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Director, Compliance & Risk Management

Company: Brigham and Women’s Hospital
Location: Newton
Posted on: September 12, 2020

Job Description:

Job Description - Director, Compliance & Risk Management (3127677)

Director, Compliance & Risk Management - ( 3127677 )

Come join our Leadership Team at Newton-Wellesley Hospital! We are in search of a ChiefCompliance Officer (CCO) and Director of Risk Management. You will beresponsible for the vision, program planning, development, implementation and maintenanceof the hospital's Compliance, Risk Management and Insurance programs.

The CCO/Director isresponsible for managing the daily compliance activities within theorganization including the monitoring of all components of the NWH complianceprogram. S/he serves as an expert on compliance issues, manages auditactivities and stays abreast of new regulations and standards. Workingwith the Chief Compliance Officer of the Mass General Brigham System, you will ensurethe performance improvement and accreditation and certification processessupport the regulatory compliance process. The director also assures the compliancewith all issues surrounding accurate billing practices to third parties andpatients and prepares responses to financial inquiries.

This CCO/Directorconsults and collaborates with all levels of the organization to ensure thatcompliance issues and risks are identified and managed proactively to reduceinstitutional liability and to promote safety. This CCO/Director overseesthe investigation of all adverse events and collaborative case reviews,prepares all external reports related to such events and provides the requiredtime-based follow up and documentation to all external agencies and regulatoryorganizations.

The focusof this role is in the following key areas:

Compliance:

Plans, organizes, directs and coordinates departmental compliance program activities to help ensure that hospital practices, policies and procedures comply with State and Federal law as well as hospital standards and ethics.

Receives, reviews and initiates the investigation of all adverse events. Based on initial investigation, develops reports and/or plans for action and follow up.

Sets priorities for short-term and long-term goals for the Risk Management Services. Monitors all functions, schedules and activities.

Assists in review and development of hospital policies.

Coordinates with Accreditation and RegulatoryReadiness activities:

Works with our accreditation and regulatory readiness efforts across disciplines to ensure ongoing preparedness.

Works closely with the Regulatory Readiness Steering Committee.

Coordinates with the Office of Experience activities:

Collaborates on patient relations activities and provides guidance to staff on complex complaint issues involving legal, risk and patient safety or quality of care implications.

Ensures compliance with DPH & CMS rules related to complaints & grievances.

Data Management and Analysis:

Manages review and analysis of safety reports and manages follow-up with all significant adverse events. Identifies trends and collaborates with clinical teams to design programs to prevent medical error and reduce loss.

Reviews and evaluates aggregate adverse events and claims data, as well as other hospital information in order to identify high-risk activities, procedures and departments.

Claims Management:

Represents the hospitalas agent for service of legal process, coordinates activities such as recordrequests, depositions, etc.

Counsels hospitalemployees as necessary with regard to legal proceedings in which they areprofessionally involved.

Insurance Management:

Provides oversight, monitoring and management of the physician insurance product. Reviews and approves all physician applications for CRICO under NWH sponsorship.

Acts as staff support to insurance product advisory group.

Serves as a role model for professionalism, accountability, holding self and staff to hospital standards, coaching staff in areas of need and addressing unacceptable performance according to hospital policy.

The ideal candidatewill have the following expertise:

· Minimum of 10 yearscompliance and risk management experience required, advanced degree, (JD,Masters), Certified Professional in Healthcare Risk Management (CPHRM) orCertified Healthcare Compliance Professional (CHCP)

· Nursing or otherequivalent clinical experience

· Knowledge of Board ofRegistration in Medicine, DPH, The Joint Commission and other relevantregulations.

· Prior experience withmanaging the CRICO product preferred.

· Knowledge of medicalmalpractice and healthcare law required.

· Experience in workingwith teams in a complex organization.

· Knowledge of statisticalprocesses and measurement techniques preferred.

· Ability to adapt tochanging demands, workflow and perform under stressful situations in a calmmanner with excellent interpersonal skills.

SKILLS, ABILITIES ANDCOMPETENCIES:

Demonstrated excellent written and verbal skills.

Ability to communicate effectively and sensitively with clinicians in stressful situations

Demonstrated command of risk prevention and risk management techniques.

Demonstrated command of data management and analysis, and fiscal competence.

Requires ability to work independently and establish effective relationships with physicians, office staff and health care providers of all types and across all departments/functions of the hospital.

Requires autonomy in decision making using sound judgment based on factual information, clinical experience, the clinical process, the revenue process and hospital policies and procedures.

Requires ability to seek out and identify resources to problem solve risk issues across departments.

Confidentiality, both in management of and modeling the behaviors of oneself and the identified staff reporting to this position, is absolutely imperative.

Newton-WellesleyHospital will provide equal employment opportunities to all applicants andemployees without regard to race, color, religion, gender age, national origin,disability, marital status, genetic information, veteran or active military status,gender identity or expression, or sexual orientation.

Primary Location MA-Newton-NWH Main Campus

Work Locations NWH Main Campus

2014 Washington Street

Newton 02462

Job Professional/Managerial

Organization Newton-Wellesley Hospital(NWH)

Schedule Full-time

Standard Hours 40

Shift Day Job

Employee Status Regular

Recruiting Department NWH Risk Management

Keywords: Brigham and Women’s Hospital, Newton , Director, Compliance & Risk Management, Other , Newton, Massachusetts

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