Director of Clinical Risk Management and Quality Assurance

The Director of Risk Management is responsible for overseeing all organizational risk functions, including event reporting, patient safety, complaint resolution, regulatory compliance, and risk-related education. This role ensures the organization maintains a safe environment for patients and staff, complies with state and federal requirements, and proactively identifies and mitigates risk across all clinical operations.

Responsibilities include:

• Serving as the administrator for RL Solutions and overseeing the full event reporting lifecycle.
• Reviewing, investigating, and trending incident data to identify patterns and areas of concern.
• Developing and delivering risk education based on trended data.
• Preparing quarterly risk reports for the CEO and Governing Board.
• Conducting the annual evaluation of the Risk Management Plan and establishing new goals based on findings.
• Managing patient complaints and service recovery follow-up.
• Drafting written responses to health plans regarding patient complaints.
• Maintaining detailed logs of complaints, outcomes, and corrective actions.
• Conducting medical record reviews when Notices of Intent are received.
• Maintaining updated risk files for active and potential cases.
• Collaborating with Billing and Coding to ensure timely completion of medical records.
• Working with Compliance and physicians on amended medical record requests.
• Participating in policy and procedure development related to risk and patient safety.
• Administering annual company-wide Risk Management training.
• Assisting the Education Department with developing skills-based competencies.
• Providing customer service and risk-related training during new hire orientation.
• Serving as a member of the Hernando ESF-18 Emergency Management working group.
• Chairing the EOC Committee during inclement weather or emergency events.
• Coordinating communication and readiness activities across clinical sites.
• Providing risk-related guidance to physicians, COMs, and office staff.
• Supporting offices with compliance audit corrective action plans.
• Collaborating on risk software and educational video development.