Director, Quality & Risk Management

Salary Range: $139,003 - $208,505

The estimated base pay for this position is above. Additional individual compensation may be available for this role through years of experience, differentials, extra shift incentives, bonuses, etc. Base pay is only a portion of the total rewards package, and a comprehensive benefits program is available for qualifying positions. Please contact our Talent Acquisition team for more information.

Job Details:

Adventist Health is more than an award-winning health system. We provide whole-person care to our communities and champion the greater good - from the operating room to the boardroom, we are driven by our unique passion to live God's love through health, wholeness and hope. From Oregon to Oahu, we have a calling to always do more. Now is your chance to apply your passion to our mission.

Yuba County is California's gateway to the historic Mother Lode Country, with a diverse landscape that boasts grand rivers, thriving farmland, friendly communities and numerous recreational possibilities that extend into the Sierra foothills. Sutter County is home for the Sutter Buttes, known as the Smallest Mountain Range in the World. Considered "sister cities" our communities have that small town feel so many people are seeking. Our rivers, lakes, mountains, year-round festivals and fairs, entertainment, diverse recreation opportunities, hunting, camping, hiking, boating, fishing, community events, fine dining establishments, first-rate lodging, bikeways, and historic downtown shopping makes the Yuba and Sutter Counties a great place to live. With a lower cost of living, you can enjoy California life with Tahoe, Napa or the Bay Area only being a 2-hour drive.

We're looking for someone to join our team as a Director, Quality & Risk Management who: maintains responsibility for the direction and management of the department. Oversees the review of hospital and medical staff functions including assessing quality of patient care, evaluating use of resources, identity risk and safety factors for patients/visitors/staff and identity and assessing loss potential to the organization. Oversees Quality, Accreditation and Risk Management functions. Supervises and directs the activities of various levels of assigned personnel using both professional and supervisory discretion and independent judgment.

ESSENTIAL FUNCTIONS

· Directs the development of programs/processes related to Quality Management, Environmental & Employee Safety, Licensure & Accreditation and Performance Improvement. Maintains responsibility for developing policy/procedure, monitoring performance, developing/reviewing metrics, assessing/prioritizing risk, conducting mock inspections and reporting results to senior management. Establishes, maintains and implements policies/procedures for department operations. Maintains a database of regulatory and accrediting agencies, including their defined role with the organization. Ensures staff is compliant with hospital guidelines and regulatory agencies.

· Communicates/educates staff regarding knowledge/information necessary to ensure Quality, Safety, Licensure/Accreditation. Develops and implements an ongoing preparedness regulatory agencies' plan. Directs data entry process for incident reports. Coordinates mock surveys, as indicated. Initiates and monitors efforts to preserve evidence (surveillance video, equipment memory, etc.) and/or litigation holds. Reviews charts and presents a monthly peer review report to medical staff coordinator for credentialing of physicians. Facilitates development of proactive programs to minimize risk. Initiates and monitors efforts to preserve evidence (surveillance video, equipment memory, etc.) and/or litigation holds.

· Risk Management / Liability Claims Liaison: Acts as Site Administrator for RADAR Claims Module (Potentially Compensable Event) and maintains legal case files. Investigates and reports potentially compensable events (PCEs) and asserted claims (demands for compensation, services or litigation) to the Trust pursuant to the corporate policy for reporting to the Trust. Provides investigation findings/information to claims staff including identity of location/site/clinic involved, identity (full name, job title) of involved parties, witnesses (how they are/were involved) etc., narrative description of the events, issues identified and recommendations for additional investigation. Investigates and responds (in writing) to requests from patients/visitors for compensation or payment for services, e.g., physical therapy, home health, specialist consultation, etc.

· Serves as primary contact for defense counsel and corporate claims staff. Facilitates/verifies discovery and requests for documents, information, interviews and depositions. Obtains concurrence for settlement, trial, etc. Works with legal counsel to coordinate investigations, process and defend claims against the facility. Obtains/maintains records and documents and provides them to defense attorneys for preparation of testimony in pending litigation. Safeguards materials obtained or developed for root cause analysis to ensure documents/proceedings are protected from discovery. Initiates and monitors efforts to preserve evidence, i.e., surveillance video, equipment memory, etc., and/or litigation holds.

· Attends trial as site representative, coordinates litigation activities involving site interviews, depositions, witness preparation, etc. Approves payment for replacement of lost property after claim evaluation. Negotiates settlement of small claims within administrative authority and advises collection department of appropriate action for unpaid accounts involved in litigation.

· Performs other job-related duties as assigned.

You'll be successful with the following qualifications:

Education:

· Bachelor's degree in a healthcare-related field or equivalent combination of education/related experience: Required

· Master's degree: Preferred

Work Experience:

· Seven years' technical experience: Preferred

· Five years' leadership experience: Preferred

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA and HI) or the option of COVID-19 vaccine or weekly testing (required in OR), etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.

Job Type: Full-time

Pay: $139,003.59 - $208,505.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Day shift
• Monday to Friday

Education:

• Bachelor's (Required)

Experience:

• Leadership: 3 years (Preferred)

Work Location: One location

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