as necessary above the shoulder, requiring strength and stability.
- Push/Pull (Occasionally): Using the upper extremities to press or exert force against something with steady force to thrust forward, downward, or outward.
- Fine-Finger Movements (Continuously): Picking, pinching, typing, or otherwise working primarily with fingers rather than using the whole hand as in handling.
- Vision (Continuously): Close visual acuity to prepare and analyze data and figures and to read computer screens, printed materials, and handwritten materials.
- Cognitive Skills (Continuously): Learn new tasks, remember processes, maintain focus, complete tasks independently, and make timely decisions in the context of a workflow.
- Exposures (Rarely): Bloodborne pathogens, such as blood, bodily fluids, or tissues. Radiation in settings where medical imaging procedures are performed. Various chemicals and medications are used in healthcare settings. Job tasks may involve handling cleaning products, disinfectants, and other substances. Infectious diseases due to contact with patients in areas that may have contagious illnesses.
The above statements are intended to describe the general nature and level of work being performed by people assigned to the job classification. They are not to be construed as a contract of any type nor an exhaustive list of all job duties performed by the personnel so classified.
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