Director of Risk Management & Compliance

Job Description

Job Description

POSITION PURPOSE:
Administer and manage the facility’s risk management and compliance programs. Position also serves in capacity of privacy officer.

POSITION REQUIREMENTS / QUALIFICATIONS:

Education/Experience:
Bachelor Degree in a Health related field preferred. Five (5) years of experience as a supervisor. Five (5) years experience in risk management, healthcare compliance practices, contract negotiations and contracts. Knowledge of federal, state laws, regulations and accreditation standards.

Licensure / Certification:
CPR Certification from the American Heart Association. Licensure as a Healthcare Risk Manager in the State of Florida.

Skills / Ability:
Excellent interpersonal communication and problem-solving skills. Demonstrates proficiency in verbal and written skills. Proven skills with regulatory compliance, risk control, safety and security compliance. Sensitivity to working with diverse group of employees and patients. Knowledge of and expertise in HIPAA, Security Regulations, internal controls and resolving patient complaints and privacy breaches.

POSITION RESPONSIBILITIES (THIS IS A EXEMPT POSITION)

The incumbent serves at the pleasure of the Chief Operating Officer.

Serves as the CHI Risk Manager and Compliance Officer.

Develops, implements, oversee and manage the organization’s risk management program in a manner that fulfills the mission and strategic goals of the organization while complying with state and federal laws and accreditation standards.

Develops and implements systems, policies and procedures for the identification, collection and analysis of risk and compliance related information.

Educates and trains the leadership, staff and business associates as to the risk management program, compliance program and their respective responsibilities in carrying out the risk management program.

Leads, facilitates and advises departments in designing risk management and compliance programs within their own departments.

Collects, evaluates and maintains data concerning patient injuries, claims, worker’s compensation and risk-related data.

Investigates and analyzes root causes, patterns or trends could result in compensatory or sentinel events.

Helps to identify and implement corrective action where appropriate.

Serves as the organization’s liaison to the organization’s insurance carrier.

Assists in processing summonses and claims against the facility by working legal counsel to coordinate the investigation, processing and defense of claims against the organization.

Actively participates in or facilitates committees related to risk management, safety, compliance, continuing education, in-service training, quality improvement and others as necessary.

Provides HIPAA training, Red Flag training (and other training as necessary) to employees.

Participate as a member of Corporate Staff.

Review monthly eligibility reports for each center.

Assessing compliance with policies, plans, procedures and regulations.

Ensures that decisions are in accordance with CHI Policies.

Coordinate and ensures proper risk and compliance related training and provides support to staff.

Ensures meeting requirements for FTCA coverage.

Provides accurate and timely documentation in patient charts within the same day of intervention when applicable.

Scheduling of depositions and pre-depositions

Bill attorneys and track payments for depositions and pre-depositions.

Receive, log, review and file incident reports. Follow up on incident reports as necessary.

Development and management of an agency risk management report (quarterly updated).

Development and management of an agency compliance report (quarterly updated).

Obtain statements from providers and others as needed.

Reviews all contracts and agreements for risk and compliance purposes and provides recommendations as necessary.

Renew all insurance contracts for CHI sites.

Evaluating the reliability and integrity of management data by reviewing general controls and computer security procedures over data processing.

Determining the extent to which established objectives and goals for operations or programs are being accomplished.

Review, update and maintain CHI employees who are eligible to drive company vehicles.

Serves as Privacy Officer and assumes all the duties and responsibilities ordinarily delegated to a privacy contact person.

Provides CHI patients and others with information about CHI privacy practices and responds to privacy related inquiries.

Documents the receipt of all written requests and complaints concerning CHI privacy practices or its use and disclosure of protected health information, and coordinates the timely process of all request and complaints.

Adheres to Confidentiality Policies and Procedures / HIPAA Regulations.

Reports to work on time and ready to work with minimal absenteeism.

Provides incident reports to CEO and COO within 24 hours following notice of incident.

Performs other duties as assigned.