Executive Director, UHealth Medical Risk Management

University of Miami•Miami, FL

About The Position

The Executive Director, UHealth Medical Risk Management reports to the UHealth Chief Risk Officer and is responsible for operational direction and oversight of medical risk management efforts in accordance with applicable legal, regulatory, and accreditation requirements and standards, including collaboration with senior executives in risk strategy, governance, management, quantification, and interdependencies, in order to achieve desired goals and results. The incumbent also develops and sets strategy in partnership with key medical and administrative leadership to execute business plans.

Requirements

Bachelor's Degree in relevant field required.
Minimum 7 years of relevant experience required.
Certification in relevant specialty or field required.
Must have current Certified Professional in Health Care Risk Management (CPHRM) certification or attain CPHRM within one year of hire or equivalent certification— i.e. Certified Professional in Patient Safety (CPPS).
Ability to maintain effective interpersonal relationships.
Commitment to the University’s core values.
Ability to direct, manage, implement, and evaluate department operations.
Ability to establish department goals and objectives that support the strategic plan.
Ability to effectively plan, delegate and/or supervise the work of others.
Ability to lead, motivate, develop and train others.
Ability to recognize, analyze, and solve a variety of problems.
Ability to exercise sound judgment in making critical decisions.
Excellent communication skills.
Ability to think strategically.
Superior verbal, written, presentation, diplomatic, and conflict resolution skills.
Ability to maintain the highest levels of integrity, professionalism, and confidentiality.
Ability to interpret data to guide decision-making at the organizational level.
Ability to design program evaluation and monitor ongoing risk management and patient safety activities.
Ability to develop, implement and oversee risk management and patient safety plans and to align with organizational mission, vision, values and goals.
Ability to advocate for interdisciplinary patient safety conversations and problem-solving.
Ability to promote the principles of high reliability and just culture.
Ability to publish professional articles and contribute to the risk management and patient safety community.
Advanced knowledge of risk management and internal control standards is required.
Project management experience required.
Working knowledge of information technology, particularly how systems and applications integrate with business processes and operations required.
Knowledge of: Clinical and patient safety issues. Risk financing, legal, and regulatory operations. Healthcare operations including claims and litigation. Patient safety culture, leadership, and advocacy. Patent safety and risk solutions. Measuring and improving performance. Systems thinking design and human factors. Research methodology and the process of due diligence. Vendor liability exposures. Enterprise risk management strategies. Strategic plan development and implications of the strategic objectives on risk management and patient safety goals. Advanced risk financing Safety Management System development and implementation required.
Demonstrated ability to use established patient safety tools and data analytics to improve the environment of safety required.

Nice To Haves

Degree preferred in: Professional clinical discipline (BSN, PA, MD, etc.), risk management, industrial engineering, management science, actuarial science, or related field.
Advanced degree in related discipline is desired.
The ideal candidate will have 10+ years risk management experience in a healthcare organization or in a consulting capacity.
Academic Medical Center experience preferred.
Fellow of the American Society of Health Care Risk Management (FASHRM) desired.
Medical licensure –MD, RN, ARNP, PA—is a plus.
Experience in reporting, investigating, and implementing changes to promote patient safety preferred.

Responsibilities

Oversees all aspects of medical risk management, risk prevention, and patient safety activities.
Builds a culture of proactive risk identification, patient safety, and trust.
Leads the development of risk management and compliance programs.
Administers large, complex departmental budgets.
Analyzes financials to maximize the use of funds and ensures overall operations are within budget.
Remains informed regarding emerging threats to ensure that risks are well known and understood.
Communicates and manages expectations across all levels of the organization.
Develops detailed drill down reports and dashboards that meet the needs of management.
Collaborates with various stakeholders to develop relevant and comprehensive metrics.
Identifies deficiencies and initiates corrective action plans to reduce risk to known and acceptable levels.
Develops an ongoing program to audit all the organizational controls to ensure that they are in place and remain effective.
Maintains expertise on security trends through training and research.
Serves as subject matter expert and briefs highest levels of organization effectively.
Ensures internal control oversight and compliance with laws and regulations, safeguarding of assets, compliance with University policies and procedures, reliability of internal and external reporting, and efficiency and effectiveness of operations.
Creates an effective control environment, conducts risk assessment, implements and monitors controls.
Reports to the UHealth Chief Risk Officer regarding strategic and operational aspects of all clinical risk management activities.
Responsible for the coordination of medical risk management activity across clinical disciplines, overseeing the organization's annual risk assessment and plan, and associated reporting process, supporting the embedding of risk assessment and monitoring discipline in operating plans, and coordinating reporting on risk issues to internal and external stakeholders.
Responsible for the ongoing management of the organization's medical risk management program and oversight of all clinical risk management personnel, including recommendations regarding hiring retention, evaluation, assignment, and oversight of all facility and location-level clinical risk managers and staff.
Responsible for leadership for all clinical risk management-related legal and regulatory compliance for inpatient and outpatient hospital and hospital-based facilities; ambulatory surgical centers, and other UHealth clinical sites, including establishing required risk management staffing and support at UHealth clinical locations.
Responsible for monitoring progress and assisting management in reporting relevant risk information up, down, and across the organization.
Work closely with other executives to develop and implement an effective early intervention program intended to identify and analyze clinical events and take proactive steps to maintain relations between providers and patients/families; assure any required disclosures; and address any outstanding issues or questions related to clinical care.
Develop and service education as related to Risk Management techniques and claims outcomes to the professional, administrative, and hospital personnel of each facility of the University of Miami Health System and the UMMG.
Responsible for the development, implementation, and oversight of ongoing active training programs in clinical risk prevention methods for clinical providers and staff.
In conjunction with UHealth Chief Quality and Patient Safety Officer develop and implement an annual UHealth patient safety plan and effectively coordinate risk reporting/management functions and patient safety and quality activities.
Partner effectively with Chief Medical Officers to integrate and coordinate risk, quality and safety, billing and regulatory compliance, patient access, and patient experience functions at all UHealth clinical locations.
Work in conjunction with leadership in these functional areas to implement efficient communication and data exchange modalities and develop basic cross-training programs.
In conjunction with UHealth Chief Experience Officer and executive staff, evaluate and recommend improvements in the current process for reporting and responding to patient complaints and grievances and develop training for staff and providers related to effective communication and situation management methods.
Develop in conjunction with other executive leaders appropriate processes for patient complaints and grievances related to the quality of care and staff and reports regarding patient, staff, and provider disruptive behaviors.
Identifies opportunities for early resolution of significant events and assists in patient disclosure meetings as appropriate.
Coordinate with the UHealth Executive Director for Claims Prevention and Litigation Management regarding the identification and analysis of potential claims and implementation of lessons learned from claims and litigation analysis.
Participate in a variety of UHealth and/or community committees, as requested.