System Director, Risk Administration & Reporting - Corporate
The System Director of Risk Administration and Reporting plays a critical role in the identification, management, and mitigation of clinical risks for the Health First enterprise.
The main purpose of this position is to protect and enhance the clinical services, patient, employee, and visitor safety associated with enterprise operations, through development and implementation of clinical risk management and safety programs that will mitigate risk and promote compliance with applicable clinical standards and best practices. This position works closely with Legal, Claims, Quality, Safety and entity leadership to identify and mitigate clinical risk and to fully comply with related accreditation and regulatory requirements.
Reaches across the spectrum to educate and work collaboratively with members of the medical staff, administration, and associates to mitigate clinical risk and comply with legal and regulatory requirements in a way that is transparent, honest, and respectful.
Maintains good working relationships with internal stakeholders, enterprise leadership, patients and families, community organizations, accreditation entities, various Federal, State, Local and Regulatory Agencies, e.g.: AHCA, Department of Health; Serve as the primary liaison with such entities and agencies for surveys, investigations, inquiries and reporting.
Prepares internal clinical risk trend reports as requested for enterprise leadership and internal stakeholders; Develop risk related policies and standard operating procedures; regularly update and review.
Identifies incidents reportable to the state as “Code 15” reports and ensures timely submission of required reports to the Agency for Health Care Administration; prepares annual risk management report of incidents as required for AHCA; prepares and timely submits all required investigative or other reports to AHCA.
Collaborate with the RISO and Claims Management staff to identify all incidents which may present legal liability or expose the enterprise to litigation so that these may be reported to liability insurers by Claims Management; assists Claims Management in gathering risk management information related to incidents that present legal liability and as requested by attorneys.
Oversees all disclosures of adverse events to patients, in coordination with the RISO and System Legal Counsel; oversees investigation and processing of patient bill write-off requests related to adverse events or clinical services, in collaboration with the RISO and System Legal Counsel; oversees all required Medicare documentation and reporting of any patient bill forgiveness in collaboration with the RISO and Claims Management staff.
Performs initial review of high-risk/high-valued litigation cases to provide report to RISO for evaluation. Maintains an electronic incident reporting system to enable all health care providers and all agents and associates of the health care facility to timely report injuries and adverse incidents electronically;
Ensures that clinical risk management staff educate all clinical staff, physicians, and other internal stakeholders on their affirmative duty to report such incidents and participate in risk investigation and mitigation activities as requested.
Develops innovative approaches intended to reduce the frequency and severity of clinical risk incidents, near misses, employee, visitor, and patient injuries.
Oversees the regular and systematic review of all incident reports to identify trends as to time, place or person and design preventive measures. Identifies and mitigates risk through review of medical staff peer review issues, patient/family grievances, committee minutes, third party reports, and administrative or associate referrals.
Define and communicate a clear, compelling vision for the team that effectively ties into the mission and vision of Health First, and inspirationally lead the team to achieve that vision.
Manage selection, hiring, on-boarding and performance management of direct reports, including goal setting, coaching, developing and evaluating performance to increase workforce capability while achieving department objectives.
Develops and leads the clinical risk management team in a way that facilitates teamwork, involves mentoring, and encourages growth and development.
Promotes the field of clinical risk management and encourages department associates to seek continuing education so that they remain the industry experts.
Bachelor’s Degree in Nursing. Master’s Degree preferred
Florida RN License or ability to obtain prior to starting
Two years nursing experience in a hospital setting
Two years in a leadership role with people leadership responsibility
Risk Management License preferred
Risk Management Certification preferred
Proficiency in Microsoft Office (Outlook, Word, Excel, PowerPoint) and electronic health record systems
Knowledge of tort law, state and federal laws and regulations pertaining to Health Care, and healthcare accreditation standards
Health First works alongside other organizations and physicians in our community. Health First donates to the Brevard Health Alliance that provides healthcare services to thousands of underinsured or uninsured Brevard residents otherwise unable to pay for healthcare services.
Our associates are also actively building a healthier community through volunteering for organizations dedicated to preventing and treating health concerns such as cancer, diabetes and heart disease.