PROGRAM MANAGER, PROFESSIONAL MEDICAL & HOSPITAL LIABILITY PROGRAM - #440395
University of California Office of the President
Date: 09/15/2021 15:30 PM
City: Oakland, California
Salary: $122,000 - $142,500 / year
Contract type: Full Time
Work schedule: Full Day
Job ID: 23577
For UCOP internal applicants, please login to the internal candidate gateway at: Jobs at UCOP
UC OFFICE OF THE PRESIDENT
At the University of California (UC), your contributions make a difference. A world leader producing Nobel and Pulitzer prize recipients with over 150 years of groundbreaking research transforming the world. Choose a career where you can leverage your knowledge, skills and aspirations to inspire and support some of the greatest minds in the world, and those who will follow in their footsteps. Working at the University of California is being part of a unique institution, and a vibrant and diverse community. At the University of California, Office of the President, we propel our mission through impactful work locally, in government centers and systemwide. We are passionate people, serving the greater good.
The University of California, one of the largest and most acclaimed institutions of higher learning in the world, is dedicated to excellence in teaching, research and public service. The University of California Office of the President is the headquarters to the 10 campuses, six academic medical centers and three national laboratories and enrolls premier students from California, the nation and the world. Learn more about the UC Office of the President
The Office of Risk Services is responsible for developing and implementing Enterprise Risk Management systemwide, identifying and developing strategies to minimize the impact of risk, developing a center of excellence for managing risk, reducing costs and improving safety by executing new ideas and strategic plans in a rapid manner. By strategically managing risk we can reduce the chances of loss, create greater financial stability and protect our resources in support of UC's mission.
The Professional Medical & Hospital Liability (PL) program within the Office of Risk Services is responsible for loss prevention, management of medical & dental malpractice claims and lawsuits that occur at university healthcare facilities. This includes student health, counseling and psychological service centers, veterinary services and/or lawsuits that involve university healthcare practitioners, including university physicians, dentists, residents, fellows, nurses and other healthcare employees for acts and omissions allegedly arising out of the course and scope of university employment. The Professional Medical & Hospital Liability program also provides for the legal representation of healthcare employees for licensing board investigations under certain circumstances
This position reports to the Executive Director of the Professional Medical & Hospital Liability Program. Works with office of general counsel, risk managers for five academic medical centers and campus health, third party administrator and external vendors
This individual has wide-ranging experience in professional medical and hospital liability issues, from the health systems and system-wide level, using enterprise risk management concepts and organizational objectives to resolve complex issues with organization-wide impact
This includes responding to and reporting of adverse events, exposures arising from physicians and medical staff caring for patients (patient injuries), coverage, and insurance, development of corrective actions and best practices, and education. Responsible for managing claims, including reporting, early investigation and resolution of claims. Participates in strategy and negotiation of high exposure claims. Manages, provides advice and direction to the third party administrator
Medical centers rely on this position for expert advice and direction for management of high exposure claims, interpretation of University Business and Finance Bulletin BUS-81 (Insurance Programs) and excess insurance policies and risk advice related to medical malpractice.
Professional Hospital and Medical Claims Management:
- Evaluates complicated, catastrophic cases, such as birth injury, brain damage and quadriplegia with claim costs exceeding $5,000,000. Communicates with and makes recommendations to excess insurance representatives and others within the University system
- Presents and provides recommendations regarding settlement. Attends meditations to negotiate and resolve claims
- Analyzes, answers questions on confidentiality issues, BUS 81, coverage questions, HIPAA/BAA compliance
- Manages the third party claims administrator. Provides training to claims personnel with third party claims administrator, including operating procedures, claim strategy, investigative requirements, University expectations, claim documentation, changes to University requirements on claims and reporting to excess insurance carriers
- Provides training to outside attorneys regarding University policies, necessary political sensitivities in a university setting, how to be successful in a multiple consensus driven environment, defense counsel guidelines, billing and claim strategy
- Partners with outside counsel on complex professional liability claims, including strategy and trial preparation. Works with counsel and local medical center Risk Managers on subpoenas related to physicians and staff
- Facilitates the implementation of cost recovery on claims and related strategies
Program Risk Reduction:
- Serves as the subject matter expert on professional liability and medical center risk, controls, and related policies and procedures. Lead a team of professionals charged with investigating, analyzing and resolving claims and lawsuits. Develops and refines applicable policies and procedures to enhance the team's effectiveness. Implements and monitors appropriate process improvements
- Directs, analyzes, and prepares recommendations for risk assessments and business process. Recognizes, escalates and directs discussions of policies and procedures having critical, organization-wide impact
- Performs needs analyses, monitors results; develops continual improvement processes; and counsels professional staff, departments, attorneys, and external vendors on risk mitigation and loss prevention efforts
- Assesses consistency and application of methods and integration of risk management practices and compliance with policies
- Functions as the project manager for the development and implementation of organizational and/or system-wide professional liability training programs. Facilitates involvement of subject matter experts, and other advisory groups to continually enhance the professional liability program's loss prevention
- As a technical leader, provides guidance to all levels of managers and supervisors on ways to improve risk management department processes and / or operations. Oversees and moderates the Risk Mitigation Collaborative, an in person meeting several times per year with all UC medical center risk managers, office of general counsel and third party claims administrator. The Collaborative is used to discuss emerging risks at hospitals and clinics, lessons learned from claims, and patient safety, for the purpose of improving system-wide guidelines and/or recommended best practices. Develops agenda and strategy for each collaborative, including subject matter experts on various topics
Program Data Reporting and Analytics:
- Leads a team of risk management professionals charged with compiling underwriter and actuary data
- Conducts on-going review and analyses of exposures, trends arising from adverse events and claims at the various locations. Researches and obtains risk mitigation tools to combat these exposures. Directs and/or participates in process creation, improvement, re-engineering and major systems development projects
- Work with UC personnel and external vendors to develop system-wide reporting tools to assist in review, analyzing and addressing trends
- Recommends improvements to documentation impacting public reporting, accreditation, licensing, reimbursement, patient safety, and employee safety. Uses strong data analysis skills to develop and prepare risk management reports for management: analysis of data from complex claims and lawsuits regarding risk exposures and related patient safety issues and trends.
- Advanced knowledge in healthcare risk management theory and industry best practices. Ability to apply knowledge and skills to recommend improvements to risk management processes and procedures.
- Knowledge of risk management, medical center, and UC policies and processes. In depth knowledge of relevant risk management industry federal, state, and local laws and regulations to proactively identify and mitigate compliance risks.
- Advanced technical skills to analyze and identify potential significant risks. Ability to consistently produce high quality, thorough work despite pressing deadlines by accurately completing activities the first time. Knowledge to check for quality and corrects own error.
- Project management skills to lead a team, prioritize personal and team tasks and see projects through from inception to completion on schedule. Demonstrates adaptability and flexibility to effectively handle change.
- Interpersonal skills to work collaboratively coordinate and integrate with others throughout the organization.
- Advanced analytical abilities and problem solving skills to quickly evaluate complex issues, identify options for resolution, and apply sound judgement.
- Verbal and written communication skills to effectively communicate through all mediums and with all groups. Ability to listen actively, understand varying viewpoints and receive feedback.
- Ability to perform all commonly applicable functions in word processing and spreadsheet software. Advanced knowledge of organization's risk management application programs to troubleshoot issues and recommend improvements in convenience and efficiency.
- In depth knowledge of data analysis, research and reporting, particularly in the clinical risk management industry.
- Advanced teaching skills. Ability to develop curriculums that convey complex concepts in an understandable way.
- Bachelor's degree in related area and / or equivalent experience / training.
- Advanced degree
- Minimum eight years of experience in related area.
- California State Bar License
- Certified Professional in Health Care Risk Management (CPHRM)
SALARY AND BENEFITS
Salary: $122,000 - $142,500
Benefits: For information on the comprehensive benefits package offered by the University visit: Benefits of Belonging
HOW TO APPLY
Please be prepared to attach a cover letter and resume with your application.
APPLICATION REVIEW DATE
The first review date for this job is September 24, 2021. The position will be open until filled.
CONDITIONS OF EMPLOYMENT
Background Check Process: Successful completion of a background check is required for this critical position. Background check process at UCOP
Smoke Free Work Environment: The University of California, Office of the President, is smoke & tobacco-free as of January 1, 2014. UC Smoke & Tobacco Free Policy
The University of California, Office of the President, is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age or protected veteran status. EEO/AA Employer UC Nondiscrimination Policy
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