Director of Risk Management - Full Time

UHS•Wildomar, CA

79d

About The Position

Under the direction of the Chief Executive Officer (CEO) the Director, Risk Management/Accreditation is responsible for directing, organizing, leading, implementing and supervising day to day operations of the Risk Management, Accreditation/Regulatory Compliance and Infection Control efforts for SWHS. The director serves as the hospital Patient Safety Officer, Compliance Officer and Civil Rights Coordinator in compliance with the Office of Civil Rights Requirement 1557.

Requirements

Graduate of a state accredited school of nursing or graduate of an accredited collegiate program in a health-science related field.
Master’s degree in a healthcare related field, or a Bachelor’s degree in related field with seven (7) years of director level experience; required
At least four (4) years leadership experience in an acute care facility
Certified Professional in Healthcare Risk Management of Certified Professional in Healthcare Quality

Responsibilities

Risk Management Program Administration: Serves as a resource to senior leadership, facility and medical staff. Participate in 24-hour call. Made aware of all serious incidents ensuring thorough investigations and notifications to senior leaders, and UHS Risk as warranted. Reviews and updates the Risk Management Plan, Goals and Objectives yearly.
Risk Identification: Is responsible for maintaining the risk management database and notifies Sr. Director Corporate Risk Management and/or Corporate Group Risk Manager of all G. H. I incidents. Oversees and participates in facility risk assessments for clinical and non-clinical areas. Participates in RCA’s and FEMA’s and ensures submission to Corporate Risk Management. Participates in the peer review process and presents serious incidents, when applicable
Risk Management Education: Participates in the new employee orientation for discussion of the Risk Management Program, Patient Safety, incident reporting and TERM. Acts as a resource for issues (i.e., consents, confidentiality, documentation, ethical, standard of care, compliance). Promotes Best Practices by educating facility and medical staff on risk management issues.
Risk Prevention Techniques: Participates in the development, implementation and review/revision of policies and procedures. Collaborates with clinical leaders to actively work and establish compliance with standards of care, best practices in industry accepted high-risk areas (i.e., ED, ICU, Surgery, OB, medication administration, fall prevention). Collaborates with the leadership team to promote positive patient/family/visitor experience. Works collaboratively with security and Human Resources to enforce facility safety practices (i.e. visitation, workplace violence, identification /harm prevention regarding patient belonging’s, and disclaimer for liability of vehicles parked on facility property.
Measuring Effectiveness and Risk Management Program: Provides reports to Corporate Risk Management, as per established guidelines. Complies and reports Midas RDE analysis and trends to appropriate individuals, departments and committee to be utilized for improvement of patient care. Provides confidential reports of significant occurrences and incidents to applicable peer review committees and PSC. Administration ensures the presentation of risk management information and reports are presented to the peer review committee by either the Director of Risk Management/Accreditation or the Director of Performance Improvement/Patient Engagement.
Claims and Litigation Management: Directs and participates in the investigation of serious incidents concurrently with guidance from corporate risk management. Works with CBO regarding suspension of bills. Timely forwarding of claim notices and submission of Probable Claim Reports. Through administrative support develops and institutes policies and formalizes receipt of claims notices, securing evidence and confidentiality of information and material relating to claims. Concurrently informs Corporate Insurance ,Risk Management and Senior Facility Executives of attendance on any pending trials, mediations, or depositions and submits report of activity.
Civil Rights Coordinator: Receive, review, and process grievances, filed under the grievance Facility’s grievance procedure; Coordinate Facility’s recordkeeping requirements; Coordinate effective implementation of Facility’s language access procedures; Coordinates effective implementation of Facility’s effective communication procedures; Coordinate effective implementation of Facility’s reasonable modification procedures; and Coordinate training of relevant employees, including maintaining documentation required by law.