The Director of Risk Management is responsible for the planning, development, implementation, management and administration of all aspects of Risk Management for both the Downers Grove, Illinois, and Glendale, Arizona campuses and their respective clinics.
Essential Duties and Responsibilities
University-wide Risk Management: Develop, implement and administer on a day-to-day basis a University-wide risk management program, review and analyze all new occurrence reports for regulatory and insurance concerns; conduct critical analysis of occurrences; develop remedial plans; perform appropriate reporting; and conduct Root Cause Analysis investigations. Regularly travel to and maintain a visible presence on both campuses and clinics, in Glendale, Arizona, and Downers Grove, Illinois, interact collaboratively with employees, students, interns, and residents to gain their trust and to encourage them to speak openly about risk-related issues; promote a safe, professional, and compliant educational and clinical environment. Participate in University committees as assigned. Also assist the General Counsel, Director of Human Resources, Dean of Student Services, Director of Operations, Director of Security and Safety, and related personnel in identifying, locating, and managing actual and potential risks that are or may affect the operations of the various Midwestern University colleges and educational programs on both campuses. Accompany insurance company representatives in conducting tours, answer questions regarding various buildings on both campuses located. Conduct investigations of various matters and other projects as requested. Keep the General Counsel aware of all potential and actual occurrences and issues.
Clinic Operations: Administer the risk management program on a day-to-day basis by, among other things, reviewing and analyzing all new occurrence reports for regulatory and insurance concerns; conducting critical analysis of occurrences; developing remedial plans; performing appropriate reporting; and conducting Root Cause Analysis investigations. Also assist the General Counsel, VP of Clinic Operations, Clinic Directors and related personnel in identifying, locating, and managing actual and potential risks that are or may affect the operations of the various Midwestern University clinics and patient safety in general at all locations.
Site Responsibilities: Work with internal clinics and external affiliated sites to implement educational programs such as the performance of rounds of various medical units, interact with clinic directors, employees, students, interns, and residents to address any imminent issues.
Budget Responsibilities: Develop and manage the Risk Management operational budget and department strategic plan. Work with General Counsel to identify and manage actual and potential risk that might affect the goals and mission of the University. Process and request insurance company premium renewal payments, as well as student deductible payments, for exposure occurrences.
Processing of Data: Manage and develop processes to minimize/reduce or prevent losses/risks. Ensure defined performance management/ improvement targets/ benchmarks are met. Ensure regulatory/accreditation standards related to risk management and patient safety are met. Direct and manage the identification/measurement and assessment of risk and/or patient safety issues through data collection, aggregation, quantitative and qualitative analysis and reporting of trends and unusual occurrences by key area, severity, location/department, and job. Assist General Counsel to manage, prepare, and supply summaries of cases, board reports, open/closed report for auditor as well as other on-demand historical & current reports.
Professional Liability: Assist General Counsel in tracking potential or actual professional liability cases, assist in coordination of defense counsel, obtain information and produce discovery. Maintain files and prepare reports. Notify TPA, proper administrative personnel, and insurance companies. Maintain and update Loss-Runs. Attend and monitor legal proceedings. Interact with counsel and insurance representative during legal proceedings as directed by General Counsel. Interact with students, interns, residents, preceptors, and departments to acquire information regarding potential or actual professional liability cases. Assist General Counsel in securing legal representation for students, interns, and residents needed for legal proceedings. Keep the General Counsel aware of all potential and actual occurrances and issues. Lecture to students, interns, residents about policy and procedure; HIPAA & applicable state statutes; the importance of the use of good judgement and honest, timely reporting; and all other topics concerning effective risk management.
Workers’ Compensation/Comprehensive General Liability/Auto Claims: Interact with claimant for preparation of initial claims. Notify appropriate insurance company of claim, prepare process and coordinate claims with employee, insurance company, and/or vendor to bring issue to a conclusion.
Credentialing Assistance: Upon written authorization of present and/or former students, interns, and residents of both campuses, provide litigation history and Midwestern University’s insurance coverage information to various licensure boards, insurance companies, and/or medical facilities to comply with credentialing and licensure requirements.
Certificates of Insurance: Upon notification from the appropriate sources, request, coordinate and monitor Certificates of Insurance covering students, interns, residents, and select employees of Midwestern University for rotation and credentialing requirement process.
Student Assistance: Assist students (both campuses) that acquire needle sticks, exposures and splashes with the policy and process of independent insurance coverage. Acquire and process bills from vendors of medical service for deductible payment consideration. When necessary act as student advocate to healthcare billing departments.
Insurance Applications: Gather information and documentation from every college and program to appropriately answer insurance applications questionnaires, to secure approximately 16 various insurance coverages for the University. Put information into understandable form and prepare reports where necessary and submit background information to insurance companies.
Other duties that may be assigned.
This job will supervise the Assistant Director of Risk Management and other Risk Management staff.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience
Bachelor’s degree, is required, preferably in a clinical or allied health field; Master’s degree desired.
Minimum of 7-10 years of experience in Risk Management/Compliance in a healthcare setting and risk identification and occurrence investigation experience required
Risk Management/Compliance certifications desired
Experience in reviewing and evaluating policies and releases
Experience with insurance, including workers’ compensation
OSHA training and experience
Computer proficiency in MS Office (Word, Excel, Outlook, PowerPoint), required.
Intermediate skills: Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of employees and/or students of organization.
Intermediate skills: Ability to apply common sense understanding to carry out instructions furnished in written, oral or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
Basic skills: Ability to add, subtract, multiply, and divide all units of measure using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to interpret bar graphs.
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.
While performing the duties of this job, the employee is frequently required to sit, use hands to finger, handle, or feel; talk or hear. This position regularly requires standing and walking. Occasionally you are required to reach with hands and arms, stoop, kneel, crouch or crawl. The employee must regularly lift and /or move up to 10 pounds and occasionally lift and/or move up to 25 pounds.
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. This position is occasionally exposed to fumes or airborne particles and outdoor weather conditions. The noise level in the work environment is usually moderate.
Midwestern University is an Equal Opportunity/Affirmative Action employer that does not discriminate against an employee or applicant based upon race, color, religion, gender, national origin, disability, or veterans status, in accord with 41 C.F.R. 60-1.4(a), 250.5(a), 300.5(a) and 741.5(a).