The Executive Director, UHealth Medical Risk Management reports to the UHealth Chief Risk Officer and is responsible for operational direction and oversight of medical risk management efforts in accordance with applicable legal, regulatory, and accreditation requirements and standards, including collaboration with senior executives in risk strategy, governance, management, quantification, and interdependencies, in order to achieve desired goals and results. The incumbent also develops and sets strategy in partnership with key medical and administrative leadership to execute business plans.

CORE JOB FUNCTIONS

• Oversees all aspects of medical risk management, risk prevention, and patient safety activities.

• Builds a culture of proactive risk identification, patient safety, and trust.

• Leads the development of risk management and compliance programs.

• Assists in the administration of departmental budgets related to facility and clinical risk managers.

• Analyzes financials to maximize the use of funds and ensures overall operations are within budget.

• Remains informed regarding emerging threats to ensure that risks are well known and understood.

• Communicates and manages expectations across all levels of the organization.

• Develops detailed drill down reports and dashboards that meet the needs of management.

• Collaborates with various stakeholders to develop relevant and comprehensive metrics.

• Identifies deficiencies and initiates corrective action plans to reduce risk to known and acceptable levels.

• Develops an ongoing program to audit all of the organizational controls to ensure that they are in place and remain effective.

• Maintains expertise on security trends through training and research.

• Serves as subject matter expert and briefs highest levels of organization effectively.

• Ensures internal control oversight and compliance with laws and regulations, safeguarding of assets, compliance with University policies and procedures, reliability of internal and external reporting, and efficiency and effectiveness of operations. Creates an effective control environment, conducts risk assessment, implements and monitors controls.

Knowledge, Skills and Attitudes:

• Ability to maintain effective interpersonal relationships.

• Commitment to the University’s core values.

• Ability to direct, manage, implement, and evaluate department operations.

• Ability to establish department goals and objectives that support the strategic plan.

• Ability to effectively plan, delegate and/or supervise the work of others.

• Ability to lead, motivate, develop and train others.

• Ability to recognize, analyze, and solve a variety of problems.

• Ability to exercise sound judgment in making critical decisions.  

• Ability to maintain the highest levels of integrity, professionalism and confidentiality.

DEPARTMENT SPECIFIC FUNCTIONS

• Responsible for the coordination of medical risk management activity across clinical disciplines, overseeing the organization's annual risk assessment and plan, and associated reporting process, supporting  the embedding of risk assessment and monitoring discipline in operating plans and coordinating reporting on risk issues to internal and external stakeholders.

• Responsible for the ongoing management of the organization's medical risk management program and oversight of all clinical risk management personnel, including recommendations regarding hiring retention, evaluation, assignment, and oversight of all facility and location level clinical risk managers and staff.

• Responsible to leadership for all clinical risk management related legal and regulatory compliance for inpatient and outpatient hospital and hospital-based facilities; ambulatory surgical centers, and other UHealth  clinical sites, including establishing required risk management staffing and support at UHealth clinical locations.

• Responsible for monitoring progress and assisting management in reporting relevant risk information up, down and across the organization.

• Work closely with other executives to develop and implement an effective early intervention program intended to identify and analyze clinical events and take proactive steps to maintain relations between providers and patients/families; assure any required disclosures; and address any outstanding issues or questions related to clinical care.

• Develop and service education as related to Risk Management techniques and claims outcomes to the professional, administrative, and hospital personnel of each facility of the University of Miami Health System and the UMMG.

• Responsible for the development, implementation, and oversight of ongoing active training programs in clinical risk prevention methods for clinical providers and staff.

• In conjunction with UHealth Chief Quality and Patient Safety Officer develop and implement an annual UHealth patient safety plan and effectively coordinate risk reporting/management functions and patient safety and quality activities

• Partner effectively with Chief Medical Officers to integrate and coordinate risk, quality and safety, billing and regulatory compliance, patient access, and patient experience functions at all UHealth clinical locations. Work in conjunction with leadership in these functional areas to implement efficient communication and data exchange modalities and develop basic cross-training programs.

• In conjunction with UHealth Chief Experience Officer and executive staff, evaluate and recommend improvements in current process for reporting and responding to patient complaints and grievances and develop training for staff and providers related to effective communication and situation management methods.  

• Develop in conjunction with other executive leaders appropriate processes for patient complaints and grievances related to quality of care and staff and reports regarding patient, staff, and provider disruptive behaviors.

• Identifies opportunities for early resolution of significant events and assists in patient disclosure meetings as appropriate.

• Coordinate with the UHealth Executive Director for Claims Prevention and Litigation Management regarding the identification and analysis of potential claims and implementation of lessons learned from claims and litigation analysis.

• Participate in a variety of UHealth and/or community committees, as requested.

• Any appropriate combination of relevant education, experience and/or certifications may be considered.

CORE QUALIFICATIONS

• Bachelor's Degree in relevant filed required. Degree preferred in: Professional clinical discipline (BSN, PA, MD, etc.), risk management, industrial engineering, management science, actuarial science, or related field. Advanced degree in related discipline is desired.

• Certification in relevant specialty or field required. Must have current Certified Professional in Health Care Risk Management (CPHRM) certification or attain CPHRM within one year of hire or equivalent certification—i.e. Certified Professional in Patient Safety (CPPS). Fellow of the American Society of Health Care Risk Management (FASHRM) desired. Medical licensure –MD, RN, ARNP, PA—is a plus.

• Minimum 7 years of relevant experience required. The ideal candidate will have 10+ years risk management experience in a healthcare organization or in a consulting capacity. Academic Medical Center experience preferred.