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Director of Risk Management and Compliance

4 months ago

Bangor, United States Covenant Health (Tennessee) Full time

Job Summary

The Director of Risk Management and Compliance is accountable and responsible for the management and direction of the risk management and loss prevention program for St. Joseph Hospital-Bangor, a member of Covenant Health, under the general direction of the System Vice President and Deputy General Counsel

Essential Duties and Responsibilities

+ Direct, administer, and promote the enterprise risk management program at St. Joseph Hospital- Bangor, a member of Covenant Health. Advise senior management of St. Joseph Hospital-Bangor of potential risk exposures and strategies to minimize them. Manage day-to-day risk management program operations at St. Joseph Hospital-Bangor.

+ Act as a liaison and coordinate with and serve as a resource for local leadership and clinical staff of the member facility with respect to risk management activities. Collaborate with staff to identify, monitor, and report on risk trends.

+ Oversee claims management for cases at St. Joseph Hospital-Bangor and affiliated physician practice groups, Monitors, investigates, and oversees all claims, potential claims, and licensing board complaints at St. Joseph Hospital-Bangor. Discuss issues with System legal counsel regarding the settlement and litigation of claims.

+ Work closely with defense counsel and staff in all aspects of the captive claims management operations for St. Joseph Hospital-Bangor. Ensure timely investigations and claim reports by the TPA. Monitor case activity of defense counsel on professional liability and general liability claims, including attendance at discover meetings, depositions, trial, and other relevant meetings.

+ Assist St. Joseph Hospital- Bangor and affiliated physician practice groups with and serve as a resource regarding health care licensure, accreditation, HIPAA, other regulatory standards, and ensure compliance.

+ Serve as a resource for St. Joseph Hospital-Bangor and affiliated physician practice groups regarding clinical healthcare risk management issues.

+ Data collection, management, and analysis related to risk management and claims, and prepare and present reports.

+ Conduct RCAs and collaborate with relevant staff members, including the Director of Quality at St. Joseph-Bangor to investigate to reduce risk and improve overall quality and patient care.

+ Attend relevant cross departmental committees in an effort to reduce risk and promote patient safety.

+ Develop relevant educational programs for the staff of St. Joseph Hospital-Bangor and affiliated physician practice groups.

+ Serve on relevant committees and councils at local member facility and as assigned at System level.

+ Collaborate with the Patient Relations Coordinator to address patient complaints and grievances at St. Joseph Hospital-Bangor.

+ Collaborate with legal and risk management colleagues in establishing and implementing short-and long-range organizational goals, objectives, policies and procedures for the member facility and System with respect to risk management, insurance, claims management and regulatory compliance; monitor and evaluate program effectiveness; and effect changes required for improvement.

+ Abides by the Standards of Conduct which is the basis for the Organizational Integrity Program.

+ Supports and Promotes the mission and values of Covenant Health Systems and the Catholic Health Ministry.

Job Requirements

Education

+ A Bachelor's degree is required (Master's degree preferred) in a health care field.

Experience

+ Minimum of five to six years experience in risk management/loss prevention.

+ Three to five years in management/supervisory position(s).

+ Patient care, legal or claims supervisory, computer and quality management experience is preferred.

+ Incumbent will be self-directed and require little oversight in performance of duties, which include financial, human resource, technical, quality management and team building concepts.

+ Requires excellent interpersonal skills, analytical and conceptual thinking ability, team building ability with an emphasis on performance and achievement.

+ Experience with the management of healthcare-related liability claims.

+ Knowledge of insurance and loss control.

+ Associate in Risk Management (ARM) and Professional Healthcare Risk Management (CPHRM) certifications strongly desired. Candidate would be expected to obtain certification within 18 months of employment

Covenant Health Mission Statement

We are a Catholic health ministry, providing healing and care for the whole person, in service to all in our communities.

Our Core Values:

Compassion

We show respect, caring and sensitivity towards all, honoring the dignity of each person, especially the poor, vulnerable and suffering.

Integrity

We promote justice and ethical behavior, and responsibly steward our human, financial and environmental resources.

Collaboration

We work in partnership, dialogue and shared purpose to create healthy communities.

Excellence

We deliver all services with the highest level of quality, while seeking creative innovation.

Applicants, employees and former employees are protected from employment discrimination based on race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age (40 or older), disability, and genetic information (including family medical history).