Director, Risk Management (Health System/Clinical)

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Director, Risk Management (Health System/Clinical)

University Overview

The University of Pennsylvania, the largest private employer in Philadelphia, is a world-renowned leader in education, research, and innovation. This historic, Ivy League school consistently ranks among the top 10 universities in the annual U.S. News & World Report survey. Penn has 12 highly-regarded schools that provide opportunities for undergraduate, graduate and continuing education, all influenced by Penn's distinctive interdisciplinary approach to scholarship and learning. As an employer Penn has been ranked nationally on many occasions with the most recent award from Forbes who named Penn one of America's Best Employers By State in 2021.

Penn offers a unique working environment within the city of Philadelphia. The University is situated on a beautiful urban campus, with easy access to a range of educational, cultural, and recreational activities. With its historical significance and landmarks, lively cultural offerings, and wide variety of atmospheres, Philadelphia is the perfect place to call home for work and play.

The University offers a competitive benefits package that includes excellent healthcare and tuition benefits for employees and their families, generous retirement benefits, a wide variety of professional development opportunities, supportive work and family benefits, a wealth of health and wellness programs and resources, and much more.

COVID-19 vaccination is a requirement for all positions at the University of Pennsylvania. New hires are expected to be fully vaccinated before beginning work at the University. For more information about Penn's vaccine requirements and the use of Penn Open Pass, visit the Penn COVID-19 Response website for the latest information.

Posted Job Title
Director, Risk Management (Health System/Clinical)

Job Profile Title
Director, Risk Management (Health System)

Job Description Summary
Overall development and administration of a comprehensive and integrated medical professional claims control and loss prevention program throughout the University of Pennsylvania Health System. This includes inpatient facilities, outpatient and ambulatory care settings, and all clinical practice locations. The program will incorporate all UPHS, local, state, federal, and JCAHO regulations and standards. The position reports directly to the Chief Quality Officer and Senior Counsel of Claims and Risk Management, and will report monthly, or more frequently if indicated, on the status of claim activity, critical risk management issues and all other essential components of the program.

Job Description
  • Coordinates the provision of comprehensive risk management services at Health System facilities and practices including coordination between and among Risk Management, CEQI, Office of Patient Affairs and patient safety officers and directors on event management issues, as well as the integration of new facilities and practices into the program.
  • Evaluates and refines the occurrence reporting/risk identification system to encourage the prompt and objective reporting of incidents. Assures twenty-four-hour risk management availability for the immediate reporting of any incident, followed by the initiation of the appropriate intervention and risk management back-up support to the attorney-on-call.
  • Oversees the risk management review, triage, investigation and follow-up of incidents or occurrences including internal reporting to key stakeholders and the identification of opportunities for early intervention, and recommend and coordinate appropriate patient/family interventions to assist in mitigation of malpractice claim exposure.
  • Coordinate the preparation of potential claims files as indicated and ensure appropriate issue and severity coding of potential claims.
  • Coordinates compliance with accreditation (ie, the Joint Commission) and regulatory agency requirements for incident reporting at the local, state (ie, MCARE serious event reporting), and federal level (i.e., Safe Medical Device Act, SMDA Medical Device Implant Tracing, CMS restraint use, etc.).
  • Assists with the preparation of JCAHO and other regulatory or accrediting agency surveys and reviews.
  • Analyzes the data collected through the occurrence reporting system to assess its effectiveness in identifying trends, areas of potential risk exposure, and opportunities for improvement. Uses the data as an effective proactive tool to manage or eliminate identified areas of risk exposure, and prepares reports for use by clinical and administrative leadership including a quarterly "surprise rate" report and monthly dashboard reports for various health system entities.
  • Support the Health System's clinical risk reduction initiatives via analysis of occurrence reports and patient complaints to identify areas which departments and/or particular service lines should target for risk reduction efforts and consultation with and recommendations to senior clinical and administrative leadership on the development of departmental and/or program-specific risk reduction efforts.
  • Support the Health System's patient safety and quality initiatives through participation on committees, analysis of occurrence data to inform initiatives, and development and presentation of risk management guidance and data related to these initiatives.
  • Support of the Health System's participation in its Patient Safety Organization and related projects.
  • Oversees development and implementation of protocols and projects (ie the ongoing development and updating of procedure-specific consent forms) designed to reduce risk exposure.
  • Oversees scheduling and preparation of cases reviews/presentations for the Medical Legal Committee, the CCA Claims Review Committee, the UPHS Nursing Claims Review Committee and the various Incidents and Occurrences Committees. Also, supports the Professional Liability Oversight Committee which meets quarterly.
  • Assures risk management representation on committees (i.e.: Infection Control, Safety, Standards & Evaluations, Drug Use & Effects Committee, etc.) that address issues with either direct or peripheral risk management concerns.
  • Provides consultation on an as-needed basis on risk management-related issues
  • Develops educational and training programs to increase Health System employee participation in the occurrence reporting process, the management of patient/family disclosure and interventions, mechanisms for achieving risk reduction, and heighten employee consciousness of liability and prevention of risk throughout the organization. Promotes the educational mission of the Health System by providing lectures to selected undergraduate and graduate classes at the University of Pennsylvania School of Nursing.
  • Provides claims management support including reporting potential claims, assistance with opening new claims, reporting new claims, closed claims and claims with reserve changes to the excess insurance carrier, coordinating reserving meeting agenda, preparing top sheets for new claims for reserving, preparing monthly open and closed claims reports, assisting in-house malpractice counsel and outside defense counsel in the interpretation and understanding of the medical aspects of claims, coordinates appropriate peer reviews, and participates in claims reviews and analysis regarding settlement or defense strategies.


QUALIFICATIONS:

BA/BS degree in Nursing with Professional Nursing License in Commonwealth of PA required; Master's Degree required; must have a minimum of 5 years of clinical experience with at least 5 years of recent experience in health care risk management, quality assurance, or case management positions preferred; Certified Professional in Healthcare Risk Management (CPHRM) certificate preferred; may be required to travel throughout Medical Center, University Campus & Health System.

* Must submit cover letter with application

Job Location - City, State
Philadelphia, Pennsylvania

Department / School
President's Center

Pay Range
$90,860.00 - $142,844.66
Salary offers are made based on the candidate's qualifications, experience, skills, and education as they directly relate to the requirements of the position, as well as internal and market factors and grade profile.

Affirmative Action Statement
Penn adheres to a policy that prohibits discrimination on the basis of race, color, sex, sexual orientation, gender identity, religion, creed, national or ethnic origin, citizenship status, age, disability, veteran status, or any other legally protected class.

Special Requirements
Background check required after a conditional job offer is made. Consideration of the background check will be tailored to the requirements of the job.

University Benefits
  • Health, Life, and Flexible Spending Accounts: Penn offers comprehensive medical, prescription, behavioral health, dental, vision, and life insurance benefits to protect you and your family's health and welfare. You can also use flexible spending accounts to pay for eligible health care and dependent care expenses with pre-tax dollars.
  • Tuition: Take advantage of Penn's exceptional tuition benefits. You, your spouse, and your dependent children can get tuition assistance here at Penn. Your dependent children are also eligible for tuition assistance at other institutions.
  • Retirement: Penn offers generous retirement plans to help you save for your future. Penn's Basic, Matching, and Supplemental retirement plans allow you to save for retirement on a pre-tax or Roth basis. Choose from a wide variety of investment options through TIAA and Vanguard.
  • Time Away from Work: Penn provides you with a substantial amount of time away from work during the course of the year. This allows you to relax, take vacations, attend to personal affairs, recover from illness or injury, spend time with family-whatever your personal needs may be.
  • Long-Term Care Insurance: In partnership with Genworth Financial, Penn offers faculty and staff (and your eligible family members) long-term care insurance to help you cover some of the costs of long-term care services received at home, in the community or in a nursing facility. If you apply when you're newly hired, you won't have to provide proof of good health or be subject to underwriting requirements. Eligible family members must always provide proof of good health and are subject to underwriting.
  • Wellness and Work-life Resources: Penn is committed to supporting our faculty and staff as they balance the competing demands of work and personal life. That's why we offer a wide variety of programs and resources to help you care for your health, your family, and your work-life balance.
  • Professional and Personal Development: Penn provides an array of resources to help you advance yourself personally and professionally.
  • University Resources: As a member of the Penn community, you have access to a wide range of University resources as well as cultural and recreational activities. Take advantage of the University's libraries and athletic facilities, or visit our arboretum and art galleries. There's always something going on at Penn, whether it's a new exhibit at the Penn Museum, the latest music or theater presentation at the Annenberg Center, or the Penn Relays at Franklin Field to name just a few examples. As a member of the Penn community, you're right in the middle of the excitement-and you and your family can enjoy many of these activities for free.
  • Discounts and Special Services: From arts and entertainment to transportation and mortgages, you'll find great deals for University faculty and staff. Not only do Penn arts and cultural centers and museums offer free and discounted admission and memberships to faculty and staff. You can also enjoy substantial savings on other goods and services such as new cars from Ford and General Motors, cellular phone service plans, movie tickets, and admission to theme parks.
  • Flexible Work Hours: Flexible work options offer creative approaches for completing work while promoting balance between work and personal commitments. These approaches involve use of non-traditional work hours, locations, and/or job structures.
  • Penn Home Ownership Services: Penn offers a forgivable loan for eligible employees interested in buying a home or currently residing in West Philadelphia, which can be used for closing costs or home improvements.
  • Adoption Assistance: Penn will reimburse eligible employees on qualified expenses in connection with the legal adoption of an eligible child, such as travel or court fees, for up to two adoptions in your household.



To learn more, please visit: https://www.hr.upenn.edu/PennHR/benefits-pay

To apply, visit https://wd1.myworkdaysite.com/en-US/recruiting/upenn/careers-at-penn/job/FMC-Tower/Director--Risk-Management--Health-System-Clinical-_JR00057399-2

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