Director of Risk Management

Pipeline Health•Gardena, CA

7d•Hybrid

About The Position

The Director of Risk Management is responsible for continual improvement in the quality, safety, and satisfaction of care delivery at all Pipeline Health facilities. This role works closely with the Executive Team, hospital leadership, and hospital quality and risk departments to develop, implement, and manage the risk management and Patient Safety Programs. The primary goals are to improve patient care and outcomes, reduce the risk of adverse outcomes from patient care activities, monitor compliance with regulatory and accreditation requirements and standards, and reduce and/or mitigate the risk of professional liability. Frequent travel between PLH facilities is required. The Director will actively and consistently contribute to department operations and communications, behaving in a manner consistent with the mission, vision, and values of Pipeline Health, and upholding standards of AIDET (Acknowledge, Introduce, Duration, Explanation, Thank you) patient communication.

Requirements

Minimum of five (5) years of experience in healthcare administration with specific experience in healthcare risk management, patient safety, and regulatory management.
The ability to obtain Risk Management certification within one year, if not already obtained.
Critical thinking, service excellence and good interpersonal communication skills, strong organizational skills, ability to follow verbal instructions, and PC (computer) skills.
A capacity to learn, synthesize, make critical judgments, work independently, place patients and families first, and collaborate with the executive team members who are recognized leaders within health care.

Nice To Haves

Clinical experience, preferred.

Responsibilities

Maintains confidentiality by assuring security of confidential files and information and communicating only with those who have a need-to-know confidential information.
Uses critical thinking to investigate issues and process failures, gathering facts before formulating opinions or action plans.
Surveys Pipeline Health facilities frequently to be recognized as a supportive team member, a credible resource for regulatory, accreditation, and patient safety issues, able to accurately represent Pipeline Health’s needs related to patient safety, accreditation, and regulatory issues to the Executive Team, and able to timely recognize unfavorable trends and provide effective intervention.
Maintains goodwill in all investigations without assigning blame and preserves staff dignity.
Supports implementation of infection prevention standards and is an active participant of the EOC Committee.
Serves as a resource, when necessary, in assisting other departments/programs in developing their policies and procedures and patient safety initiatives.
Effectively negotiates to achieve resolution concerning risks, exposures, and standards deficiencies, utilizing facilitation techniques appropriately.
Effectively implements, monitors, and manages a robust patient safety culture.
Evaluates the plans, policies, procedures, and process changes implemented as a result of risk management, patient safety, and quality management activities.
Develops and maintains collaborative relationships with key departments and committees as assigned.
Reports claim information on potential liability cases to General Counsel.
Develops a collaborative relationship throughout the organization to leverage resources to advance risk prevention and claims and litigation/professional liability lessons-learned programs.
Recommends appropriate revisions to new or existing policies, procedures, and forms to reduce risk and exposures.
Performs other related duties as assigned.
Develops, implements, and maintains an organizational risk management plan.
Develops, implements, and maintains an organizational patient safety plan.
Administers a nationally approved survey on Patient Safety Culture at least once every 12 months and provides timely feedback to the Executive Team as directed.
Analyzes a wide variety of data (i.e., occurrences, complaints, surveys, etc.) to identify undesirable care, outcome, and process trends in order to assess the overall safety of care.
Develops, maintains, and monitors routine risk management and patient safety data reports that capture outcomes, causes, interventions, and barriers to safe patient care.
Recognizes process failures that are appropriate to refer to Performance Improvement/Quality for action.
Develops and provides an annual report on risk management and patient safety activities and data.
Uses critical thinking to investigate risks and exposures by gathering and formulating data based on facts, using timelines and other tools for investigating incidents and recreating events such as root cause analysis and FMEA.
Proactively coordinates and facilitates performance improvement teams to support key initiatives, including but not limited to, activities focused on clinical quality improvement, patient safety and risk reduction, patient experience, efficiency, FMEAs, and medical staff improvement (e.g., OPPE, FPPE).
Facilitates investigations and management of timely submissions of patient and health plan grievances.
Serves as Pipeline Health’s Safety Officer.
Acts as a resource for compliance with requirements to report specific incidents to local, state, federal, and accrediting agencies.
Serves as the liaison between applicable government, regulatory, and key stakeholders and conducts facilitation of on-site visits and evaluations.
Maintains current knowledge regarding state licensure requirements for staff working in the Pipeline Health facilities.
Maintains current knowledge regarding all applicable standards and regulations of The Joint Commission (TJC) and HFAP (Healthcare Facilities Accreditation Program) necessary to maintain accreditation.
Recognizes and implements appropriate investigation and intervention of sentinel events, including both those reviewable by The Joint Commission and those that are not reviewable by the Joint Commission.
Gathers, monitors, and maintains awareness of current clinical outcomes data; timely informs and presents data to leaders of trends.
Leads and/or participates in efforts to improve outcomes.
Conducts routine audits and mock surveys to aid in preparedness, tracking, trending, and facilitation of corrective action plans.
Evaluates regulatory compliance concerns and makes recommendations for improvement to ensure that safety/regulatory recommendations are implemented in accordance with accreditation standards and guidelines.
Develops formal and informal mechanisms for risk identification and undesirable outcomes in care, including but not limited to, Incident Reports, Safety, Security and Facility Reports, patient complaints, review of pertinent quality improvement information, internal and external audits, staff referrals, and medical records reviews/chart audits.
Develop statistical and qualitative reports on risk management issues, tracking and trending patterns, communicating this information effectively to administration, leadership, and other appropriate audiences.
Develop policies and procedures in key areas designed to mitigate clinical risk and/or improve patient outcomes; acts as a resource to other departments developing policies, procedures, and improved processes intended to mitigate patient risk of harm.
Promotes a positive work culture and upholds Pipeline Health policies and procedures, including the Pipeline Health Code of Conduct.
Uses AIDET in interactions with patients and family members.
Acts with a sense of urgency when performing tasks.
Performs basic unit/department maintenance such as keeping files, drawers, cabinets free from unnecessary clutter.
Reports on any equipment and/or environmental issues for repair.
Abides by HIPAA (Health Insurance Portability and Accountability Act) regulations.
Speaks up to stop the line and escalates potential safety events if necessary.
Completes and attends monthly training assigned.
Must always uphold confidentiality in regard to Pipeline Health activities, reports, financials, patient health information, and other proprietary information specific to Pipeline Health.
Maintains open lines of communication with all hospital departments.
Demonstrates effectiveness in planning and implementing the performance improvement program to meet the needs of the Pipeline Health facilities.
Maintains current knowledge of accreditation and licensing requirements and must be a resource to staff on these regulations to improve management of outcomes and ensure compliance.
Maintains awareness of changes in the regulations and requirements by accrediting bodies.
Consults with other departments as appropriate to collaborate in patient care and performance improvement activities.
Wears nametag properly; follows dress code policy; answers phone correctly and promptly; is prepared for meetings; meets deadlines; does not participate in gossip; acts ethically and treats others with respect; respects customer’s and co-worker’s time; establishes and maintains effective relationships with customers and co-workers.
Maintains an environment of collaboration and cooperation among the Executive Team and hospital departments.
Contributes toward effective, positive working relationships with internal and external colleagues.
Demonstrates cooperation, flexibility, reliability, and dependability in all daily work activities and a willingness to collaborate with others for the good of the customer and the organization.
Attends staff meetings; follows HIPAA guidelines; follows patient rights policy; complies with the compliance program; demonstrates knowledge of role in a disaster; demonstrates knowledge of fire and fire drill procedures; working knowledge of hospital emergency codes; always utilizes standard precautions in the clinical setting; safely manages the environment of care by demonstrating a working knowledge of the requirements of the: Life Safety program, Utilities Management program, Hazardous Materials program, Emergency Preparedness program, Safety Management program, Medical Equipment Management program, Security Management program.