The Director of Risk Management is responsible for leadership, innovation, governance, and management necessary to identify, evaluate, mitigate, and monitor Sound Physicians’ operational and strategic risk as well as to monitor potential legal matters received by the organization and provide timely response to specific requests or claims based upon internal guidelines. The day-to-day operation of the position, include but are not limited to, clinical risk and insurance management, claims handling, and litigation management.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Many or all of the following are done under the direction and in collaboration with the Chief Compliance Officer CCO and General Counsel GC. The CCO and GC are expected to appropriately delegate responsibilities and tasks to the Director of Risk Management the following responsibilities:
Develops enterprise risk management tools, practices, and policies to analyze and report enterprise risks, and to manage risks according to an enterprise risk management framework.
Drafts and reviews risk management policies to ensure compliance with applicable regulations including, but not limited to, physician and advance practitioner licensing and patient safety, claims management and other risk management industry practices.
Monitors and analyzes risks within Sound Physicians’ business and reports these risks to ensure alignment with organizational objectives.
Works closely with compliance and privacy to assure coordination and consideration of these areas in investigations, reviews and recommendations.
Ensures Sound Physicians’ risk management policies and strategies are in compliance with applicable regulations and strategic imperatives of the organization.
Assists with ensuring compliance of the organization with healthcare legislation and guidance published by regulatory bodies.
Participates in coordination and development of business-wide programs for safe patient care and risk-free services utilizing internal and external safety trends.
Monitors and analyzes risks within the company's business units and reports on these risks to the CCO and GC.
Initiate and complete all aspects of the claims process, including but not limited to documenting in the claims management system, filing claims with appropriate insurance carriers, confirming attorney assignments, and documenting the litigation intake log in accordance with departmental guidelines
Audit the litigation intake log on at least a quarterly basis to verify accuracy and report discrepancies to the Chief Compliance Officer or other appropriate persons
Responsible for performing job duties in accordance with the mission, vision and values of Sound Physicians.
Ability to communicate effectively with a variety of contacts, including outside attorneys, senior management, and business associates.
Excellent organizational abilities.
Excellent written and oral communication skills.
Attention to detail and accuracy.
Client service oriented (both internal and external)
Creative and persistent problem solver
Able to handle confidential material in a reliable manner
Strong interpersonal skills to handle sensitive situations and confidential information. Position continually requires demonstrated poise, tact, diplomacy, and good judgment.
Ability to multi-task and prioritize workload in a fast-paced environment
EDUCATION / EXPERIENCE:
Minimum: Bachelor’s degree in Business Administration or related field
Preferred: J.D. Degree from an ABA-accredited law school and currently licensed to practice law in a state and eligible to apply for an active membership in either the Ohio, Tennessee or Washington State Bar required, depending upon office location.
Minimum: 5 years of in-house legal experience at a healthcare or hospital system or related law firm experience consisting of progressive experience as health care risk manager and experience in claims management and litigation.
Preferred: 8+ years of in-house legal experience at a healthcare or hospital system or related law firm experience with experience as health care risk manager and experience in claims management and litigation.
LIST SPECIAL JOB OR ENVIRONMENTAL CONDITIONS:
Indoor office environment
Travel: Approximately 3 short trips per year, depending on office location
OTHER PHYSICAL AND/OR SPECIAL REQUIREMENTS ABOUT YOUR JOB:
Sitting at desk for up to eight hours (w/breaks)
Working on computer for up to eight hours (w/breaks)
Moving/lifting file boxes (up to 25 lbs.)
This job description reflects the present requirements of the position. As duties and responsibilities change and develop, the job description will be reviewed and subject to amendment.
Internal Number: DIREC01421
About Sound Physicians
Sound Physicians is a leading healthcare organization with a proven track record of improving quality, satisfaction and financial performance for its hospital partners nationwide. Sound combines a high-performance model with engaged providers to drive reproducible results across the acute episode of care – through emergency medicine, critical care, hospital medicine, transitional care and advisory services.