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    Director, Risk Management - Houston, United States - Memorial Hermann Health System

    Memorial Hermann Health System
    Memorial Hermann Health System Houston, United States

    3 weeks ago

    Memorial Hermann Health System background
    Description

    At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.

    Job Summary

    The Director of Risk Management will administer the functions of the clinical risk management program and claims management program. This individual will be responsible for coordinating those systems necessary for identification, evaluation, monitoring, reduction and/or elimination of professional and general liability risk exposure. Provide counseling and education to clinical personnel, facility leadership and medical staff members related to patient safety, risk exposures including risk prevention and risk reduction. Administration of the hospital's claim management program will be with the guidance and support of Memorial Hermann Hospital System Risk Management.Job Description

    Minimum Qualifications

    Education: Baccalaureate degree healthcare-related degree preferred

    Licenses/Certifications: (None)

    Experience / Knowledge / Skills:

    • Minimum of five (5) years health care experience clinical experience preferred
    • Minimum of two (2) years experience in clinical risk management preferred
    • Knowledge of PC based computer software, i.e., Word, Excel, Access and/or similar systems preferred
    • Ability to work independently and interdependently
    • Broad knowledge and familiarity with healthcare-related and accreditation requirements
    Principal Accountabilities
    • Responsible for training and evaluating staff on specific policies and procedures that affect the area of Risk Management.
    • Identifies and takes appropriate action to correct and/or report ethics and compliance issues or any violation that they are aware of in the department and/or the facility.
    • Assists in resolution of patient treatment issues, such as refusal of treatment, consent issues and AMA discharges.
    • Coordinates development of corrective action plan to address identified risk exposures.
    • Conducts annual evaluation of the effectiveness of the Risk Management Program and develops/modifies goals as indicated.
    • Counsels clinical personnel on family/care provider conflicts and responds to adverse patient outcomes.
    • Controls and reduces costs, and ensures that controllable expenses meet or exceed budget; forecasts operational needs, submitting a complete and timely budget; review budget reports and takes corrective action to address negative variances.
    • Works closely with the Quality Manager to ensure compliance with statutory mandates, regulatory requirements and accreditation standards of professional organizations such as JCAHO. (Statutory and regulatory requirements include but are not limited to the following: FDA, OSHA, EPA, EMTALA, Medicare and Medicaid provisions of the Social Security Act.)
    • Disseminates information and research related to changes in regulatory requirements and clinical research pertinent to potential liability exposures and risk issues.
    • Facilitates development and implementation of educational programs for employees and leadership related to risk management based on analyses of risk assessments, historical and concurrent occurrence and claims data, and national trends.
    • Makes recommendations and consults with Performance Improvement to provide monthly report for facility administration and Memorial Hermann Hospital System Risk Management Department.
    • Has authority to delay patient billing, as appropriate, until investigation of events or problems claims and/or resolution of the claim/suit are completed.
    • Assists Memorial Hermann Hospital System Risk Management and defense attorneys in investigation of claims and preparation of defense.
    • Assures prompt completion of interrogatories, requests for production and other litigation assistance at the direction of the Memorial Hermann Hospital System Risk Management.
    • Actively participates as a member of select committees critical to effectiveness of the Risk Management and Patient Safety Programs.
    • Environment of Care Committee/Subcommittees
    • Patient Safety Teams/Committees
    • Quality Management Committees
    • Assists appropriate medical staff and nursing committees in the resolution of medical quality of care and nursing quality of care issues posing clinical risk exposures.
    • Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
    • Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.
    • Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann's service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
    • Other duties as assigned
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