Senior Director, Quality and Risk
Location; Mayfield, KY
JOB DESCRIPTION
- Direct the activities and resources for the Quality Management department to achieve departmental and organizational objectives.
- Responsible for the facilities' risk management activities, which include, but may not be limited to:
- A general knowledge of facility insurance programs.
- Administering the risk management program on a day-to-day basis.
- Managing and analyzing risk management data, trending, identifying gaps in results or program aspects, identifying opportunities for improvement, preparing reports to communicate data findings and analysis of information.
- Conducting education applicable to risk management and patient safety initiatives.
- Complying with regulatory and accreditation standards.
- Formulating policy to support risk management initiatives and principles.
- Participating in committees to integrate risk management into committee work product.
- Interfacing with the corporate risk management department on claims management.
- Minimizing loss to protect the assets of the facility.
- Responsible for reviewing and formulating policy or organizational changes and making recommendations for approval by senior management. This position management and provides oversight for accreditation surveys.
- Develop and implement departmental goals, plans, and standards consistent with the clinical, administrative, legal, and ethical requirements/objectives of the organization.
- Direct and evaluate departmental operations, including patient care delivery, information technologies, service level determination, and complaint management, to achieve performance and quality control objectives.
- Plan and monitor staffing activities, including hiring, orienting, evaluating, disciplinary actions, and continuing education initiatives.
- Prepare, monitor, and evaluate departmental budgets, and ensures that the department operates incompliance with allocated funding. Coordinates and directs internal/external audits.
- Create and foster an environment that encourages professional growth.
- Integrate evidence-based practices into operations and clinical protocols.
- Provide prompt notification to appropriate parties upon receipt of claim or lawsuit.
- Assist HSC Risk, leadership and external counsel in defense of the claims as instructed.
- Provide leadership, counsel, and support in areas of Risk Management.
- Escalate significant risk issues with urgency.
- Collaborate with site patient safety / quality improvement and patient experience leadership to respond to patient grievances.
- Use decision making ability to analyze and recommend disposition strategies.
- Oversee and direct occurrence reporting process for site. Ensures timely data entry of reports received. Completes necessary trend analysis of occurrence reports.
- Collect data for risk exposures and provides feedback to the involved departments. Ensure identified risk management strategies are undertaken by affected areas.
- Develop a safety culture where reporting is encouraged and use of SIM reporting system is monitored, with interventions to address issues as needed.
- Provide in-service education on risk management topics, both standard basic education and complex focused topics as needed and / or requested.
- Provide statistical analysis for review by appropriate committees as requested.
- Create and implement new programs to foster a culture of safety and safe environment for patients, visitors, and staff.
- Coordinate and oversee the development of comprehensive accreditation improvement initiatives to establish compliance with regulatory agencies.
- Coordinate and ensure the implementation of organization-wide regulatory compliance activities with The Joint Commission, CMS, and other regulatory agencies.
- Facilitate the development of ongoing readiness action plans, assessments, and educational activities as appropriate.
- Utilize the standards and regulations from CMS and TJC, oversees concurrent monitors to determine if staff knowledge and clinical practice meet appropriate standards.
- Coordinate risk reduction activity in the physical environment as specified within each Environment of Care (EOC) Management Plan.
- Facilitate the organization's Regulatory Committee.
- Participate in interdisciplinary collaboration to measure and assess processes and outcomes, and proactively identify potential solutions with the multidisciplinary team and appropriate service line leaders and directors.
QUALIFICATIONS
- Bachelor's degree in Nursing required.
- Master's degree in Nursing or Business / Healthcare related field preferred.
- Certification in Risk Management through a nationally recognized program meeting preferred industry standards.
- Require critical thinking skills, decisive judgment and the ability to work with minimal supervision.
- Must be able to work in a stressful environment and take appropriate action.
- Computer skills required.
- Strong understanding of: Process Review; Root Cause Analysis; Department of Health, and Joint Commission requirements familiarity.
- Basic Life Support (BLS) American Heart Association must be obtained within 90 days of employment, if not current upon hire.
- License: Current KY or Multi-State RN licensure. CPHQ certification required within 1 year of employment.
- Five (5) years of healthcare experience as RN and two years' experience in quality / clinical nursing leadership preferred.
- Five (5) years of experience in healthcare risk management and accreditation. Experience in the insurance industry is supportive to the skill set of the risk manager.
- Three (3) years of experience in direct patient care with some experience in critical care.
- Preferred:
- Experience with presenting complex data.
- Desire to make a difference in Mayfield, KY.
- Effective Staff Management / Cultivate Success in Staff Professional Integrity.
- Lead by Example.
- Maintain Accountability Standards.
- Ability to Understand Financial Functions and Be Fiscally Responsible.
- Strategic Planning and Program Development Skills.
- Adaptable to Growth and Change.
- Communicate Effectively to Build Positive Relationships
Platinum Resource Group is a professional level consulting firm, providing resources to Fortune 1000 client companies in the areas of technology, human resources, accounting, finance, business systems and supply chain, on a contract and interim basis. PRG has operations in Orange County, San Diego, Los Angeles, and San Francisco. As a W-2 employer we offer our consultants direct deposit bi-weekly payroll, health, dental, vision benefits, paid holidays, and referral bonuses.