Summary:

Osceola Medical Center is looking for a Compliance & Risk Manager responsible for identifying, evaluating, and mitigating risks to patients, staff, and the organization. This position works proactively to minimize liability exposure, ensure regulatory compliance, and promote a culture of safety and continuous improvement.

Typical Schedule:

Daytime hours

Essential Duties & Responsibilities:

Risk Identification & Assessment:

• Conduct risk assessments and audits to identify potential threats to patient safety, data security, and organizational liability.
• Monitor incident reports, patient complaints, and adverse events to identify trends and areas of concern.

Incident Management:

• Investigate adverse events, near misses, and sentinel events- identifying and leading root cause analyses.
• Coordinate and document responses to internal and external incident investigations.

Policy Development & Compliance:

• Develop, implement, and maintain risk management policies and procedures.
• Ensure compliance with federal, state, and local regulations (e.g., HIPAA, OSHA, CMS, The Joint Commission).

Claims Management:

• Manage and coordinate malpractice and liability claims, working closely with legal counsel and insurance providers.
• Serve as a liaison for claims reporting and resolution.

Training & Education:

• Provide education and training to staff on risk reduction strategies, patient safety, and compliance requirements as needed.
• Promote a proactive safety culture through regular communication and learning initiatives.

Collaboration & Reporting:

• Collaborate with Director of Continuous Quality Improvement, CEO, Legal, HR, CMO, and Clinic Operations Director to align risk mitigation strategies.
• Prepare reports for senior leadership on risk trends, mitigation efforts, and improvement opportunities.

Knowledge, Skills, & Abilities:

• Demonstrate ethical and professional behavior.
  • In-depth understanding of healthcare risk management principles, strategies, and best practices.
  • Knowledge of clinical risk assessment tools, incident reporting systems, and root cause analysis methods.
  • Familiarity with healthcare laws and regulations, including:
  • HIPAA (Health Insurance Portability and Accountability Act)
  • OSHA (Occupational Safety and Health Administration) regulations
  • CMS (Centers for Medicare & Medicaid Services) guidelines
  • The Joint Commission standards for DNV accreditation.
  • Knowledge of state and federal laws related to medical malpractice, patient rights, and patient safety.
  • Understanding of the claims process, including documentation, investigation, and resolution.
  • Familiarity with insurance policies (malpractice, general liability) and how they apply to healthcare organizations.
  • Strong ability to analyze data, identify risk patterns, and determine root causes of adverse events.
  • Skilled in using quantitative and qualitative methods to assess and mitigate risk.
  • Excellent verbal and written communication skills to communicate risk-related issues and recommendations to leadership, staff, and external stakeholders.
  • Strong organizational and time-management skills to manage multiple projects and initiatives simultaneously.

Education:
Required:

• Bachelor's degree in Healthcare Administration, Nursing, Public Health, Business Administration, Risk Management, or a related field.
• Certified Professional Health Risk Manager (or within 1 year of hire).

Preferred:

• Master's degree in Healthcare Administration, (MHA), Business Administration (MBA), Public Health (MPH), Law (JD), or a related discipline.
• Strong understanding of HIPAA, OSHA, The Joint Commission, CMS, and other healthcare-related regulations.
• Excellent written and verbal communication skills.
• Ability to handle confidential information with discretion.
• Strong problem-solving and analytical skills.