The Director of Enterprise Risk Management (“Director”) reports to the Sr. Vice President and General Counsel and plays a critical role in the governance of risks and opportunities for Health First. The main purpose of this position is to protect and enhance the value of Health First, which includes protecting the organization from losses that impact patient safety, finance, strategy/reputation, technology, regulatory/legal and fortuitous loss associated with ongoing operations, as well as risk inherent in the implementation of strategic business opportunities. The Director is responsible for developing and implementing the strategic direction of the loss control/risk management program as well as the insurance and liability claims programs, blending key elements to yield global risk management strategies in alignment with Health First’s mission, vision and goals. The Director is responsible for the day to day administration and general operation of these programs. Specific aspects include ensuring that all programs comply with Federal and State regulations and guidelines, General Counsel guidelines, contractual aspects associated with insurance program management, hospital, medical group and other Integrated Delivery Network (IDN) operating systems, and other internal and external oversight. The essential functions listed are typical examples of work performed by positions in this job classification, and are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Specific duties and responsibilities may vary depending on department or program needs without changing the general nature and scope of the job or level of responsibility.
- Acts as Health First’s linchpin for managing risk across the enterprise, including risk mitigation and risk financing, as well as having a matrix linkage to Finance, Compliance, and Quality.
- Develops and manages the overall risk-management program as well as risk management functions while directing the activities of subsidiary risk management functions.
- Provides advice and counsel to the senior management, and physicians regarding risk management, insurance, and licensing issues.
- Serves as an independent and objective point for all risk related issues that affect Health First’s short and long term strategic plans and their operating and financial performance.
- Ensures the risk management framework is pervasive across all of the internal control structures across Health First. Identifies external threats and competitive opportunities, along with strategic initiatives to address them.
- Recommends to senior management new risk policies and/or amendments to existing policies. Advises management of emerging risk and compliance issues and consults and guides the organization in the establishment of controls to mitigate risks.
- Provides leadership and acts as the focal point for communicating and coordinating risk mitigation activities with potential and actual liability exposure related to Finance, Claims, Quality/Patient Safety, and Compliance.
- Closely collaborates with Compliance and Quality Management/Patient Safety to ensure Health First’s adherence to new and changing federal and state regulations and statutes such as HIPAA, Medicare, Stark and Joint Commission.
- Maintains awareness of legislative activities that may affect risk management programs and communicates activities to appropriate departments and physicians.
- Defines and continually adjusts the organization’s acceptable risk levels, targets, and objectives.
- Manages risk across the enterprise through strategic oversight over Risk Management and Education, Risk Financing and Insurance, Loss Prevention, Patient and Employee Safety, and Brokering functions
- Responsible for the development, planning, coordination and administration of a systematic program designed to encompass and address the organization’s risk in strategic, operational, external, financial, IT and security operations to reduce liability and related costs.
Performs other duties as assigned.