Director, Risk Management, Jackson's Skilled Nursing Homes, Full-Time, Days

Jackson's Skilled Nursing Homes

Department: Skilled Nursing Homes (this role will oversee the below Skilled Nursing Home Facilities):

• Perdue Medical Center-19590 Old Cutler Road - Miami, FL 33157
• Long Term Care Center-2500 NW 22nd Avenue, Miami, FL 33142

Shift details: Full-Time, Days

Summary

The Director of Risk Management provides administrative oversight of Jackson Health System (JHS) Risk Management Administration Programs whose goals include but are not limited to interventions to reduce, prevent, minimize and control risks associated with provision of health care delivery services to patients, the general public and staff. Through the oversight function identifies, analyzes and intervenes to reduce, prevent, control and minimize these risks which may lead to financial loss exposure for the JHS.

Responsibilities

• Provides the leadership framework for planning, directing, coordinating and improving services by the division that are responsive to the needs of the Jackson Health System.
• Provides leadership support in the communication and integration of the JHS Mission and Vision Statement.
• Designs, develops, manages, and implements with the assistance of institutional medical, nursing, clinical, support, and administrative staff Risk Management and Safety Management Program that has as a goal the control, prevention, reduction and minimization of hazards and manages staff activities to reduce the risk of human injury to assure a safe environment for patients, personnel and visitors.
• Provides oversight, maintains and operates the institutional Incident Reporting System in accordance to institutional policies and State of Florida regulatory requirements.
• Assists in the oversight, through the Department's Claims and Litigation Unit administrative staff, ensuring that any claims and litigation matters presented to the institution are appropriately timely assigned, investigated and handled in accordance with the Department's process mechanisms, standard tort and administrative claims investigation techniques/guidelines, and prevailing laws of the State of Florida.
• Provides and manages the Risk Management Information System in an effort to generate various standard and ad hoc management reports of incident report activity involving patients, employees and the general public as well as the claims and litigation activity reports as required under the provisions of the Joint Risk Management Program.
• Provides and presents the reports, as needed and required, to different institutional committees, including but not limited to those charged with Quality Management, Performance Improvement functions and the governing board of JHS, the University of Miami School of Medicine Practice Management and affiliated hospitals and health care facilities.
• Provides analysis of the reported data and develops recommendations aimed at preventing, controlling, reducing and minimizing incidents involving patients, the public and staff.
• Provides oversight and manages, through administrative staff, the Environment of Care/Environmental health and Safety Programs for JHS and its affiliates. Ensures that the Risk Management and Environment of Care/Environmental Health and Safety for JHS and its affiliates are in compliance with Florida State Licensure, Joint Commission for Accreditation of Hospitals (JCAHO), the Departments of Health and Human Services (HHS), and other applicable and prevailing state, local and federal regulations. Ensures that the administrative Departmental staff are appropriately licensed and credentialed to perform their tasks.
• In collaboration with medical, nursing, clinical, support, and administrative leadership, provides oversight and actively recommends and assists with development and implementation of programs for control, reduction, prevention and minimization of risk exposure for patients, the general public and staff.
• Actively participates in the JHS Performance Improvement Program.
• Initiates, continuously assesses and promotes improvement in Risk Management and Environment of Care Programs.
• Plans, coordinates and provides Risk Management in-service education to medical, nursing, ancillary clinical and administrative staff under the auspices of the Joint Risk Management Program, including new employee, annual and service/unit specific education.
• Develops risk control, reduction, prevention and minimization educational programs, with the assistance of institutional leadership, resulting from root cause analyses or through the on-going identification, analysis and trending of incident reporting data activity.
• Plans, coordinates and directs the activities of the Risk Management and Safety personnel.
• Recruits, evaluates and maintains an effective staff to carry out assigned responsibilities.
• Provides for the training and development of the staff and plans and coordinates educational programs as required. Serves as a member of various JHS and University of Miami School of Medicine committees, including but not limited to peer review, quality management and credentialing.
• Coordinates, prepares, distributes, and presents reports as required.
• Assists in the review of contracts and agreements for indemnification, insurance and liability provisions for JHS and works with legal counsel on these issues.
• Serves in a consultative capacity and role to the institution on risk management issues.
• Collaborates with Clinical Resources and Clinical Quality Management in the identification, evaluation, investigation, and analysis of critical/sentinel events with the goal of developing joint strategies in minimizing risk to patients, visitors and staff.
• Provides Risk Management licensure oversight and program administration to JHS Managed Care licensed HMO as required under 641 F.S.
• Works with legal counsel on issues which require legal oversight and review. Assigns counsel for legal and administrative actions for JHS and University of Miami School of Medicine Joint Risk Management Program. Ensures staff participation in required education programs and appropriate orientation and training courses to maintain competency in job skills, knowledge and equipment.
• Ensures that employees respect the rights, privacy and property of others at all times, including the confidentiality of information according to Administrative Policies and all applicable laws and regulations.
• Oversees and establishes operating coordination with Human Resources to ensure that personnel issues and processes for background checks, etc. are carried out consistently.
• Develops, coordinates and participates in a multi-faceted educational training program that focuses on the elements of the compliance program and ensures that all appropriate employees and management are knowledgeable of and comply with the federal and state standards.
• Reports on a regular basis to the Governing Board, CEO, and Compliance Committee on the progress of implementation and assists these components in establishing methods to improve the institution's efficiency and quality of services and reduce institutional vulnerability to fraud, abuse and waste.
• Ensures that independent contractors and agents who furnish medical services to the institution are aware of the requirements of the corporate compliance program with respect to, but not limited to, coding, billing and marketing. Develops policies and programs that encourage managers and employees to report suspected fraud and other improprieties without fear of retaliation.
• Role models behaviors of service excellence and CARE values (Compassion, Accountability, Respect and Expertise).
• The leader understands and adheres to JHS compliance standards as they appear in the Code of Conduct, Compliance Policies, and all other JHS Policies and Procedures and supports the commitment of JHS in adhering to federal, state and local laws, rules and regulations governing ethical business practices for health care providers by demonstrating knowledge of procedures for protecting and maintaining security, confidentiality and integrity of employee, patient, family and organization information.
• The leader further understands that JHS is committed to its role in preventing health care fraud and abuse and complying with applicable state and federal laws related to health care fraud and abuse.
• This commitment is supported and enabled through an anonymous hotline which serves as one of several mechanisms for reporting suspected fraud, waste and/or abuse, as well as other compliance related issues.
• The leader to report through any of the reporting mechanisms (e.g., anonymous hotline, supervisor, Compliance Officer) any suspected health care fraud, waste and/or abuse as well as other compliance-related issues.
• Performs all other related job duties as assigned.

Experience

Generally requires 7 to 10 years of related experience. Management experience is required.

Education

Bachelor's degree in related field is required. Master's degree is strongly preferred.

Credentials

Valid license or certification is required as needed, based on the job or specialty.

Jackson Health System is an equal opportunity employer and makes employment decisions without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, disability status, age, or any other status protected by law.