Sr. Director, Risk Management

2 days ago

Philadelphia, United States Children's Hospital of Philadelphia Full time

SHIFT:

Day (United States of America) Seeking Breakthrough Makers

Children's Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation.

At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric care-and your career.

CHOP's Commitment to Diversity, Equity, and Inclusion

CHOP is committed to building an inclusive culture where employees feel a sense of belonging, connection, and community within their workplace. We are a team dedicated to fostering an environment that allows for all to be their authentic selves. We are focused on attracting, cultivating, and retaining diverse talent who can help us deliver on our mission to be a world leader in the advancement of healthcare for children.

We strongly encourage all candidates of diverse backgrounds and lived experiences to apply.

A Brief Overview
The Sr. Director of Risk Management leads the organization's clinical risk management activities, which includes administering the daily functions of the risk management program; managing claims against the facility, its employees and staff; managing and analyzing risk management data; conducting risk management educational programs; providing risk management perspective on institutional initiatives and situations; and complying with risk management standards of the Joint Commission and other state and regulatory agencies, all with the objective of promoting patient safety, enhancing quality of care, and controlling and minimizing loss to protect the assets of the institution.

What you will do
  • Loss Prevention/ Patient Safety -Work collaboratively with the Office of Patient Safety and Quality on the review and investigation of patient incidents, and provide assistance as necessary to patient safety initiatives including RCAs and ACAs. Conduct system-wide loss prevention and control activities including orientation programs and ongoing educational programs. Participate in due diligence and consider potential liability for new clinical services, delivery models, and collaborative clinical agreements. Provide thoughtful and strategic Risk Management perspective on institutional clinical issues such as new programs and policies. Assure RM staffing on multidisciplinary committees including the Patient Safety, Health Information Management, Infection Prevention and Control, Therapeutic Standards, Medical Devices, Environmental Health & Safety, and Credentials committees as well as ad-hoc clinical committees.
  • Claims Management - Acting under the direction, supervision and control of the Office of General Counsel, investigate serious clinical events, keep senior management and others apprised of such events, preserve evidence, comply with reporting requirements to state and federal agencies including the NPDB, MMSEA and Mcare, ensure proper reporting to insurance carriers, assist defense counsel in all aspects of litigation defense, and support defendants throughout the litigation process. Maintain up-to-date knowledge of status of all claims, provide Hospital operational expertise to defense strategies and discovery requests, identify the need for adjustments to loss reserves, and provide administrative support for the Claims Review Committee function and other administrative aspects of the Joint Insurance Program.
  • Medical-Legal Support to Clinicians - cultivate relationships with clinical staff at all levels to enhance reporting of clinical events by providing daily advice on all matters of a medical legal nature including challenging patient/family issues, staff discord issues, and other urgent patient issues. Provide advice to the Family Relations Department during resolution of patient complaints and billing disputes, and make referrals to in-house counsel when appropriate.
  • Administrative - Lead and develop clinical risk management staff. Prepare budgets. Keep abreast of all relevant regulatory and statutory changes that affect the system's clinical risk management program. Develop local and national risk management peer contacts. Communicate with Board level, as needed.
Education Qualifications
  • Bachelor's Degree Required
  • Master's Degree Business Administration, Law, Health Administration or related field Preferred
Experience Qualifications
  • At least eight (8) years risk management experience (or comparable experience) Required
  • Risk management experience (or comparable experience) in an academic institution Preferred
  • Clinical background Preferred
Skills and Abilities
  • High competency in Microsoft Word and Excel. (Required proficiency)
  • Medium competency in PowerPoint. (Required proficiency)
  • Strong verbal, written and interpersonal skills. (Required proficiency)
  • Strong analytical skills. (Required proficiency)
  • Must be able to prioritize work, possess good practical judgment and be able to work in crisis management mode. (Required proficiency)
Licenses and Certifications
  • Certified Professional in Healthcare Risk Management - American Society for Health Care Risk Management - upon hire - Preferred

To carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community. As a condition of employment, CHOP employees who work in patient care buildings or who have patient facing responsibilities must be fully vaccinated against COVID-19 and receive an annual influenza vaccine. Learn more.

Employees may request exemptions for valid religious and medical reasons. Start dates may be delayed until candidates are immunized or exemption requests are reviewed.

EEO / VEVRAA Federal Contractor | Tobacco Statement

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