Interim Risk Director | MS, CHC, CPHRM Last Updated: April 24, 2018 (4 months ago)
Interim Risk Director | MS, CHC, CPHRM
Currently Available
Leadership & Acute Care Experienced

A highly skilled Director of Risk with over 20 years of experience in the healthcare risk management arena. Specialties include oversight of all aspects of the Risk Management program including regulatory compliance, potential claims, claims management, data analysis, and incident & adverse event reporting. Expertise in root cause analysis, Failure Mode & Effects Analysis (FMEA) and fostering internal risk identification procedures.

References & Reviews

• “She has a great balance between practical knowledge and common sense.”
• “She's great at adjusting her message to fit her audience!”
• “She determined the best way to investigate major issues, coordinated with the state department, handled the press and worked with the malpractice insurance carrier to resolve major occurrences.”
• “She really led a crisis management intervention for us, finding the problem and implementing immediate resolution, she was able to maintain and enhance the hospital's reputation.”
• “She was diligent in investigating a situation that just didn't look right, she worked very well with PR folks, was successful in getting claims batched, and ensured we had very little liability at the end, she really knocked it out of the park!”
• “She has a masterful understanding of risk and a passion for it!”

• Engages physicians and nursing and comfortable navigating at the C/Board level to transform care to ensure the quality of care and increase patient safety
• Strong resolutions skills and represents organization during patient interactions and complaints and coordinates issues with legal affairs
• Designed and implemented a successful process for responding to government audits
• Conducted and managed complex investigations
• Implemented a physician payment audit process
• Analyzed and re-structured the liability insurance program and achieved a reduction in the cost of insurance
• Established the annual compliance and risk management planning process
• Implemented annual compliance and risk management updates and education in all hospitals
• Conducted a captive feasibility study before merging a self-insurance trust into a newly created captive. Subsequent responsibility for captive operations and served on the captive board
• Instrumental in the development and implementation of initiatives that successfully promote patient safety, quality outcomes and minimize risks
• Implemented Compliance 360 for effective audit and compliance reporting, claims reporting, and policy/procedure management
• Implemented Fair Warning as a mechanism to monitor HIPAA compliance
• Compliance
• Risk Management
• Legal Services
• Contract Management
• Fiscal Integrity
• Medical Staff Credentials Verification
• Patient Safety
• Budget Compliance
• Incident Reporting
• Claims Investigations
• Interim Risk Manager | 350+ Bed Acute Care Hospital
• Chief Risk Officer | 500+ Bed Acute Care Hospital
• Master of Science (MS)
• Certified in Healthcare Compliance (CHC)
• Certified Professional in Healthcare Risk Management (CPHRM)

Resume Content

Title:

Interim Risk Director | MS, CHC, CPHRM

Date Available:

Currently Available

Summary:

Leadership & Acute Care Experienced

A highly skilled Director of Risk with over 20 years of experience in the healthcare risk management arena. Specialties include oversight of all aspects of the Risk Management program including regulatory compliance, potential claims, claims management, data analysis, and incident & adverse event reporting. Expertise in root cause analysis, Failure Mode & Effects Analysis (FMEA) and fostering internal risk identification procedures.

References & Reviews

• “She has a great balance between practical knowledge and common sense.”
• “She's great at adjusting her message to fit her audience!”
• “She determined the best way to investigate major issues, coordinated with the state department, handled the press and worked with the malpractice insurance carrier to resolve major occurrences.”
• “She really led a crisis management intervention for us, finding the problem and implementing immediate resolution, she was able to maintain and enhance the hospital's reputation.”
• “She was diligent in investigating a situation that just didn't look right, she worked very well with PR folks, was successful in getting claims batched, and ensured we had very little liability at the end, she really knocked it out of the park!”
• “She has a masterful understanding of risk and a passion for it!”

Qualifications & Achievements:

• Engages physicians and nursing and comfortable navigating at the C/Board level to transform care to ensure the quality of care and increase patient safety
• Strong resolutions skills and represents organization during patient interactions and complaints and coordinates issues with legal affairs
• Designed and implemented a successful process for responding to government audits
• Conducted and managed complex investigations
• Implemented a physician payment audit process
• Analyzed and re-structured the liability insurance program and achieved a reduction in the cost of insurance
• Established the annual compliance and risk management planning process
• Implemented annual compliance and risk management updates and education in all hospitals
• Conducted a captive feasibility study before merging a self-insurance trust into a newly created captive. Subsequent responsibility for captive operations and served on the captive board
• Instrumental in the development and implementation of initiatives that successfully promote patient safety, quality outcomes and minimize risks
• Implemented Compliance 360 for effective audit and compliance reporting, claims reporting, and policy/procedure management
• Implemented Fair Warning as a mechanism to monitor HIPAA compliance

Expertise:

• Compliance
• Risk Management
• Legal Services
• Contract Management
• Fiscal Integrity
• Medical Staff Credentials Verification
• Patient Safety
• Budget Compliance
• Incident Reporting
• Claims Investigations

Experience:

• Interim Risk Manager | 350+ Bed Acute Care Hospital
• Chief Risk Officer | 500+ Bed Acute Care Hospital

Education:

• Master of Science (MS)
• Certified in Healthcare Compliance (CHC)
• Certified Professional in Healthcare Risk Management (CPHRM)

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