Full-Time 3 Commercial Place Professional Days 48.7800 Through 73.1600 * GENERAL SUMMARY * The Program Manager, Enterprise Risk Management manages all non-clinical risk management activities of the organization and supports clinical/mental health risk management activities of the organization. A high level of independence in performance of the role and/or solution of problems is expected, however, demonstrated cooperation and collaboration is essential for successful functioning. Reports to department leadership. * ESSENTIAL DUTIES AND RESPONSIBILITIES * Directs all investigations regarding non-clinical events and supports clinical/mental health risk management investigations as needed. * Works collaboratively with clinical and non-clinical areas to evaluate risk and loss potential. * Analyzes data, conducts risk assessments of all locations with the objective of minimizing and preventing claims of general and professional liability against the Health System and its subsidiaries. * Works with staff to proactively implement risk reduction strategies. * Conducts claims investigations, develops defense strategies, evaluates monetary value and resolves claims. * Participates as a team member in negotiating settlements for management approval. In litigated claims, assists in-house and external legal counsel in obtaining and assessing facility records and personnel. * Maintains claim files securely and enters pertinent information into the applicable claims system as needed. * Identifies, reports and tracks Potential Compensable Events (PCE's) for the Health System. * Reports claims to insurance carriers (e.g., General Liability, Professional Liability, Auto, Inland Marine, Fine Arts, Employment Practices, Property) and manages claims until resolution. * Complies with codes/laws/rules/regulations concerning patient care, including those mandated by state and federal agencies, incident reporting, and investigative activities with federal, state and local enforcement authorities. * Assists in the adverse drug event investigations. * Reviews occurrence data for early risk identification and consults with department leadership for follow up. * Coordinates with the Quality Department regarding causal analysis of events as needed. * Provides training and education on clinical risk. * Serves as an active member of various committees. * Develops and administers policies and procedures in accordance with regulatory and legal compliance. * Creates processes to measure and analyze the effectiveness of services and processes. * Performs all other duties as assigned. * LICENSES AND/OR CERTIFICATIONS * Required Licenses and/or Certifications * Valid Virginia driver's license and be able to meet the insurance requirements of the hospital, if required by position. * Preferred Licenses and/or Certifications *

Current Virginia state license as a Registered Nurse or Registered Nurse holding a valid Compact State license preferred. *

Certified Professional Healthcare Risk Management (CPHRM) certification preferred. * MINIMUM EDUCATION AND EXPERIENCE REQUIREMENTS * Required Education and Experience *

Bachelor's degree in related field required. * Preferred Education and Experience *

Captive insurance company management and Secondary Payer Act claims resolution experience preferred. * Required Knowledge, Skills, and Abilities *

Ability to prepare reports, policies, and budgets at a level normally acquired through completion of a bachelor's degree in relevant field. *

Professional knowledge of areas of responsibility to include theory, practice, and administration in order to direct planning and implementation. *

Understanding and working knowledge of HIPAA, OSHA/VOSH, DNV-GL, ISO-9001, EMTALA, and federal Conditions of Participation regulations required. *

Working knowledge of risk management and performance / continuous improvement models. *

Proficient skills in word processing, spreadsheet, and presentation software such as Microsoft Office (Word, Excel, PowerPoint, and Outlook) and other applicable software. *

Requires analytical skills necessary to organize and oversee work of subordinates, if any. *

Ability to travel to offsite locations required. *

Increased Security Clearance Required for Job Roles at Children's Pavilion or in any licensed DBHDS program we offer: FBI fingerprinting, criminal background check, and Child Protective Services Registry Search * WORKING CONDITIONS * Normal office environment with little exposure to excessive noise, dust, temperature and the like. * PHYSICAL REQUIREMENTS * Click here to view physical requirements.