What are the responsibilities and job description for the Community Director Risk/Compli position at Appalachian Regional Healthcare (ARH)?
Overview
The Community Director of Risk and Compliance (formerly CCRAO for policy purposes) performs the functions of a Risk Manager, Compliance Officer, and HIPAA Privacy and Security Officer at the community level.
Responsibilities
Lead and encourage respective community to a culture with a focus on the identification, communication, and resolution of risk, compliance and safety issues.
Lead respective community in all activities related to patient safety and any resulting loss events which may lead to exposures to ARH and help limit the potential loss from those professional and general liability exposures.
Aid in development of programs to identify, analyze, monitor and remediate risk exposures.
Actively participate in the legal process at the direction of the Chief Legal Officer including investigation and documentation related to claims, potential claims, complaints (including employee complaints), or incidents.
Plans, develops and presents educational sessions with employees and providers regarding loss prevention and reduction techniques, insurance coverages and exclusions, medical record documentation, legal issues and the ARH Compliance Program.
Act as a liaison with patients/families and the care team for patient care concerns.
Assist with the quality improvement programs.
Assist with peer review activities.
Collects data on community activities to monitor the performance of processes that involve risks, compliance or may result in sentinel events. Participates is proactive risk assessments to mitigate risks and promote patient safety.
Investigates matters related to compliance, risk and any resulting corrective action with
all departments, contracted vendors, and others as appropriate.
Timely communicates any matter deemed potentially illegal, unethical, or otherwise improper to the Assistant Vice President of Risk and Patient Safety, Chief Legal Officer.
Timely communicates all compliance related issues to Chief Compliance Officer.
Leads the local Community Compliance Committee.
Ensures the services in the community are compliant with applicable laws and regulations and implements system initiatives in that regard.
Responds to, and acts as a liaison to the Office of Legal Affairs and the Compliance Department with respect to, investigations or site-visits by regulatory agencies to facilities in the community including implementation of any corrective action plans.
Monitors the use and disclosure of, and addresses issues associated with the privacy and security of, individually identifiable health information and other patient medical data at the community level.
Implements the ARH Compliance Plan at the community level.
Assist ARH internal auditors concerning audits related to the community.
Performs other duties as assigned.
Qualifications
Education
Required: Bachelor of Science in Nursing or other health related fields.
Preferred: Master’s degree in Risk Management/Patient Safety or Nursing/Healthcare related field or CPHRM
Minimum Work Experience
Minimum of two (2) years related experience
Required Skills, Knowledge, And Abilities
Strong knowledge and understanding of regulatory health law and requirements of accrediting agencies.
Organized, persistent, and creative individual with strong communication skills.
Microsoft Office or related products.
Knowledge of electronic event reporting products and data management systems.
Knowledge of electronic medical records systems.
Able to function effectively, independently, and efficiently in a dynamic work environment.
Must be accountable and willing to accept responsibility. Qualities of leadership and integrity are essential to the position.
Demonstrated organization, facilitation, communication (written and verbal), and presentation skills are required.
The Community Director of Risk and Compliance (formerly CCRAO for policy purposes) performs the functions of a Risk Manager, Compliance Officer, and HIPAA Privacy and Security Officer at the community level.
Responsibilities
Lead and encourage respective community to a culture with a focus on the identification, communication, and resolution of risk, compliance and safety issues.
Lead respective community in all activities related to patient safety and any resulting loss events which may lead to exposures to ARH and help limit the potential loss from those professional and general liability exposures.
Aid in development of programs to identify, analyze, monitor and remediate risk exposures.
Actively participate in the legal process at the direction of the Chief Legal Officer including investigation and documentation related to claims, potential claims, complaints (including employee complaints), or incidents.
Plans, develops and presents educational sessions with employees and providers regarding loss prevention and reduction techniques, insurance coverages and exclusions, medical record documentation, legal issues and the ARH Compliance Program.
Act as a liaison with patients/families and the care team for patient care concerns.
Assist with the quality improvement programs.
Assist with peer review activities.
Collects data on community activities to monitor the performance of processes that involve risks, compliance or may result in sentinel events. Participates is proactive risk assessments to mitigate risks and promote patient safety.
Investigates matters related to compliance, risk and any resulting corrective action with
all departments, contracted vendors, and others as appropriate.
Timely communicates any matter deemed potentially illegal, unethical, or otherwise improper to the Assistant Vice President of Risk and Patient Safety, Chief Legal Officer.
Timely communicates all compliance related issues to Chief Compliance Officer.
Leads the local Community Compliance Committee.
Ensures the services in the community are compliant with applicable laws and regulations and implements system initiatives in that regard.
Responds to, and acts as a liaison to the Office of Legal Affairs and the Compliance Department with respect to, investigations or site-visits by regulatory agencies to facilities in the community including implementation of any corrective action plans.
Monitors the use and disclosure of, and addresses issues associated with the privacy and security of, individually identifiable health information and other patient medical data at the community level.
Implements the ARH Compliance Plan at the community level.
Assist ARH internal auditors concerning audits related to the community.
Performs other duties as assigned.
Qualifications
Education
Required: Bachelor of Science in Nursing or other health related fields.
Preferred: Master’s degree in Risk Management/Patient Safety or Nursing/Healthcare related field or CPHRM
Minimum Work Experience
Minimum of two (2) years related experience
Required Skills, Knowledge, And Abilities
Strong knowledge and understanding of regulatory health law and requirements of accrediting agencies.
Organized, persistent, and creative individual with strong communication skills.
Microsoft Office or related products.
Knowledge of electronic event reporting products and data management systems.
Knowledge of electronic medical records systems.
Able to function effectively, independently, and efficiently in a dynamic work environment.
Must be accountable and willing to accept responsibility. Qualities of leadership and integrity are essential to the position.
Demonstrated organization, facilitation, communication (written and verbal), and presentation skills are required.