Director of Risk Management

Kaweah Health is a publicly owned, community healthcare organization that provides comprehensive health services to the greater Visalia area in central California. With more than 5,000 employees, Kaweah Health provides state-of-the-art medicine and high-quality preventive services in our acute care hospital, specialized health centers and clinics. Our eight-campus healthcare district has 613 beds and offers comprehensive health services across a broad continuum of care.   

It takes a special person to work for Kaweah Health. We serve a region where the needs are great, which makes the rewards even greater. Every day, we care for people facing unique challenges and in need of healing. Throughout it all, our focus is to make a difference, and we do — in the health of our patients, our loved ones, and our community.

Benefits Eligible

Work Shift

Department

QUALIFICATIONS

License /Certification
Preferred: Current Registered Nurse license
Education
Required: Bachelor's degree
Preferred: Master's degree
Experience
Required: Two or more years of healthcare experience in risk, quality and/or patient safety.
Preferred: Three or more years of management/supervisory experience.
 

JOB RESPONSIBILITIES
Essential
The Director of Risk Management (RM) Department facilitates the identification, evaluation, and management and mitigation of issues representing general or professional liability to patients, visitors, staff, and Kaweah Health property for the Kaweah Health (Kaweah Health).Meets weekly with the Performance Improvement (PI) Director to review high severity Occurrence Reports. Meets biweekly with the Chief Operating Officer (COO), Chief Nursing Officer (CNO), Chief Medical Officer (CMO), and the PI Director to review high severity patient Occurrence Reports. Consults and collaborates with Compliance and Internal Audit regarding risk assessments of various Kaweah Health departments. Completes regular scheduled visits to all Kaweah Health campuses and departments to perform risk assessments, evaluate the physical environment, and observe staffs' performance. Consults with the Executive Team to plan appropriate risk assessments completed by outside consultants. Consults with appropriate Vice Presidents to minimize the adverse effects of accidental losses to the Kaweah Health. Facilitates the timely identification and resolution of issues to reduce or prevent the potential for loss or injury. Ensures the appropriate follow-up by managers to each area assessed as needing improvement.
Coordinates the Kaweah Health's self-insurance program, the Excess insurance program, and the commercial insurance programs. Manages the Kaweah Health's self insurance programs within the guidelines established by the Kaweah Health's governing body. Meets quarterly with the Kaweah Health's insurance broker to review coverage and obtain the best market value for the Kaweah Health. Recommends selection and retention of insurance carriers or self-funding mechanisms to the Executive Team. Reviews the Insurance Trust Fund agreement every three years with Kaweah Health Counsel and the Chief Financial Officer (CFO). Coordinates an insurance review by an independent consultant of all Kaweah Health insurance policies every 2 years (odd years).
Responsible for all aspects of claim and potential claims management. Meets weekly and as needed, usually by telephone, with the Kaweah Health Counsel to review claims and determine defense strategies. Has the authority to settle minor property or liability claims either by writing off accounts or by providing reimbursement. Ensures the RM claims database is accurate, complete, and current. Consults with defense and administrative counsels regarding preventive and corrective measures to be taken in situations with legal risks. Responsible for retaining, directing, and approving the compensation of Kaweah Health Defense Counsel. Consults with the Executive Team and the Compliance Officer to ensure compliance with applicable codes, laws, rules, and regulations concerning patent care.
Coordinates the process of reporting adverse events to local, state, and federal organizations. Works in conjunction with the Compliance Officer and the PI Director to ensure appropriate agency reporting is completed. Ensures records of such reporting are maintained in the appropriate departments. Actively participates, either as a facilitator or assistive role, in root cause analysis and development of action plans, and maintains files of such activities. Consults with physicians for disclosure of adverse events to patients and/or families.
Provides risk management education to Kaweah Health staff. Develops and provides appropriate orientation education for Kaweah Health staff, managers, and physicians. Identifies risk management trends from the RM database, PI Database, and literature to determine the RM education needs of staff. Works with Kaweah Health staff responsible for staff education to ensure on-going risk management topics are presented when applicable.
Ensures the Kaweah Health's Complaint and Grievance process functions appropriately. Ensures the PI grievance database is accurate, current, and complete, and that regular reports are sent to the appropriate individuals and committees. Ensures that grievances are responded to appropriately and timely.
Provides RM expertise in reviewing, revising, or developing new Kaweah Health policies, procedures, forms, and contracts. Ensures policies and procedures contain the appropriate risk prevention and management strategies, and complies with regulatory statutes. Ensures Kaweah Health policies and procedures are archived appropriately when revised. Reviews Kaweah Health contracts for the appropriate language to minimize risk to the Kaweah Health. Ensures the Kaweah Health's RM Plan is accurate and current. Provides regular RM reports to various Kaweah Health staff, committees, and the Board of Directors.
Maintains professional educational growth through awareness of healthcare industry trends and current laws and regulations. Attends a minimum of one professional RM education program per year. Educates Kaweah Health staff and the governing board on any regulatory changes or trends that may affect the Kaweah Health's RM Program.
Ensures the RM Department staff functions and performs efficiently, effectively, and appropriately. Reviews and revises, as appropriate, the RM Department Policy and Procedure Manual every 3 years to ensure standards are current. Ensures the necessary education and provides coaching of the RM staff to promote professional growth and competency. Consistently assesses and improves department processes and performance. Establishes a realistic financial budget and monitors expenses appropriately.
Consults with the medical staff for risk management issues. Regularly attends and actively participates in the Bioethics Committee. Is available to and consults with physicians regarding questions of obtaining informed consent, and termination of relationship with patients. Provides consultation to physicians regarding disclosure of adverse events to patients and families, and other risk management issues. Notifies physicians, as a courtesy, of any claims brought against the Kaweah Health involving his/her patient.
 

Additional
Demonstrates the knowledge and skills necessary to provide care and services appropriate to the population served on the assigned unit or work area.

Pay Range

If you want to use your talents alongside people who face each day with courage and purpose, in an environment that empowers you to do your absolute best, this is where you belong.