Risk Management Director
Kaiser Permanente
Description: Job Summary:
Directs risk management programs by contributing to proactive planning and strategy for audits and analyses to evaluate risk management programs. Provides thought leadership on reporting and specialized data analysis for professional liability cases, risk management trends and issues, significant events, and near misses. Collaborates across organizations to manage processes for collecting and analyzing data from multiple reporting systems, sources, and emerging industry trends to identify opportunities to improve risk and threat management. Influences strategy, holds teams accountable, and directs the development and refinement of protocols for incident response. Provides proactive, strategic advice for the Board of Trustees and subsidiary governing boards, and to senior leadership and related entities to minimize risk and preserve corporate assets. Holds teams accountable for disseminating risk management-related information to providers, staff, and external partners across organizations. Contributes to the development of policies and procedures to maintain compliance with State and Federal laws, regulations, patient rights, and professional ethics.
Essential Responsibilities:
Prepares individuals for growth opportunities and advancement; builds internal collaborative networks for self and others. Solicits and acts on performance feedback; drives collaboration to set goals and provide open feedback and coaching to foster performance improvement. Demonstrates continuous learning; oversees the recruitment, selection, and development of talent; ensures performance management guidelines and expectations to achieve business needs. Stays up to date with organizational best practices, processes, benchmarks, and industry trends; shares best practices within and across teams. Motivates and empowers teams; maintains a highly skilled and engaged workforce by aligning resource plans with business objectives. Provides guidance when difficult decisions need to be made; creates opportunities for expanded scope of decision making and impact.
Oversees the operation of multiple units within a department by identifying member and operational needs; ensures the management of work assignment completion; translates business strategy into actionable business requirements; ensures products and/or services meet member requirements and expectations while aligning with organizational strategies. Gains cross-functional support for business plans and priorities; assumes responsibility for decision making; sets standards, measures progress, and fosters resolution of escalated issues. Communicates goals and objectives; analyzes resources, costs, and forecasts and incorporates them into business plans; prioritizes and distributes resources. Removes obstacles that impact performance; guides performance and develops contingency plans accordingly; ensures teams accomplish business objectives.
Ensures compliance by: contributing to the development of policies and procedures to maintain compliance with State and Federal laws, regulations, patient rights, and professional ethics; driving a culture of compliance, holding teams accountable for compliance with, and contributing to Kaiser Permanentes policies and procedures and applicable federal and state laws and regulations as they relate to Risk Management; contributing to strategy and best practices for assisting other departments in complying with highly complex accreditation and regulatory risk management requirements (e.g., policies and procedures, legal claims manager), aligning regional and national initiatives; contributing to guidelines and holding teams accountable for preparation for and participation in regulatory audits and related projects (e.g., annual audits, accrediting bodies); and communicating to senior leadership and influencing adoption of regulatory compliance matters as they apply to risk management.
Directs Risk Management consulting by: providing proactive, strategic advice for the Board of Trustees and subsidiary governing boards, and to senior leadership and related entities to minimize risk and preserve corporate assets; influencing the development and implementation of plans for communications, outreach, and education as part of a comprehensive response plan to mitigate risk; providing expertise by serving as a member of risk management-related forums (e.g., Quality Council, Patient Safety Committee, Professional Liability Committee); and shaping goals and processes for comprehensive risk management consultation to clinical and administrative staff across organizations on all clinical and non-clinical risk management issues.
Directs documentation, analysis, and reporting by: influencing the design and management of sophisticated risk management data sources to align with strategic objectives; contributing to a standard documentation process across organizations; engaging with senior leadership to influence strategies for the design, development, and production of reports on scheduled cadence to senior leadership, Board committees, and regulators; providing thought leadership on reporting and specialized data analysis for professional liability cases, risk management trends and issues, significant events, and near misses; driving organization-wide processes for data and risk analyses with consideration for organizational goals; shaping standards for the utilization of reports and analyses in developing recommendations and action plans; shaping expectations for researching risk exposure data and prepare underwriting submissions in the areas of insured risks, including general and professional liability and contributing to guidelines for consulting on certificates of insurance, indemnification letters, and credentialing responses as they relate to insured risks, including general and professional liability programs; and holding teams accountable for determination, investigation, analysis, and resolution of potentially compensable events, compensable events, and regulatory investigations.
Directs Risk Management education and training by: setting standards for comprehensive, ongoing risk management-related training and education for providers, staff, and external audiences; driving a culture of continuous learning and holding teams accountable for integration of learning into work strategies; holding teams accountable for training evaluation and improvements aligned with organizational objectives and monitoring their sustainability; influencing strategic goals for risk management training and education across sphere of influence based on industry trends and organizational needs; and holding teams accountable for disseminating risk management-related information to providers, staff, and external partners across organizations.
Guides Risk Management incidents by: influencing strategy, holding teams accountable, and directing the development and refinement of protocols for incident response; contributing to organization-wide incident investigation practices; directing the development of escalation protocols and holding managers accountable for incident resolution and/or mitigation; influencing guidelines for root cause analysis, process improvements, and corrective actions, providing guidance and expertise as needed; and ensuring facilitation of organizational awareness and handling of highly impactful clinical risk issues.
Directs Risk Management programs by: influencing strategic direction and goals for comprehensive integrated, enterprise-wide risk reduction and prevention programs; contributing to proactive planning and strategy for audits and analyses to evaluate Risk Management programs; and shaping Health and Safety programs based on analyses, observations, industry best practices, and strategic organizational goals.
Directs threat monitoring and risk prevention by: collaborating across organizations to manage processes for collecting and analyzing data from multiple reporting systems, sources, and emerging industry trends to identify opportunities to improve risk and threat management; shaping strategy for analysis, validation, and interpretation of new and ongoing threats and risks, ensuring alignment with organizational goals and facilitating partnerships with other functions (e.g., Quality Management, Patient Safety, Operations, Customer Service Call Center, Member Services, EH&S, and Security); overseeing and shaping strategy for a comprehensive risk financing program through combined self insurance and insurance procurement to preserve corporate assets by reducing the impact of financial loss in the areas of property casualty, workers compensation, general liability, and professional liability; ensuring effectiveness and consistency of risk and threat response processes across organizations; strategically leading the review and analysis of high-level product safety risks; shaping general guidelines for preparation of initial processing and receipt of clinical / safety events; and driving risk management knowledge sharing across the organization to support the reduction of preventable errors in health care delivery. Minimum Qualifications:
Minimum two (2) years of experience managing operational or project budgets.
Minimum five (5) years of experience in a leadership role with direct reports.
Minimum six (6) years of experience using medical terminology.
Minimum four (4) years of program / project management experience.
Bachelors degree in Analysis, Research, Statistics, Health Care (e.g., Registered Nurse), Healthcare Administration, Health Care Management, Economics, Business, Homeland Security, or related field AND minimum eight (8) years of experience in risk management, quality program, claims management, patient safety, or directly related field OR Minimum eleven (11) years of experience in risk management, quality program, claims management, patient safety, or a directly related field.
Additional Requirements:
Knowledge, Skills, and Abilities (KSAs): Systems Thinking; Change Management; Negotiation; Business Process Improvement; Loss Prevention; Risk Management; Compliance Management; Confidentiality; Applied Data Analysis; Business Relationship Management; Conflict Resolution; Relationship Building; Risk Assessment; Adaptability; Organizational Skills; Risk Identification; Patient Safety; Trusted Advisor; Legal Risk Management; Insurance Regulations, Policies, and Procedures; Insurance Contracts; Clinical Risk Assessment; Health Information Systems; Health Care Compliance; Internal Controls; Data Integration; Relational Database Management; Member Service; Microsoft Office; Personal Courage Preferred Qualifications:Five (5) years of experience with risk management-related applications (e.g., event reporting software, case management software, patient safety database).Four (4) years of Early Resolution or Mediation training/experience.
Directs risk management programs by contributing to proactive planning and strategy for audits and analyses to evaluate risk management programs. Provides thought leadership on reporting and specialized data analysis for professional liability cases, risk management trends and issues, significant events, and near misses. Collaborates across organizations to manage processes for collecting and analyzing data from multiple reporting systems, sources, and emerging industry trends to identify opportunities to improve risk and threat management. Influences strategy, holds teams accountable, and directs the development and refinement of protocols for incident response. Provides proactive, strategic advice for the Board of Trustees and subsidiary governing boards, and to senior leadership and related entities to minimize risk and preserve corporate assets. Holds teams accountable for disseminating risk management-related information to providers, staff, and external partners across organizations. Contributes to the development of policies and procedures to maintain compliance with State and Federal laws, regulations, patient rights, and professional ethics.
Essential Responsibilities:
Prepares individuals for growth opportunities and advancement; builds internal collaborative networks for self and others. Solicits and acts on performance feedback; drives collaboration to set goals and provide open feedback and coaching to foster performance improvement. Demonstrates continuous learning; oversees the recruitment, selection, and development of talent; ensures performance management guidelines and expectations to achieve business needs. Stays up to date with organizational best practices, processes, benchmarks, and industry trends; shares best practices within and across teams. Motivates and empowers teams; maintains a highly skilled and engaged workforce by aligning resource plans with business objectives. Provides guidance when difficult decisions need to be made; creates opportunities for expanded scope of decision making and impact.
Oversees the operation of multiple units within a department by identifying member and operational needs; ensures the management of work assignment completion; translates business strategy into actionable business requirements; ensures products and/or services meet member requirements and expectations while aligning with organizational strategies. Gains cross-functional support for business plans and priorities; assumes responsibility for decision making; sets standards, measures progress, and fosters resolution of escalated issues. Communicates goals and objectives; analyzes resources, costs, and forecasts and incorporates them into business plans; prioritizes and distributes resources. Removes obstacles that impact performance; guides performance and develops contingency plans accordingly; ensures teams accomplish business objectives.
Ensures compliance by: contributing to the development of policies and procedures to maintain compliance with State and Federal laws, regulations, patient rights, and professional ethics; driving a culture of compliance, holding teams accountable for compliance with, and contributing to Kaiser Permanentes policies and procedures and applicable federal and state laws and regulations as they relate to Risk Management; contributing to strategy and best practices for assisting other departments in complying with highly complex accreditation and regulatory risk management requirements (e.g., policies and procedures, legal claims manager), aligning regional and national initiatives; contributing to guidelines and holding teams accountable for preparation for and participation in regulatory audits and related projects (e.g., annual audits, accrediting bodies); and communicating to senior leadership and influencing adoption of regulatory compliance matters as they apply to risk management.
Directs Risk Management consulting by: providing proactive, strategic advice for the Board of Trustees and subsidiary governing boards, and to senior leadership and related entities to minimize risk and preserve corporate assets; influencing the development and implementation of plans for communications, outreach, and education as part of a comprehensive response plan to mitigate risk; providing expertise by serving as a member of risk management-related forums (e.g., Quality Council, Patient Safety Committee, Professional Liability Committee); and shaping goals and processes for comprehensive risk management consultation to clinical and administrative staff across organizations on all clinical and non-clinical risk management issues.
Directs documentation, analysis, and reporting by: influencing the design and management of sophisticated risk management data sources to align with strategic objectives; contributing to a standard documentation process across organizations; engaging with senior leadership to influence strategies for the design, development, and production of reports on scheduled cadence to senior leadership, Board committees, and regulators; providing thought leadership on reporting and specialized data analysis for professional liability cases, risk management trends and issues, significant events, and near misses; driving organization-wide processes for data and risk analyses with consideration for organizational goals; shaping standards for the utilization of reports and analyses in developing recommendations and action plans; shaping expectations for researching risk exposure data and prepare underwriting submissions in the areas of insured risks, including general and professional liability and contributing to guidelines for consulting on certificates of insurance, indemnification letters, and credentialing responses as they relate to insured risks, including general and professional liability programs; and holding teams accountable for determination, investigation, analysis, and resolution of potentially compensable events, compensable events, and regulatory investigations.
Directs Risk Management education and training by: setting standards for comprehensive, ongoing risk management-related training and education for providers, staff, and external audiences; driving a culture of continuous learning and holding teams accountable for integration of learning into work strategies; holding teams accountable for training evaluation and improvements aligned with organizational objectives and monitoring their sustainability; influencing strategic goals for risk management training and education across sphere of influence based on industry trends and organizational needs; and holding teams accountable for disseminating risk management-related information to providers, staff, and external partners across organizations.
Guides Risk Management incidents by: influencing strategy, holding teams accountable, and directing the development and refinement of protocols for incident response; contributing to organization-wide incident investigation practices; directing the development of escalation protocols and holding managers accountable for incident resolution and/or mitigation; influencing guidelines for root cause analysis, process improvements, and corrective actions, providing guidance and expertise as needed; and ensuring facilitation of organizational awareness and handling of highly impactful clinical risk issues.
Directs Risk Management programs by: influencing strategic direction and goals for comprehensive integrated, enterprise-wide risk reduction and prevention programs; contributing to proactive planning and strategy for audits and analyses to evaluate Risk Management programs; and shaping Health and Safety programs based on analyses, observations, industry best practices, and strategic organizational goals.
Directs threat monitoring and risk prevention by: collaborating across organizations to manage processes for collecting and analyzing data from multiple reporting systems, sources, and emerging industry trends to identify opportunities to improve risk and threat management; shaping strategy for analysis, validation, and interpretation of new and ongoing threats and risks, ensuring alignment with organizational goals and facilitating partnerships with other functions (e.g., Quality Management, Patient Safety, Operations, Customer Service Call Center, Member Services, EH&S, and Security); overseeing and shaping strategy for a comprehensive risk financing program through combined self insurance and insurance procurement to preserve corporate assets by reducing the impact of financial loss in the areas of property casualty, workers compensation, general liability, and professional liability; ensuring effectiveness and consistency of risk and threat response processes across organizations; strategically leading the review and analysis of high-level product safety risks; shaping general guidelines for preparation of initial processing and receipt of clinical / safety events; and driving risk management knowledge sharing across the organization to support the reduction of preventable errors in health care delivery. Minimum Qualifications:
Minimum two (2) years of experience managing operational or project budgets.
Minimum five (5) years of experience in a leadership role with direct reports.
Minimum six (6) years of experience using medical terminology.
Minimum four (4) years of program / project management experience.
Bachelors degree in Analysis, Research, Statistics, Health Care (e.g., Registered Nurse), Healthcare Administration, Health Care Management, Economics, Business, Homeland Security, or related field AND minimum eight (8) years of experience in risk management, quality program, claims management, patient safety, or directly related field OR Minimum eleven (11) years of experience in risk management, quality program, claims management, patient safety, or a directly related field.
Additional Requirements:
Knowledge, Skills, and Abilities (KSAs): Systems Thinking; Change Management; Negotiation; Business Process Improvement; Loss Prevention; Risk Management; Compliance Management; Confidentiality; Applied Data Analysis; Business Relationship Management; Conflict Resolution; Relationship Building; Risk Assessment; Adaptability; Organizational Skills; Risk Identification; Patient Safety; Trusted Advisor; Legal Risk Management; Insurance Regulations, Policies, and Procedures; Insurance Contracts; Clinical Risk Assessment; Health Information Systems; Health Care Compliance; Internal Controls; Data Integration; Relational Database Management; Member Service; Microsoft Office; Personal Courage Preferred Qualifications:Five (5) years of experience with risk management-related applications (e.g., event reporting software, case management software, patient safety database).Four (4) years of Early Resolution or Mediation training/experience.
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