Job Description for Hospital Risk management 2017

ICC Third Party Administrators 
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ICC   Global Administrative Services Dan Martinez CEO

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Director of Hospital Risk Management  2017 

 ICC's Job Description of Hospital Risk Management 2017 

ICC's Job Description of Hospital Risk Management 2017 

After many years of trial and error, ICC has officially changed our job description of a hospital risk manager for the following reasons:  

A Director of Hospital Risk Management is the nucleus of the entire safety operation of a hospital. When a loss occurs, it is the risk manager’s fault for failing to preserve a safety environment for the hospital.  It is not paramount for RN(s) to be a Director of Hospital Risk Management, stemming from the acceptance that doctors can do no wrong.  Therefore, RN(s) are more likely than not to unconsciously overlook fallacies, compromising a hospital’s reputation. Doctors, unconsciously, are more likely than not to undermine an RN's recommendations.  For this reason, ICC as a Third Party Administrator, is not linked to this philosophy as objectively the best Risk Management Technique that can initiate a reduction in loss exposure, restore public confidence, and patient safety to hospitals.     

  Visit  ICC's school to become a Hospital Risk Manager and Certification  ICCHRM 

                                ICC’s Job Description for Director of Hospital Risk Management 2017  

 

   1.          MBA in business administration, insurance or business law.  

   2.         10 year claims management experience working in the insurance industry in the subsequent  areas :                   

  •           Medical |Mal-practice, workers’ compensation, product liability, E & O, director’s liability, Insurance                    interpretation, Federal and State regulations| and statues, OSHA Compliance and Joint 
  •      Commission on Accreditation of Healthcare Organizations (JCAHO).
  •  
  •  Reporting Relationship:    

   3.      ICC‘s  Director of Hospital Risk Management Reports directly to the chief executive officer (CEO)

   4.       ICC’s Director of Hospital Risk Management Provide recommendation/reports to Hospital Board of                              Directors quarterly.

            Responsibilities

           ICC Consults with legal counsel on matters involving hospital professional liability to include litigation                          matters as:

  • Hospital program components, including professional liability, general liability, workers’ compensation, motor – vehicle liability, property, directors | officers, fiduciary liability, ( ERISA, OSHA, HIPPA, JCAHO, Medicare and Medicaid regulations, health-care regulations, state reporting requirements, patient safety, pro-active root cause analysis (PARCA), and RCA.
  •  
  • Oversee all insurance contracts with insurance providers to include, but not limited to, contract fee for service.
  • ·       Allocate degree of risk through the purchase of commercial liability insurance, self- insurance, self-                     insurance retention, (SIR), Stop loss policies and set reserves.

              Loss control and claims management :

  •       Monitor incidents and claims reporting system Pursuant to (JCAHO) and ERISA‘s requirements.
  •  
  • ·        Investigate a thorough legal defense when obtaining statements, depositions, obtaining production of                documents and Interrogatories.
  •  
  • ·   Note *** Root  Cause Analysis  is not protected in the discovery process.  The only way that RCA can be protected is if an attorneys investigates an RCA as a work product. Or, under an attorney client privilege.  All others are discoverable --- unless there is an exception to the rule which is generally subjective. .

         Oversee  Hospital Quality Management and Safety Programs:

  •   Oversee/manage a system to share hospital – wide quality – management and patient safety data with              appropriate departments and administrative personnel.
  •   Oversee/manage a system for tracking and trending of generic screening of potentially high – risk behavior          leading to patient, staff and visitor injuries.

         Resource for Education on Risk Management :

  •   Oversee and manages a formal program for ongoing education for all hospital staff including surgeons and         ER who are independently contracted.

            Administrative Duties and Responsibilities :

  •   Supervise all professional and support staff in risk management departments
  •   Monitor department budget and assets of self- insurance funds

       Chain of Command  in Hospital Administration

          ·       Hospital  Board of Directors                                      

  • ·      Hospital  CEO/ Vice President  Must surrender their Medical license to avoid Ethical Violations  
  •      
  •       Chief Financial Officer  ment
  •    
  •  
  •       Director of  Risk Manager is over the following departments
  •        
  •       Chief compliance office
  • ·         Patient safety Manager Workers' Compensation Manager
  • ·         Claims Manager 
  •       Medical Billing | Record 
  • ·         Quality Manager   PARCA RCA
  • ·          

 Note ******* The Director of Risk Management has the authority to fire all medical staff except the CEO, VP      CFO. This is a general outline of ICC’s Hospital risk management program that maintains the stability in          hospital safety and reduce the risk of loss exposure.  Not all hospitals agree with ICC’s approach as there      are always alternative ideas that are either a power play or actually work.  ICC is just one version of                  reducing loss run exposure, and maintain quality physicians and having less public negatively.

     By  Dan Martinez | CEO  

                                                                         ICC Underwriters ®