Head of Risk Business Management (f/m/d)

DHR Health - US:TX:Edinburg - Days
Our Vision is to create a world-class health system to advance medicine and increase access for the communities we serve by empowering caregivers to heal through compassion, knowledge, innovation, integrated care and excellence.

The Risk Management Supervisor is responsible in assisting the Director for the day-to-day coordination of the hospital's Risk Management function including, but not limited to ensuring risks are identified and managed to reduce institutional liability and to promote patient safety; collect aggregate data from adverse event reports, claims and loss prevention strategies, for identification of corrective and preventive actions; investigate sentinel events, root cause analyses and peer review; and develop and conduct continuing education programs for medical, nursing and clinical support staff. Position is also primarily responsible for maintaining policies and forms through their respective committees.
Minimum associate's degree in health related field or equivalent required.
Excellent customer service skills required.
Computer skills with knowledge of Microsoft Office suite required.
Bilingual (English/Spanish) preferred.
Certification in healthcare risk management preferred.
Knowledge of medical malpractice and healthcare law preferred.
Experience in loss control and claims management preferred.
Risk management experience in a healthcare setting preferred.
Promotes the facility's mission, vision and values by effectively communicating them to others. Is the primary staff member responsible for maintaining and updating forms and policies facility-wide, working with the committee chairs to facilitate evaluation and approval of the documents.

• Develops, coordinates and administers facility-wide systems for risk identification, investigation, and reduction; maintains a network of informational sources and experts; performs risk surveys and inspects patient care areas; reviews facility and to assess loss potential.
• Participates on committees directed towards promoting patient, staff, and environmental safety issues.
• Maintains risk management statistics and files in compliance with Joint Commission and state and federal agencies; Also strives to verify that the following information is accurate, available, and secure: includes medical records, patient billing records, policies and procedures, incident reports, medical examiner's reports (if available), as well as any other data pertinent to a particular claim.
• Collects and evaluates, and distributes relevant data concerning patient's injuries: aggregate data summaries, monthly trend analyses of incidents, claim profiles and provides aggregate analysis of risk data; maintains statistical trending of losses and other risk management data.
• Informs directors of service and department heads regarding occurrences, issues, findings, and risk management suggestions; provides feedback to directors at all levels in the effort to eliminate risks; assists clinical chairs and department heads in designing risk management programs within their departments.
• Works with legal counsel to coordinate the investigation, processing, and defense of claims against the facility; records, collects, documents, maintains, and provides to defense attorneys any requested information and documents necessary to prepare testimony in pending litigation.
• Responds to professional liability and facility liability questions posed by physicians, nurses, and other personnel.
• Required on-call responsibility that may require presenting in-person to a hospital location.
• Advises security on procedures to reduce the frequency and/or minimize the severity of property loss or assets.
• Provides assistance to departments in complying with The Joint Commission, Centers for Medicare & Medicaid Services (CMS), Texas Department of State Health Services (DSHS), or other accrediting agencies, regarding risk management related standards.
• Recommends appropriate revisions to new or existing policies and procedures to reduce the frequency of future occurrences; recommends ways to minimize risks through system changes; reviews and revises facility policies as appropriate to maintain adherence to current standards and requirements.
• Educates and trains leadership, staff and business associates as to the risk management program, and their respective responsibilities in carrying out the risk management program.
• Coordinates risk and safety management orientation and continuing education programs for providers, management, and staff to enhance awareness of their role in patient safety, risk reduction, and event reporting.
• Acts as liaison to outside agencies such as local, state, federal, or voluntary accrediting agencies. Prepares reports of events as required by law or in accordance with voluntary participation. Coordinates internal surveys and inspections, monitors reports, and coordinates corrective actions or recommended improvements with management and staff.
• Develops and maintains positive working relationships with clinicians, management, and staff to promote open communication and accurate flow of information.
• Assists with the communication and documentation of errors or serious events in accordance with legal requirements and/or accreditation standards.
• Directly refers to administration those incidents with claims potential; Assists in processing summons and complaints served on present and previous employees; assists in defendants in completing necessary documents.
• With director of guest relations: reviews patient complaints that may be the source of potential legal action; discusses and offers solutions when possible to resolve with patient and/or family any grievances perceived as potential liability claims.
• Participates in evaluation of claims for settlement; negotiates settlement of small claims within administrative authority; replacement of lost property after evaluating claim.
• Reviews national and local claims data; analyzes prior claims, lawsuits, and complaints against the facility.
• Notifies the liability insurance carrier of all actual and potential claims, including primary and excess carriers as necessary.
• May verify with the Medical Staff Services Coordinator that each independent practitioner provides proof of adequate professional liability insurance at the time of initial credentialing and at reappointment.
• VP of Quality, Patient Safety, and Accreditation → 3. Chief Of Quality

CUSTOMER SERVICE:

Provide excellent customer service to all DHR customers. S program which outlines the Customer Service Principals including: Employees must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served in his/her assigned unit. The individual must demonstrate knowledge of principles of growth and development over the life span and possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirement relative to his or her age.

AMERICANS WITH DISABILITIES ACT: (ADA) :

Indicated by bold print within performance standards, preceding individual numbered criteria.
Light/moderate lifting up to 20 lbs, from the floor to shoulder height.

Operating office equipment
Operating mechanical equipment
Operating Personal Vehicle
Person who performs these duties are not called upon as part of their employment to perform or assist in emergency medical care or first aid or to be potentially exposed in some other way.

Intelligence: To comprehend language, to understand relationships between words, and to understand meanings of whole sentences and paragraphs. Ability to perform arithmetic operations quickly and accurately. Form Perception: Ability to perceive pertinent details and objects or in pictorial or graphic material to make visual comparisons and discriminations and see slight differences in shapes and shadings of figures and widths and lengths of lines. Clerical Perception: Ability to receive pertinent details and verbal or tabular material. Ability to move the hand and foot coordinately with each other in accordance with visual stimuli.