Job Description 

Operations and Compliance - Responsible for the oversight of the data management and analysis for the Loss Control Program inclusive of reports to management, Board and outside agencies.

Claims Management - Works actively with legal counsel in investigating claims, developing defense strategy, and evaluating the monetary value of the claim.  This person participates as a team member in negotiating settlements for management approval.  In litigated claims, this person has the authority to direct legal counsel and other personnel involved in claims management and to give final approval for defense strategies.  He or she approves payment of fees for defense counsel and payment of other expenses of claims defense.  He or she assists legal counsel in accessing facility records and personnel and may act as a corporate representative during pretrial and trial proceedings.

Risk Financing -

This person participates in negotiating coverage issues with carriers including levels and scope of coverage as well as premiums, provides oversight to the Self-Insured Trust Fund, and prepares reports to the governing body on Risk Management.

Provides supervisory leadership oversight for Infection Control, Organizational Improvement/Patient Safety and Accreditation.

Function  

Has full responsibility for the operations of the risk management program that may include an enterprise liability approach to exposures.  Has authority to retain, direct and approve compensation of defense counsel. 

Minimizes risk by responding to all regulatory and insurance survey report recommendations and deficiencies.

Conducts systems analyses to uncover and identify patterns that could result in compensable events.  Assists clinical departments in designing risk management programs within their departments.  Develops and implements departmental, facility and corporate policies and procedures that affect liability exposures

Loss Prevention and Patient Safety - Responsible for the development of loss prevention programs that may include, but are not limited to, safety issues.  Organizes, manages and provides facility-wide educational programs conducted for facility employees and medical staff regarding health risk management and related subjects

Direct Reports

Administrative Coordinator - Accreditation and Regulation

Infection Control Coordinator

Administrative Coordinator Organizational Improvement

Clinical Risk Manager .6 FTE

Insurance Specialist .5 FTE

Secretary, Risk Management - .6 FTE

Job Purpose 

Is responsible for the Corporate risk management activities, including but not limited to managing claims against the facility, interfacing with defense legal counsel, managing and analyzing risk management data, conducting risk management education programs, complying with risk management related standards by JCAHO and other accrediting and regulatory agencies with the objective of promoting patient safety, enhancing quality care and minimizing loss to protect the assets of the corporations and administers the self-insured trust fund.  Provides Corporate oversight to Accreditation, Infection Control and Organizational Improvement/Patient Safety Officer.

Education 

Four-year college degree, Masters preferred.

3-5 years in health care risk management.