Healthcare Risk & Compliance Manager

Commonwealth of VA Careers; Petersburg (VA); On-site; USD 60,000 - 82,000; Full time

Job summary

Commonwealth of VA Careers seeks a Risk Manager at Hiram Davis Medical Center to lead the facility's risk management program, oversee incident investigations, and ensure compliance with CMS, HIPAA, and safety standards.

The role requires strong data analysis, policy development, and ongoing training for staff, with collaboration across departments to reduce exposures and improve patient safety.

Qualifications

• Knowledge of rules and regulations governing Risk Management programs, including state & federal requirements regarding Joint Commission and CMS standards.
• Strong analytical and problem-solving skills, with demonstrated ability to interpret complex data, identify trends, and implement solutions.
• Excellent project management and organizational abilities, with experience managing multiple priorities in a fast-paced environment.
• Superior written and verbal communication skills, including the ability to present information effectively to diverse audiences.
• Proficiency in quality improvement methodologies such as Lean, Six Sigma, or PDSA/PDCA cycles.
• Experience with electronic health records (EHR) systems and health information management.
• Comprehensive knowledge of HIPAA regulations and healthcare privacy/security requirements.
• Advanced proficiency in data analysis, statistical methods, and healthcare metrics.
• Demonstrated experience in policy development, implementation, and management.
• Ability to review clinical documentation to determine standards of care compliance.
• Significant experience reviewing Mortality and Morbidity cases.
• Strong independent decision-making skills with ability to work autonomously.
• Proficiency in PC applications and healthcare-specific software.

Responsibilities

• Performance Management, with requirements of the performance planning and evaluation system which must be met and evaluations must be completed by the established deadlines with proper documentation.
• Manages the interdisciplinary facility-wide risk management program designed to address risk identification, reporting, analysis, investigation and reduction.
• Collects, evaluates, and distributes relevant data on client/staff injuries and other relevant risk management issues.
• Provides recommendations for, and monitors implementation of risk reduction and management strategies.
• Completes event investigation, root-cause analysis, and follow-up including Failure Mode and Effects Analysis (FMEA) for events.
• Coordinates insurance carrier surveys and plans of correction in response to survey findings.
• Prepares and submits documentation and reports in accordance with established timelines and in a manner determined to be appropriate by CMS, DBHDS, and OIG.
• Receives, evaluates, and processes all patient events and recommend action when necessary.
• Evaluates employee and visitor events and recommends action when necessary.
• Prepares a summary of events for Quality and Safety Committee.
• Submits in-depth reports of findings and recommendations to resolve operations deficiencies.
• Collaborates with appropriate parties to ensure that the facility maintains an inventory of all exposures requiring insurance coverage and that these needs are coordinated with DBHDS.
• Provides monthly Risk Management employee training to new hires and on-going training to existing employees.
• Multiple duties to be completed during the investigation such as documentation, timeframes, evidence, interviewing, etc.
• Prepares and submits a signed and dated investigation summary report and transmittal memo with all documentary evidence and the finding recommendation (Substantiated, Unsubstantiated, or Improbable) to the Facility Director/CEO and Human Rights Advocate (Office of Quality Improvement as needed/requested).
• Brief the Facility Director/CEO and Human Rights Advocate (Office of Quality Improvement as needed/requested) to provide additional information.
• Will serve on multiple various committees, not limited to agency Safety Committee.

Skills

Risk management

Regulatory knowledge

Data analysis

Quality improvement

Project management

Education

Master's degree in healthcare administration

Tools

EHR systems

Healthcare software

Job description

Commonwealth of VA Careers seeks a Risk Manager at Hiram Davis Medical Center to lead the facility's risk management program, oversee incident investigations, and ensure compliance with CMS, HIPAA, and safety standards.

The role requires strong data analysis, policy development, and ongoing training for staff, with collaboration across departments to reduce exposures and improve patient safety.