Insurance and Risk Management Director jobs in West Virginia

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Bachelor's degree

EXPERIENCE:

1. At least 3 years' experience in related field, including experience with enterprise risk management, quality improvement, healthcare administration, legal support and/or claims management.

PREFERRED QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Masters or Law degree

2. Certified Risk Manager (CRM) or Certified Professional in Healthcare Risk Management (CPHRM).

EXPERIENCE:

1. 5 years' experience in relevant field, including experience with enterprise risk management, quality improvement, healthcare administration, legal support and/or claims management.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1. Development and implementation of the organization's enterprise risk management programs in a manner that fulfills the mission and strategic goals of the organization while complying with state and federal laws and accreditation standards related to safety and risk management.

2. Identification, risk evaluation and coordination of corrective action implementation related to risk issues. This includes management and oversight of the organization's occurrence reporting system; Collects, evaluates, maintains data concerning patient injuries and other risk-related data. Provides leadership in the identification and implementation of corrective action plans where appropriate.

3. Provides and/or coordinates intervention and education related to risk management issues to pro mote safe work practices and quality care and services; in an environment that is beneficial to the safety, health and wellbeing of all patients, visitors and hospital staff.

4. Coordinates risk programs with hospital departments, administration; Educates and trains the leadership, staff and business associates as to the risk management program, and their respective responsibilities in carrying out the risk management program.

5. Investigates and analyzes root causes, patterns, or trends that could result in compensatory or sentinel events. Provides leadership in the identification and implementation of corrective action plans where appropriate.

6. Actively participates in, or facilitates, committees related to risk management, safety, and quality improvement.

7. Reports real and potential risk situations to the General Counsel, Claims Manager, Governing Body, medical staff, administration, hospital departments and committees, as appropriate.

8. Establishes monitoring methods to avoid, eliminate and/or reduce risk situations associated with the provision of patient care and services.

9. Assisting in claims management activities to include coordination with corporate claims and legal department as well as any attorneys retained to manage hospital medical malpractice activities.

10. Creating and implementing policies and procedures that improve both patient care and employee safety. Ensure the application of institutional policies, especially those regarding patient rights, confidentiality and full disclosure.

11. Working closely with clinical and other departments to ensure the organization's procedures and policies are being followed by all employees.

12. Collaborating with clinical staff and management for prevention of clinical and other risks throughout the facility. Develops effective working relationships with clinical staff and administrative personnel to facilitate the delivery of patient care and compliance.

13. Interfacing with legal counsel for medical malpractice defense, court orders and legal and regulatory concerns.

14. Working closely with the organizations general counsel to address various legal issues present throughout the organization, as necessary and appropriate.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. See attached Physical Demands

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Cognizant of environmental factors, infection control issues and maintains a safe environment.

SKILLS AND ABILITIES:

1. Must be highly organized and able to work in fast-paced environment, action-oriented and able to operate in ambiguous environments with minimal direction around new areas of work; must work independently and be detailed -oriented, with strong accuracy and completeness, diligence and discipline. Strong presentation skills, comfort presenting in large groups of executives.

2. Leadership experience, experience with compliance, audit, or legal helpful, demonstrated experience building teams and relationships with stakeholders; ability to motivate and inspire others, merge many ideas into a cohesive plan

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