The Director of Risk Management plans, establishes and administers risk and claims management activities for the MemorialCare Medical Foundation (MCMF) risk and claims management programs designed to enhance the quality of patient care, improve patient safety, and prevent losses to the organization. Performs risk and legal analyses and provides clinical consultative services on risk prevention and mitigation strategies. Responsible for management and daily oversight of professional liability claims, procurement of insurance coverage and risk financing, interfacing with defense counsel to establish defense strategies, as well as communication to key stakeholders on claim status.
Principal Duties and Responsibilities:
Demonstrate Memorial Care’s core values of respect, justice, compassion, stewardship, and excellence to customers, employees, and visitors; and provides quality service in the performance of work assignments and duties.
Oversees MemorialCare Medical Group and Greater Newport Physicians IPA insurance portfolio.
Responsible for management and daily oversight of all liability claims, NOIs, summons and complaints, and subpoenas. Retains, directs, and approves compensation of defense counsel, interfaces with defense counsel to establish defense strategies, and communicates to key stakeholders on claim status.
Design and implement policies and procedures related to loss prevention, patient safety, risk mitigation, patient rights and/or physician responsibilities incorporating state and federal regulations, clinical best practice or other professional guidelines as applicable to the appropriate care setting.
Conduct risk assessments and acts as a resource to administration, physicians, patients and employees relating to risk management services and clinical best practices for patient safety.
Assist with redesign of clinical care processes in order to ensure patient safety and care processes are consistent with applicable legal, regulatory and licensing requirements.
Conduct investigations of activities regarding actual or alleged liability (excluding Workers' Compensation) relative to patients, employees, physicians, and visitors. Analyzes potentially compensable events against standards of care and makes recommendations for actions
Provide investigative and other support for event analysis (Root Cause Analysis, Intense Analysis, Failure Mode Effect Analysis) and designs and leads Lean and other process improvement activities.