Responsibility for the development, leadership, and management of a best-in-class enterprise professional, property and casualty liability and related claims and clinical risk management programs in support of the mission and vision of Thomas Jefferson University and its system of academic, community physicians and other clinical care providers; responsibility for establishing and systematizing educational programs for physicians and advanced practice professionals in support of clinical risk goals; responsibility for integrating clinical risk and professional liability programs to promote patient safety, quality and performance improvement in furtherance of the goals of the EVP and Chief Quality Officer; responsibility for establishing a compensable event and physician support programs; aligning with the enterprise medical director regarding the above; actively supporting and assisting the senior vice president of insurance and hospital CFO in the operation of the captive insurance programs and brokerage and placement activities; serving as chair, as requested, or an integral member of enterprise risk and claims committees and serving as an integral member of the appropriate committees with respect to the captive insurance program.
1. Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson
2. Develop management architecture, tools, practices, and policies to analyze, report and monitor clinical risk, enterprise risk, and other risk activities impacting institutional integrity.
3. Ensure the organization’s clinical risk and enterprise risk management policies and strategies are consistent with its mission and vision and in compliance with applicable regulations, rating agency standards, strategic imperatives of the organization, and are at all times consistent with its mission.
4. Evaluate and monitor all clinical, enterprise, and operational risk management activities within the organization’s business units and report on same to executive leadership.
5. Chair or provide key input into the various organizational committees that oversee the clinical and enterprise risk and integrity processes and activities, and ensure alignment with organizational objectives and enterprise risk program.
6. Supervise and provide leadership for all medical professional and general liability claims management operations of the organization on a system-wide basis, inclusive of supervision of the reserving, adjustment, and settlement of claims; litigation management; reporting of incidents and claims; analyzing incident and claim trends and providing executive management with regular reports regarding how trends can be monitored and mitigated.
7. Provide leadership for and supervise the property and casualty insurance/reinsurance purchase process for TJU and JH.
8. Primary responsibility for the supervision and management of the insurance/reinsurance brokerage function.
9. Primary responsibility for representing the organization to insurance/reinsurance underwriters.
10. Direct and supervise the programs of patient advocacy, apology & disclosure, and proactive risk mitigation within the organization.
11. Direct the efforts of the VP and Medical Director, and provide leadership and support to the mitigation of medical staff insurance and related risk; develop proactive education programs throughout the organization aimed at training and education on risk management and improvements in performance and quality.
12. Provide inspiration, leadership, and support for all clinical risk management staff in place throughout the system.
Active engagement with enterprise Medical Director in connection with the development, operation and education of faculty and providers regarding clinical risk; establish, in conjunction with the Enterprise Medical Director, programs to ensure the development transparent, efficient and impactful claims and risk data ,the effective and efficient operation of claims and other committees and programs to support providers post adverse events; work cooperatively with the SVP of Insurance in connection with placement of insurance and operation of captive insurance companies.
Master's degree in Nursing required; minimum of 12 years of increasingly responsible experience in creating and managing clinical, professional liability, and general claims programs, and clinical risk educational programs; sound understanding of the operation of captive insurance companies and reserving philosophy; minimum of 10 years’ experience in operating and managing an academic teaching facility's and large physician practice’s insurance and risk management education programs; minimum of 10 years of medical professional and general liability claims management experience, inclusive of the management, reserving, adjustment and adjudication of potentially compensable events and claims, in particular with respect to specialty group practice issues; and experience operating in the Philadelphia professional liability environment.
Master's degree in Nursing required; JD degree preferred; CPHRM designation from the American Society for Health Care Risk Management; minimum of 15 years of increasingly responsible experience in the areas of risk management, claims management, and clinical risk education programs; experience with captive insurance companies and their operations; demonstrated ability in the establishment of robust clinical risk and professional liability programs for a large AMC; and minimum of 15 years of medical professional and general liability claims management experience, inclusive of the management, reserving, and adjustment of claims and potentially compensable events.
Internal Number: 9249232
About Thomas Jefferson University and Jefferson Health
Jefferson Health delivers state of the art healthcare services to patients throughout the Delaware Valley and southern New Jersey. Jefferson (Philadelphia University + Thomas Jefferson University) provides more than 8,400 students from nearly 40 states and 40 countries with 21st century professional education. Combined, we have over 30,000 employees.
Jefferson Health, with 14 hospitals (seven are Magnet designated by the ANCC for nursing excellence) and 40+ outpatient and urgent care locations, offers a broad range of primary and complex, highly specialized care that touches the lives of more than four million patients annually. U.S. News & World Report has ranked Thomas Jefferson University Hospital among the nation’s best in eight specialties. Jefferson Health also includes the NCI designated Sidney Kimmel Cancer Center; it is one of only 70 such centers in the nation.
Thomas Jefferson University has ten colleges and three schools that offer more than 160 undergraduate and graduate programs. Our University is dedicated to inter-professional and transdisciplinary approaches to learning that offer a vibrant and expandable platform for professional education. Through this uniq...ue model, we are preparing our students for current and yet to be imagined careers.
As an employer, Jefferson maintains a commitment to provide equal access to employment. Jefferson values diversity and encourages applications from women, members of minority groups, LGBTQ individuals, disabled individuals, and veterans.