Risk Management Director - Healthcare jobs in Flagstaff, AZ

Risk Management Director - Healthcare develops and administers risk management programs. Creates and modifies policies to comply with safety legislation, JCAHO, HIPAA, and industry practices. Being a Risk Management Director - Healthcare coordinates and develops hospital-wide programs for quality patient care and risk-free services. Acts as the liaison to attorneys, insurance companies, and individuals. Additionally, Risk Management Director - Healthcare investigates any incidences that may result in an asset loss. Oversees insurance designed to protect the health system from loss. Collects information related to the claims and lawsuits made against the health system. May require a bachelor's degree. Typically reports to top management. The Risk Management Director - Healthcare typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Risk Management Director - Healthcare typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)

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Director of Risk Management
  • Summit Healthcare
  • Show Low, AZ FULL_TIME
  • General Position Summary:

    The primary responsibility of the Risk Manager is to protect Summit Healthcare Association’s (“SHA”) interests and contribute to the quality of patient care by contributing to the minimization/mitigation of risk across the Association’s system.  This position is responsible for SHA’s risk management activities for both the hospital-based services (inpatient and outpatient) and practice-based services (multi-specialty physician practices).

    Required knowledge and experience includes health care risk management, claims management, risk financing, investigational and incident analytical skills, patient safety, and specific health care legal issues.

    Functions include, but may not be limited to, coordinating insurance coverage and risk financing, managing claims against the facility, interfacing with defense legal counsel, administering the risk management program on a day-to-day basis, managing and analyzing risk management data conducting risk management educational programs, complying with risk management related standards by CMS and the health care industry, all with the objective of maintaining patient safety, enhancing quality care, and minimizing loss to protect the assets of SHA. This position is responsible for reviewing and formulating policy or organizational changes and making recommendations for final approval by senior management.  This individual also assists the SHA with evaluation of and/or development of contracts, and work with defense counsel in management of claims, and assist internal staff in appropriate response to complaints.

    The Director of Risk Management serves on the Enterprise Compliance and Risk Management Committee, the SHA Institutional Review Board, and makes periodic presentations to the Board of Trustees, the Medical Executive Committee, and other groups as requested or needed.

     

    Essential Functions / Major Responsibilities:

    ·         Designs and implements a system-wide enterprise risk management program based on the Domains of Risk as outlined by the American Society of Healthcare Risk Managers.

    ·         Designs and implements risk management education for all associates of the SHA and the medical staff.

    ·         Oversees the insurance purchasing program for the SHA.

    ·         Oversees the work of appointed defense counsel responsible for the preparation, management, and disposition of claims.

    ·         Participates in disaster planning and is a core member of the Incident Command team during a declared emergency.

    ·         Provides on a quarterly basis to the Board of Trustees a report on risk management activities.

    ·         Develops annual programmatic goals and objectives.

    ·         Knows and adheres to all laws, regulations pertaining to patient health, safety and medical information, and serves as an educator to the SHA per same.

    ·         Responsible for data management, claims management, and the education components of SHA’s risk management program.

    ·         Promotes the organizational patient safety initiatives.

    ·         Designs and coordinates system-wide recall program and tracking of same.  Monitors recall and hazardous use bulletins and notifies the appropriate department director with specific information regarding current issues

    ·         Develops department budget for management approval.

    ·         Works directly with legal counsel and the Area Claims Manager as a team member in the defense of claims. Has ongoing access to facility liability defense counsel to consult regarding both preventive and corrective measures to be taken in situations having legal connotation.

    ·         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 to assess loss potential.

    ·         Participates on committees directed towards promoting risk, legal, and patient safety issues.

    ·         Maintains risk management statistics and files in compliance with CMS and state and federal agencies; promotes maximum confidentiality by limiting access of such information. 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, evaluates, and distributes relevant data concerning patient injuries: aggregate data summaries, monthly trend analyses of incidents, claims profiles; 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 and/or other SHA associates 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 and/or submit for claim reimbursement.

    ·         Responds to professional liability and facility liability questions posed by physicians, nurses, and other personnel.

    ·         Provides assistance to departments in complying with CMS, AZ DHS or other accrediting/oversight 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.

    ·         Has full responsibility for operations of the risk management program that may include an enterprise liability approach to exposures.

    ·         Directs loss control/loss prevention activities and reports results to senior administration.

    ·         Designs and implements risk management surveys and studies; conducts surveys, studies, and special projects to assist in long-term planning and changes to facility policies and systems that reduce risk and losses.

    ·         Responsible for identifying and communicating regulatory requirements.

    ·         Leads development of organization-wide approach on disclosure of medical errors and obtains physician support.

    ·         Analyzes the risk of loss versus cost of reducing risk.

    ·         Supervises accumulation of risk management cost data for budgetary and historical purposes: prepares budgets for departmental operations.

    ·         Works with Medical Staff Services to develop and maintain risk management profiles on physicians and integrates that information into the credentialing process in compliance with state and federal agencies, CMS and/or other accrediting bodies, and institutional requirements.

    ·         Submits recommendations for changes in the existing risk control and risk-financing procedures based on changes in properties, operations, or activities.

    ·         Evaluates correspondence from attorneys, patients, and other outside sources, and formulates responses, as necessary.

    ·         Records, collects, documents, maintains, and communicates to insurance carrier and/or attorney any information necessary to prepare testimony in pending litigation.

    ·         Directs and coordinates release of records and information in response to subpoenas, court orders, attorney requests, state and federal agency investigations, and other inquiries from outside sources.

    ·         Maintains legal case files and strives to maintain maximum protection from discoverability of such files.

    ·         Answers medical/legal inquiries of physicians, nurses, and administrators regarding emergent patient care issues and loss control.

    ·         Resolves treatment issues, including patient decisions made against medical advice (AMA), refusals of treatment, and consent issues; initiates court orders as appropriate via outside legal counsel.

    ·         Maintains awareness of legislative activities that may affect risk management programs.

    ·         Collects, evaluates, and distributes relevant data concerning patient injuries: aggregate data summaries, monthly trend analyses of incidents, claims profiles; 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

    ·         Collaborates with department leaders to perform risk assessments and   develop targeted risk mitigation processes

    ·         Facilitates and participates in process improvement activities to achieve optimal financial, operational, clinical and satisfaction outcomes.

    ·         Educates members of the Summit Association team about risk concepts

    ·         Assists the Patient Advocate with complicated patient and customer complaints through investigation, problem management and resolution recommendations, including financial restitution

    ·         Coordinates data collection for submissions of Association applications for risk financing – fiduciary, general and professional liability, property, vehicle, storage, crime and umbrella policies

    ·         Assists with the ongoing preparation of the Enterprise Compliance and Risk Management Committee.

    ·         Reviews medical records for indications of malfeasance, fraud or theft and for liability issues associated with real or potential complaints

    ·         Reviews Summit’s incident reporting documents regularly and participates       in investigation, assignment and/or resolution of reported issues

    ·         Strives to identify and mitigate liabilities throughout the Association

    ·         Assists with Worker’s Compensation program as needed.

    ·         Conducts risk management rounding regularly.

    ·         Implements processes related to best practices for Risk Management (such as Leapfrog processes).

    ·         Reviews patient complaints which may result in legal action.  Works with patient advocate to offer solutions to patient grievances.  Works with billing and Compliance Officer in deciding on appropriateness of billing waivers/write offs.

    ·         Supports process of root cause analysis in the event of a sentinel or near miss event.  Coordinates review of medical information, debriefs all individuals as identified, may perform cause and effect assessment.

    ·         May conduct a Root Cause Analysis in coordination with Quality.

    ·         Assures quality and safety in patient care practices by providing an environment that promotes reporting of patient occurrences and staff involvement in process improvement and creation of best practices for patient care. Is responsible for supporting a Patient Safety Plan that: fosters an environment that focuses on processes and outcomes rather than individual blame and ensures that safety is a priority in design and redesign of services.

    ·         Displays proper etiquette and mannerisms that reflect the Shine Behavior Guidelines.

    ·         Promotes the Patient Safety Standards as a core value of the organization.

    ·         Prepares for and attends meetings as requested

    ·         Leads development of organization-wide approach on disclosure of medical errors and obtains physician support.

     

    Secondary Functions:

     

    ·         Completes projects assigned by the Administrative Team.

    ·         Collaborates and attends meetings with outside agencies as needed

    ·         Mentors new managers

    ·         Addresses e-mail and phone messages.

    ·         Participates in departmental and hospitalwide informational meetings and inservices, including staff meetings, hospitalwide forums, and seminars.

    ·         Reviews department and hospitalwide policies and procedures annually.

    ·         All other related duties as assigned.

     

    Job Scope:

     

    This job involves:

    ·         A wide diversity of work situations.

    ·         A high level of complexity.

    ·         Responsible for developing new policies, procedures, practices, and programs.

    ·         Performance of duties with little direction.

     

    Supervisory Responsibility:

     

    ·         Decisions are made within broad interpretation of applicable laws and governmental guidelines and information disseminated throughout the healthcare system.

    ·         Partially accountable for long-range operational planning.

     

    Interpersonal Contacts:

     

    Contacts:

    ·         Are normally made with others both inside and outside the hospital.

    ·         Are made with own department, staff, and supervisor as well as other departments and locations.

    ·         Frequently contain confidential/sensitive information necessitating discretion at all times.

    ·         Include face-to-face, telephone, and e-mail contact.

    ·         Include contact with staff, patients, and physicians.

     

    Specific Job Skills & Mental Activities:

     

    This position requires general knowledge related to the care of patients and the workings of a healthcare system and knowledge of general office equipment (including the nurse call system, telephone system, fax machine, copy machine, computer, and commonly used hospital programs) as well as excellent computer, communication, critical thinking, problem solving, leadership, supervisory, interpersonal skills, basic math skills, and be able to exercise independent judgment skills. This position also requires knowledge of hospital equipment and programs, including Hospital Information Systems and department specific equipment. This position requires self-direction and self-motivation. Must be able to read, write, speak, and understand English.

     

    Education and/or Experience:

     

    ·         Bachelor’s degree in healthcare or related field (Required).  Masters Degree in business, insurance, law, health administration, public administration, or nursing and/or J.D. preferred.

    ·         Certification in Risk Management. (ARM, CPHRM or FASHRM required, or achieved within 2 years).

    ·         Current AZ RN license (required if RN).

    ·         If applicable, license to practice law in the state of AZ and bar affiliation.

    ·         Must possess demonstrated leadership demonstrated ledership in the field of health care risk management.

    ·         Must possess a solid understanding of clinical cae in an integrated delivery system that includes acute care, outpatient surgery centers, home health agencies, and multi-specialty group practices

    ·         Must possess a strong understanding of how statutory and regulatory law shapes clinical health care risk management

    ·         Experience in health care related contract drafting and transactional matters

    ·         Working knowledge of federal healthcare regulations

    ·         Interpersonal skill set to work with all types of staff from front line to the Board level, and with outside constituents and vendors

    ·         CPR Certification (required within 30 days of hire date).

    ·         5 years previous experience in a variety of healthcare settings (required).

    ·         2-4 years previous managerial experience (required).

     

    Preferred skills

    ·         Knowledge of fundamental legal processes and requirements

    ·         Basic knowledge of risk financing processes

    ·         Proficiency in planning, coordinating and implementing

    ·         Good judgment and decision making abilities

    ·         Ability to influence change without direct authority

    ·         Negotiation skills

    ·         Ability to work independently and as part of a team

    ·         Analytical skills

    ·         Comfort in handling challenging situations that may involve adverse outcomes

    ·         Ability to identify and analyze risk inherent in new and existing processes and programs

    ·         Experience selecting techniques appropriate for treating loss exposures

    ·         Experience identifying potential risk and loss in various enterprise settings

    ·         Strong written and oral communication skill; strong presentation skills.

     

    Physical Demands & Job Conditions:

    Exerts up to 10 lbs. of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Involves sitting for much of the day, and involves walking daily to provide rounding and/or standing for brief periods of time.

    Physical motions include finger dexterity, standing, walking, stooping, talking, reaching, feeling, sitting, bending, kneeling, grasping, listening/hearing, handling, lifting up to 10 pounds, and repetitive motions of the hands, wrists, and feet.

    This is a safety sensitive position.

     

    OSHA Exposure Category:

    Involves no regular exposure to blood, body fluids, or tissues, and tasks that involve exposure to blood, body fluids, or tissues and are not a condition of employment.

              

  • 1 Month Ago

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Director of Risk Management
  • Summit Healthcare Association
  • Show Low, AZ FULL_TIME
  • General Position Summary: The primary responsibility of the Risk Manager is to protect Summit Healthcare Association’s (“SHA”) interests and contribute to the quality of patient care by contributing t...
  • 1 Month Ago

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Nurse Risk Management Director
  • Clinical Management Consultants
  • Snowflake, AZ FULL_TIME
  • A local community medical center is searching for a motivated Nurse Director of Risk Management who has experience working in acute care. This will be an exciting opportunity to join a 90 bed medical ...
  • 24 Days Ago

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Vegetation Management Field Director
  • EnviroSystems Management, Inc
  • Flagstaff, AZ FULL_TIME
  • EnviroSystems Management, Inc. is seeking a Vegetation Management Field Director to support various vegetation and noxious weed survey and treatment projects in the southwest. The ideal candidate woul...
  • 1 Month Ago

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Clinical Risk Manager
  • Northern Arizona Healthcare
  • Flagstaff, AZ FULL_TIME
  • Overview The Clinical Risk Manager is responsible for the management, on-going development, implementation, coordination and documentation of NAH risk reduction programs, error prevention, and assist ...
  • 20 Days Ago

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System Director of Patient Safety and Risk Mgmt
  • Nealy Pierce
  • Flagstaff, AZ FULL_TIME
  • Nealy Pierce has been engaged by a non-profit Health System to assist in the recruitment of a System Director of Patient Safety and Risk Management. This system is a non-profit, community-based, award...
  • 8 Days Ago

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Senior Financial Analyst
  • Korn Ferry
  • Bellemont, AZ
  • Company Description: Our client is a high growth start up in the sustainable forest & wood products manufacturing space....
  • 3/28/2024 12:00:00 AM

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Financial Representative
  • Modern Woodmen of America
  • Flagstaff, AZ
  • The ideal candidate will deliver personalized investment solutions to help clients work toward their long-term financial...
  • 3/28/2024 12:00:00 AM

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Financial Service Representative - 602 W. Route 66
  • Money Mart
  • Parks, AZ
  • Job Description During a typical day, you will: Deliver results on store profitability goals Provide a quality customer ...
  • 3/26/2024 12:00:00 AM

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RN - House Supervisor
  • Northern Arizona Healthcare
  • Cottonwood, AZ
  • Overview The Administrative Coordinator assumes administrative responsibility for all hospital services during all shift...
  • 3/25/2024 12:00:00 AM

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Branch Office Administrator
  • Edward Jones
  • Flagstaff, AZ
  • Would you call yourself a relationship builder, a problem solver or a critical thinker? If you answered yes, we need you...
  • 3/13/2024 12:00:00 AM

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Lead Server - Mormon Lake Properties
  • Aramark
  • Mormon Lake, AZ
  • Job Description The Wait Staff Lead position is vital to achieving excellent guest service and executing catering events...
  • 3/5/2024 12:00:00 AM

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Branch Office Administrator
  • Edward Jones
  • Flagstaff, AZ
  • Would you call yourself a relationship builder, a problem solver or a critical thinker? If you answered yes, we need you...
  • 2/26/2024 12:00:00 AM

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Retail Store Manager in Training
  • Sedona Store (Sedona, Arizona)
  • Sedona, AZ
  • 166 Coffee Pot Drive Sedona Arizona, 86336, Position Description: Responsible for the oversight, leadership and achievem...
  • 1/24/2024 12:00:00 AM

Flagstaff is a city in and the county seat of Coconino County in northern Arizona, in the southwestern United States. In 2015, the city's estimated population was 70,320. Flagstaff's combined metropolitan area has an estimated population of 139,097. The city is named after a ponderosa pine flagpole made by a scouting party from Boston (known as the "Second Boston Party") to celebrate the United States Centennial on July 4, 1876. Flagstaff lies near the southwestern edge of the Colorado Plateau, along the western side of the largest contiguous ponderosa pine forest in the continental United Sta...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Risk Management Director - Healthcare jobs
$130,218 to $172,574
Flagstaff, Arizona area prices
were up 2.5% from a year ago

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