Heritage Oaks Hospital is part of the UHS Family of Providers which has been highly regarded as an integral part of the greater Sacramento and Northern California mental health system since 1988. Conveniently located in northern Sacramento, Heritage Oaks is a fully accredited, 125-bed acute psychiatric hospital offering a full range of individually tailored treatment services to adolescents, adults and senior adults, including treatment for substance abuse and chemical dependency issues with drugs and alcohol. Heritage Oaks is a Medicare provider in addition to contracts with most commercial health insurance plans. We are committed to providing service excellence to all and ensuring our patients receive the optimal level of care that will be most beneficial to their health and recovery.

We are currently seeking a forward thinking and compassionate Director of Risk Management to be part of our Senior Leadership Team. The Director of Risk Management, an essential member of Senior Management, has broad responsibility to ensure the hospital’s compliance at all times with all Joint Commission, CMS, and state regulatory agencies standards and requirements. The Director of Risk Management is responsible for staff training and education on the hospital’s risk and performance initiatives and measures including outcomes measurement and reporting. The Director of Risk Management is responsible for coordinating the loss control efforts and advising management and administration on all potential sources of loss and for making recommendations to minimize or eliminate exposure. The structure and functions of the Risk Management Program are designed so as to comply with guidelines and standards of TJC, other regulatory agencies, and the UHS T.E.R.M.© Program. The Director of Risk Management has broad responsibility to ensure the hospital’s compliance at all times with the UHS Code of Conduct and Compliance Program policies.

QUALIFICATIONS

Education: Bachelor’s Degree from accredited college or university in Nursing, or related health field is preferred. Master’s Degree preferred. Combination of education and experience considered.

Preferred Licensure: Currently licensed to practice by the California State Board of Nursing.

Experience: Four (4) years of experience in quality and risk management/improving organizational performance within an acute medical or psychiatric treatment setting.

Additional Requirements: A strong knowledge of JOINT COMMISSION, state of CA standards, CMS standards, and any other applicable federal and state laws and regulations governing mental health care facilities.

STANDARDS OF PERFORMANCE:

Risk Identification and Evaluation:

· Ensures appropriate and timely reporting of occurrences by maintaining a Healthcare Peer Review Reporting system (Occurrence notification system); enters incidents into the MIDAS Database.

· Collects and screens all reports.

· Analyzes and trends data.

· Identifies actual and potential risk situations and facilitates the determination of causative factors.

· Refers occurrences for follow‑up to appropriate department or medical committee; ensures that all Level III/IV are referred to the CRM and PCR entered into STARS within ten days.

· Receives immediate and concurrent reporting of adverse patient outcomes identified by the PI process.

· Performs risk surveys and inspects patient care areas in concert with hospital's safety (EOC) program committee objectives.

· Reviews reports on facility and equipment to assess loss potential.

· Receives and investigates reports of product problem to determine appropriate response and establish record keeping responsibilities. In the event of patient injury, establishes direction from Corporate Risk Management in the appropriate action for defense strategy.

· Receives information (verbally or formally on the HPR) from facility staff regarding patient events which may lead to a claim.

Risk Reduction:

· Networks with department directors to implement system changes aimed at optimally reducing or eliminating causative factors.

· Networks with medical staff to ensure active involvement and participation in:

A. Risk identification

B. Risk analysis

C. Risk reduction/loss prevention problem solving and program development designed to benefit the clinical aspects of patient care and safety

· Networks with medical staff to ensure the credentialing and privilege delineating process requires information regarding professional liability experience, results of peer review activities, changes in medical staff memberships, clinical privileges, licensure, etc.

· Interfaces with the Patient Advocate specific to patient complaints and assesses/recommends action, on those, which may be a source of potential litigation.

· In conjunction with hospital administration recommends actions when possible to resolve with patient and/or family any grievances against hospital perceived as potential liability claims.

· Refers policies that present particular risk in relation to previously identified problems to Corporate Risk Management

· Identifies particular practices having legal connotations to target planning of preventive and corrective measures.

· Assesses liability and probability of legal action.

· Is available to resolve treatment issues, including patient refusal of treatment, consent issues, HIPAA violations, AMA's, etc. under direct supervision of CEO, Corporate Legal Council, and Corporate Risk Management.

Compliance Program:

· Conducts/facilitates in-services to educate employees and physicians

· Participates in developing/reviewing policies and procedures.

· Operates to maintain and facilitate system ensuring hospital and employee adherence to UHS Compliance Program.

Employee/Physician Education:

· Facilitates, develops, and provides educational programs to insure all employees and medical staff are aware of the Risk Management concepts and its relation to their specific duties/job role in identifying and reducing liability exposures.

· Plans and presents risk management and compliance information to all new employees at hospital orientation.

· Plans and presents risk management and compliance information to all employees at annual update.

· Plans, presents, facilitates, and/or recommends in-services to all departments as necessary to address risk management/performance improvement and compliance problems.

· Plans, facilitates, presents information and suggests topics on risk management/performance improvement and compliance to Committees or hospital departments as necessary and based upon occurrences or claim patterns.

Reporting, Report Preparation and Submission:

· Provides aggregate analysis of risk and performance improvement data and trend analysis of incidents to:

A. Administration

B. Corporate Risk Management

C. Patient Safety Council

D. MEC

E. Performance Improvement

F. Environment of Care/Safety Committee (Safety related only)

G. Governing Board

H. Other Committees/Department as necessary and related to the department.

· Incidents with Claims Potential

A. Directly reports to Administration those incidents with claims potential.

B. Reports to Corporate RM any serious risk event involving actual or potential injury to patients and visitors; enters PCR’s (Level III/IV incidents) into STARS Database within 10 business days of the incident.

Medical Staff:

· Advises the Medical Director and Medical Executive Committee as needed.

· Serves as a resource to the Medical Staff Credentialing Process and the Credentials Committee as needed. Data from physician peer review and risk management activities are utilized in the decision-making process of granting privileges to and reappointment of medical and allied health staff.

· Develops, coordinates, presents/facilitates educational programs specific to medical staff concerns.

· Advises physicians on issues of interest or concern including Informed Consent process; Documentation and communication; Accountability; Response to patient/family complaints; and internal problem solving.

· Provides methods to communicate patient events to the Facility Risk Manager that may result in a claim.

Professional Growth and Development:

· Consults with Medical Director as necessary.

· Regularly reviews current literature pertinent to Risk Management and Regulatory Agency Requirements.

· Attends appropriate management and risk management seminars.

· Consults with Corporate Risk Management as necessary.

OVERSEE: PerformanceImprovement:

· Ensure the hospital meets Joint Commission, CMS, OSHA and state regulatory requirements.

· Develop and implement a Performance Improvement Plan, evaluate the results monthly and report the results to PI Committee, MEC and BOG

· Ensure that all deficiencies identified through the Performance Improvement analysis are addressed with appropriate problem solving actions

· Analyze statistical data of the hospital to determine and respond to trends.

· Consult with senior staff and directors in the development of department specific programs and quality measures which are within the standards of Joint Commission, CMS, TDSHS, OSHA regulations and all

other applicable federal, state or local law/regulations governing health-care entities.

OVERSEE: Claims Management:

· Assists CEO in facilitating the processing of summons and complaints served on the hospital and its employees.

· Reports receipt of summons and complaints immediately to Corporate Risk Management and Insurance Department

· Assists the Corporate Risk Management as needed to intervene, document and assist in the investigation of all claims.

· Coordinates investigation of claims within the facility:

A. Directs in‑house claims investigation.

B. Preserves all pertinent information (medical record, x-rays, equipment, lab/pathology specimens, relevant reports/ policies and procedures)

C. Facilitates early reporting.

D. Establishes early control of situation.

E. Assists in obtaining materials for attorneys.

F. Maintains all legal case files and ensures maximum protection and discoverability.

· Coordinates with and assists attorneys as they interface with the facility and employees.

· Advises Business Office of actions consistent with directions from Corporate Office for unpaid accounts involved in litigation.

Committee Participation:

· Performance Improvement

· Patient Safety Council

· Peer Review

· Environment of Care/Safety

· Medical Staff Committee

· Utilization Review

· Credentials

· Pharmacy & Therapeutics

· Infection Control

· Board of Governors

· Other Committees/Meetings as necessary

KNOWLEDGE, SKILLS, AND ABILITIES:

THIS LIST MAY NOT BE COMPLETE FOR ALL KNOWLEDGE, SKILLS AND ABILITIES REQUIRED FOR THIS POSITION.

· Knowledge of JOINT COMMISSION, CMS, TDSHS and all federal and state laws/regulations.

· Knowledge of quality management principles, practices and techniques.

· Knowledge of performance improvement planning techniques and goals.

· Knowledge of computers and various software.

· Strong analytical interpretation skills.

· Skill in organizing and prioritizing workloads to meet deadlines.

· Skill in telephone etiquette and paging procedures.

· Effective oral and written communication skills.

· Ability to communicate effectively with patients and co-workers.

· Ability to adhere to safety policies and procedures.

· Ability to use good judgment and to maintain confidentiality of information.

· Ability to work as a team player.

· Ability to demonstrate tact, resourcefulness, patience and dedication.

· Ability to accept direction and adhere to policies and procedures.

· Ability to recognize the importance of adapting to the various patient age groups (child, adolescent, adult and geriatric).

· Ability to work in a fast-paced environment.

· Ability to meet corporate deadlines.

· Ability to react calmly and effectively in emergency situations.

· Ability to supervise personnel.

Additional Requirements:

A strong knowledge of The Joint Commission, HCFA, OSHA regulations, and patient rights standards and all other applicable federal and state laws and regulations governing mental health care facilities.

One of the nation’s largest and most respected hospital companies, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Steadily growing from a startup to an esteemed Fortune 500 corporation, UHS today has annual revenue nearing $10 billion. UHS is recognized as one of the World’s Most Admired Companies by Fortune; ranked #276 on the Fortune 500, and listed #275 in Forbes inaugural ranking of America’s Top 500 Public Companies.

EEO Statement:

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Notice:

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.

Job Type: Full-time

Pay: $110,000.00 - $150,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Physical setting:

• Office

Schedule:

• Monday to Friday

Ability to commute/relocate:

• Sacramento, CA 95841: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Risk management: 3 years (Required)

Work Location: In person

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