About this role
UTHealth Houston is looking for a Director of Healthcare Risk Management (RN) who will be responsible for the planning, implementation, and effectiveness of a system of internal controls that provides reasonable assurance that healthcare risk management operations are effective and efficient, organizational assets are protected, and financial information is reliable and compliant with applicable laws, regulations, policies, and procedures. This employee must be a Registered Nurse (RN) with both clinical and legal experience, serving as the bridge between our physicians, other healthcare providers, and clinical staff, and our legal department. This role oversees and coordinates the systems and processes necessary to identify, evaluate, monitor, reduce, and/or eliminate professional liability risk exposures. The Director also provides consultation, education, and guidance to clinical personnel, leadership, and medical and dental staff regarding patient safety and risk exposures, with an emphasis on prevention and risk reduction. In addition, this position is responsible for managing and executing UTHealth Houston's risk management program and related activities across all UTHealth Houston locations. You will be in the office three days a week and working from home the other two. This employee must be on call for medical and legal emergencies related to patient care and adverse events. In such an event, this person initially speaks with our clinical staff about the situation, then develops a strategy to limit risk and litigation exposure and consults with the legal team. You should be able to engage in conversations that include medical and legal professionals and comprehend both clearly. Again, you must at least have your Registered Nurse license and experience with these sorts of scenarios. What we do here changes the world. UTHealth Houston is Texas’s resource for healthcare education, innovation, scientific discovery, and excellence in patient care. That’s where you come in. Once you join us, you won't want to leave. It’s because we reward our team for the excellent service they provide. Our total rewards package includes the benefits you’d expect from a top healthcare organization (benefits, insurance, etc.), plus:
• 100% paid medical premiums for our full-time employees • Generous time off (holidays, preventative leave day, both vacation and sick time – all of which equate to around 37-38 days per year) • The longer you stay, the more vacation you’ll accrue! • Longevity Pay (Monthly payments after two years of service) • Build your future with our awesome retirement/pension plan! We take care of our employees! As a world-renowned institution, our employees’ wellbeing is important to us. We offer work/life services such as...
• Free financial and legal counseling • Free mental health counseling services • Gym membership discounts and access to wellness programs • Other employee discounts, including entertainment, car rentals, cell phones, etc. • Resources for child and elder care • Plus many more! Position Key Accountabilities:
• Coordinates and evaluates all healthcare claims and lawsuits filed against the institution and its healthcare provider employees. Interfaces with the University of Texas System Office of General Counsel, the Texas Attorney General, various private plaintiffs, and defense attorneys in the defense of various healthcare claims and lawsuits. • Represents the institution in mediations and other negotiations in attempts to settle various healthcare claims and lawsuits. Attends depositions and assists attorneys in working up defense of healthcare claims and lawsuits. Assures prompt completion of interrogatories, requests for production, and other litigation assistance to The University of Texas System Office of General Counsel and the Texas Attorney General. • Serves as the subject matter expert on risk management policies and procedures. • Reviews institutional policies and procedures to ensure they include appropriate risk assessment and loss prevention provisions. Assists in the resolution of patient treatment issues, such as refusal of treatment, consent issues, and general concerns regarding the care received. • Counsels clinical personnel on family/care provider conflicts and responds to adverse patient outcomes. Has the authority to delay patient billing, as appropriate, until investigation of the event or problems, claims, and/or resolution of the patient complaint and/or claim/lawsuit. • Oversees the internal operations of the healthcare risk management function on a day-to-day basis. Coordinates an efficient, well-balanced workflow for the healthcare risk management and support staff. Oversees contract nurse investigators and reviewers. Supervises healthcare risk management specialists and other office staff in connection with specific tasks. • Coordinates and evaluates all licensing board matters received by healthcare provider employees and students. Assists in the institution's professional credentialing activities. Interfaces with The University of Texas System and private insurers for professional liability insurance coverage of the institution's healthcare providers. • Conducts healthcare risk management education activities and inventories participation of the institution's healthcare providers in risk management education. Conducts general healthcare risk management education for the institution's non-healthcare employees. • Participates in and/or staffs various institutional committees that address professional liability, risk management, sentinel events, medical errors, and other safety matters. Works closely with risk management and patient relations personnel employed with various outside hospitals. Organizes and maintains several databases and files relating to the scope of work. Performs other duties as assigned. • Manages Human Resources activities for direct reports in regards to: recruiting and selection; hiring and termination, training, development, mentoring, counseling, performance evaluations, and salary planning. • Responsible for the design, execution, and effectiveness of a system of internal controls which provides reasonable assurance that operations are effective and efficient, assets are safeguarded, and financial information is reliable and compliant with applicable laws, regulations, policies, and procedures. • Performs other duties as assigned.
Certification/Skills:
• Extensive knowledge of healthcare risk management principles, professional liability, patient safety, regulatory requirements, and risk prevention and reduction practices. • Strong knowledge of healthcare claims and litigation management, including experience working with legal counsel, insurers, licensing boards, and other regulatory entities. • Strong analytical, investigative, and critical-thinking skills with the ability to evaluate complex clinical and operational risk issues, identify potential exposure, and recommend appropriate risk mitigation strategies. • Excellent interpersonal, consultation, negotiation, and communication skills with the ability to advise clinical personnel, physicians, senior leadership, legal counsel, and other internal and external stakeholders on sensitive and complex matters. • Strong leadership and management skills with the ability to oversee healthcare risk management operations, establish priorities, manage staff and external resources, and ensure effective and efficient execution of the risk management program. • Work may involve handling biohazardous, chemical, and radiological materials, as well as operating associated equipment. Required safety training and appropriate engineering and administrative controls, including the use of personal protective equipment, must be followed. • Certified Professional in Healthcare Risk Management (CPHRM) by the American Hospital Association (AHA) required • Registered Nurse (RN) State Licensure or Nurse Licensure Compact (NLC) by the Texas Board of Nursing (BON) required Minimum Education: Bachelor's Degree in Nursing required, Master's Degree in a healthcare-related field, and/or MBA preferred Minimum Experience: 7 years of experience in a hospital/hospital system, clinic health care, patient safety, or clinical quality management required Experience in healthcare risk management, contracts management, or a healthcare-related regulatory or legal environment required Experience practicing as a Registered Nurse (RN) in a clinical setting 5 years of management experience leading people and projects preferred Physical Requirements: Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects. Security Sensitive: This position is a security-sensitive position pursuant to Texas Education Code §51.215 and Texas Government Code §411.094. To the extent that a position requires the holder to research, work on, or have access to critical infrastructure as defined in Texas Business and Commerce Code §117.001(2), the ability to maintain the security or integrity of the infrastructure is a minimum qualification to be hired for and to continue to be employed in that position. Personnel in such positions, and similarly situated state contractors, will be routinely reviewed to determine whether things such as criminal history or continuous connections to the government or political apparatus of a foreign adversary might prevent the applicant, employee, or contractor from being able to maintain the security or integrity of the infrastructure. A foreign adversary is a nation listed in 15 C.F.R. §791.4. Residency Requirement: Employees must permanently reside and work in the State of Texas.