This position is Full-Time, Exempt, and Benefitted
The Risk Management/Compliance Director will develop, implement, and coordinate the comprehensive internal risk management program, which identifies, investigates, analyzes, treats, manages and evaluates the risks that impact patient care and pose financial risks to Gritman Medical Center. The two risk management functions are loss prevention, reducing the frequency of a particular loss, and loss control, attempting to decrease the severity of the loss or dollars paid out. The risk management program is designed to protect the organization's financial resources, develop loss prevention programs and assist with claims and litigation management. The Risk Management Director centralizes the risk management programs; maintains and coordinates the administrative activities and reports relating to risks.
They oversee Gritman's compliance by way of the seven elements of a compliance program. They are responsible for developing, implementing and having oversight over the program. Monitoring and educating on specific federal and state legal and regulatory issues and matters involving ethical and legal business practices. The Director handles inquiries regarding any aspect of compliance, investigates any information or allegation concerning unethical or improper business practices, and follow through with the appropriate corrective action. They plan and oversee the regular and periodic audition of the hospital's operations in order to correct any barriers to the efficacy of the compliance program. They prepare, present and distribute the committees activities and reports to employees, Board of Directors, physicians, vendors or volunteers as deemed necessary.
Bachelor's Degree in nursing, business management, healthcare management or risk management.
Minimum Work Experience
Three (3) years previous experience in the healthcare field, preferably in a management role.
Effective verbal and written communication skills. Must be able to work with all levels in the organization: medical staff, patients and their families, outside agencies (i.e., insurance carrier, state inspectors and legal counsel).
Ability to objectively investigate, evaluate and resolve issue.
Ability to negotiate in order to resolve complaints.
Ability to maintain confidentiality.
Possess the skills to review and analyze reports, meeting minutes and data, using the information effectively in the risk management process.
Basic understanding of the hospital industry and care of patients.
Knowledge of risk techniques and insurance systems as related to the healthcare environment.
The Risk Management/Compliance Director:
• Is proactive, with a preventative focus, in the identification of areas of potential concern or loss prior to accident or injury;
• Develops and implements a continuous process to identify risk and exposures to loss, primarily financial (property, net income, liability and personnel) loss;
• Works with department managers and quality management staff to identify high-risk situations, which pose actual or potential risk (through use of incident reports, complaints, threats to sue, serious events, peer review, quality improvement information, surveys, safety inspections, committee meetings/minutes, recalls, state/federal/local laws and court decisions);
• Implements, after a thorough analysis, the best solution(S) to control or decrease the identified risk. Frequently these solutions require an in depth review of policies and procedures, processes and systems; changes in policies, procedures, processes, and systems; and education;
• Supervises, implements and maintains the seven elements of the compliance program;
• Oversees the auditing and monitoring programs;
• Oversees the Compliance Hotline
• Enforces standards and procedures and conducts investigations as needed with proper remedial action.
• Oversees through appropriate means, that the facility is conducting activities and operations in compliance with local, state, and federal regulations, accrediting organizations standards and laws governing healthcare operations.
• Monitors solutions, after implemented for proper implementation of solutions and for success of changes made;
• Participates in orientation for new staff, medical staff, board and volunteers;
• Provides/organizes educational programs for staff and medical staff to inform, share progress and elicit cooperation to control risks;
• Participates in appropriate committees relevant to risk management functions;
• Provides information for peer review and medical staff credentialing;
• Serves as the liaison representative to the professional liability insurance carrier and legal counsel to process and provide information pertinent to claims or potential litigation.
Gritman Medican Center staff, medical staff, board and volunteers.
-Lifting Occasional-Maximum of 20lbs. from floor to waist, 2x year. Frequent- None Items Lifted-Files
-Push/Pull: Minimal force required to push a cart on level and un-level surfaces, 2-4 times per year.
-Carry: < 5 lb. binders 300+ yards.
-Fine Motor: High Degree required for computer and writing tasks.
-Computer: 7-8 hours per day with 75%-85% Data Entry and 15%-25% Mouse. Phone is 20% of each day. Uses fax and copier with frequency as well. Standing: up to 30 minutes at one time and 30 minutes in one day.
-Sitting: up to 20 minutes at one time and 7.5 hours in one day.
-Kneeling: up to 1 minute at one time and 10 minutes in one day.
-Stooping: up to 1 minute at one time and 10 minutes in one day.
Work is conducted primarily in an office environment.