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Director of Risk Management and Compliance

Responsible for overseeing WCF’s risk management, compliance and corporate insurance programs, along with other programs as contracted by PBS, including but not limited to; patient safety reports, medical malpractice claims, HIPAA and Corporate Compliance, OSHA and other regulatory compliance, and patient grievances. Conducts internal reviews to identify potential risk and develop solutions to mitigate and prevent risk in the organization. Responsibilities 1. Facilitates, updates, and manages organization’s risk management program to ensure compliance with statutory and regulatory requirements. 2. Reviews, analyzes, evaluates and categorizes patient safety reports, assists in identifying trends, and creates program to encourage better reporting. 3. Responsible for risk prevention and mitigation in provider offices including safety and regulatory compliance. 4. In collaboration with the CMO, reviews and investigates potential litigation and pre-litigation claims and supports providers through claim cycle. 5. Manages captive and ensures placement of reinsurance for captive. 6. Updates programs and internal policies to keep current with new rules and regulations. 7. Collaborates with training department to provide educational programs for employees on patient safety and compliance issues. 8. Collaborates with Performance Improvement team to avoid and/or reduce risk associated with patient care and employee safety. 9. Serves as Chairman of the Risk Management/Compliance Committee. 10. Responsible for investigating, documenting, and reporting events as needed to appropriate authorities to maintain compliance with WCF policies and state and Federal regulations. 11. Develops and implement a system for informing a patient or patient’s representative following an adverse incident when appropriate 12. Assists in researching and responding to questions regarding high risk issues, corporate compliance, HIPAA, OSHA, OIG, AHCA, CMS and biomedical compliance. 13. Provides updates to leadership on latest risk management and compliance issues that will impact organization. 14. Leads the Risk Management/Compliance Committee meetings to regularly review and update the education, training, and standards of conduct to reflect the current federal, state and local laws and regulations. 15. Coordinates the logging of advice received from governmental authorities and other payers. 16. Coordinates a system for maintaining documentation of (a) any reports received regarding suspected compliance violations, (b) any investigation conducted, and (c) any conclusions or findings and the corrective or responsive actions taken, if any. 17. Coordinates and implement process and mechanics for internally auditing and monitoring compliance on an ongoing basis. 18. Coordinates personnel issues to ensure that appropriate background checking and reporting is in operation, to ensure that introductory compliance training is provided to all new employees at the time of their employment, and to ensure that appropriate steps are taken to enforce the standards for conduct and the related policies and procedures consistently throughout Women’s Care Florida. 19. Oversight and management of corporate insurance program to include property/casualty, professional liability, worker’s compensation, etc. 20. Coordinates due diligence for all new development and acquisitions, including training, implementation and oversight of risk management, compliance and insurance processes. 21. Attends and participates in various quality committee, provider committee and Board meetings, as requested. 22. Works closely with the Training Team to present departmental materials and concepts to new employees during the onboarding process. Other duties as assigned Qualifications 1. Bachelor’s degree in related field or experience in lieu of education 2. Current Florida RN license 3. Minimum three years risk management/compliance experience in a health care environment PREFERRED QUALIFICATIONS: 1. BSN/MSN 2. CPHRM certification Please forward resumes to [email protected]

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