At Memorial Hermann, we're about creating exceptional experiences for both our patients and our employees. Our goal is to provide opportunities for our diverse employee population that develop and grow careers in a team-oriented environment focused on patient care.

Every employee, at every level, begins their journey at Memorial Hermann learning about the history of the organization and its established culture built on trust and integrity. Our employees drive this culture, and we want you to be a part of it.

Job Summary
Responsible for the collaborative leadership and administration of the enterprise-wide risk management claims function, including the development and monitoring of risk management strategic objectives, initiatives and key performance metrics. Provides broad clinical risk management expertise to the organization to proactively address enterprise clinical risk issues. Provides strategic and tactical direction and support to facility-based Risk Managers. Collaborates with legal counsel, loss prevention, regulatory compliance and clinical quality functions to identify and reduce risks and improve quality of care. Direct supervision of clinical Risk Management Specialists (registered nurses), Risk Manager-Outpatient and Post Acute Care Services, and administrative support staff. Oversight dotted line supervision of facility-based Risk Managers.Job Description

Minimum Qualifications

Education: Bachelors degree in Nursing required

Licenses/Certifications: Current State of Texas license to practice professional nursing. Certified Professional Healthcare Risk Management (CPHRM) designation or obtain within two (2) years of placement in role

Experience / Knowledge / Skills:

• Minimum ten years of progressive Clinical experience
• Minimum ten years experience in risk management in a hospital-based environment and/or law firm environment
• Ability to work collaboratively with health professionals at all levels to achieve established goals
• Demonstrated ability to lead and influence others positively to achieve desired results while building support for change
• Computer proficiency
• Demonstrated interpersonal, organizational, and communication skills
• Demonstrates commitment to the Partners-in-Caring process by integrating our culture in all internal and external customer interactions; delivers on our brand promise of "we advance health" through innovation, accountability, empowerment, collaboration, compassion and results while ensuring one Memorial Hermann.

Principal Accountabilities

• Leads and manages the claims management function in collaboration with the Director-Sr. Risk Management Counsel, including development and monitoring of risk management strategic objectives, initiatives and key performance metrics.
• Responsible for claims liability assessment, reserve setting input, and managing and resolving claims throughout the claims management cycle.
• Communicates with claimants, families, and counsel to resolve concerns and settle cases within approved authority limits.
• Provides oversight of and direction for facility-based Risk Managers, including their orientation, collaborative policy and procedure development, implementation of loss prevention initiatives, and professional development.
• Controls costs and ensures controllable expenses align with budget; participates in preparation of operational budget.
• Implements formal learning feedback loops to assure that key learnings from claims are communicated to facility leaders and facility-based risk managers and results in continued improvements in quality and patient safety
• Proactively monitors claims trend data to provide appropriate loss prevention or mitigation recommendations and develop strategies to reduce risks and improve safety.
• Initiates proactive enterprise clinical risk assessments in collaboration with other functional areas to improve the identification of risks and to use as a basis for prioritization of risk management initiatives.
• Responsible for developing clinical risk management education initiatives as needed and in furtherance of loss prevention initiatives, in collaboration with Quality and Patient Safety functions.
• Utilizes risk data analytics and risk mapping tools in order to proactively assess future risk areas as well as potential impact in order to identify and plan for the appropriate risk management response to such risks.
• Interfaces with insurance function as needed to assure timely notification of claims as necessary and with the loss prevention and mitigation function for continued quality improvement and risk mitigation
• Assists the Chief Risk Officer in preparation of Board reports
• Staff support for the Enterprise Risk Council
• Available for duties after regular business hours and weekend as required.
• Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
• Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.
• Other duties as assigned.