The risk management objectives include delivery of quality patient care, promotion of safety and reduction in medical errors. This objective can be met through information gathering and performance of clinical analysis, which are designed to identify patterns of patient care events that may lead to sub-optimal outcomes and identify areas where patient care needs improvement. The risk process can be defined as the identification, investigation, analysis and evaluation of risks and the selection of the most advantageous method of correcting, reducing, or eliminating identifiable risks. The risk management function also encompasses other organizational losses such as property loss, visitor injuries, and other non-patient care matters. The purpose of the hospital clinical risk management function is to coordinate and facilitate the activities to prevent and/or minimize losses associated with identifiable risks, and to minimize and prevent claims of general and professional liability against the hospital. In so doing, the loss prevention function focuses on and promotes patient safety. This position reports directly to the Director of Quality. The Facility Compliance Officer ("FCO") is designated at some Vanderbilt University Medical Center ("VUMC") regional facilities to assist the VUMC Chief Compliance Officer with facilitating the implementation, oversight, and ongoing operations of the VUMC Compliance Plan. The FCE will ensure his or her facility's compliance program responsibilities are met and the program adequately addresses the individual concerns of the facility and related affiliates (entities/concerns) that may be associated with the facility.The FCO will be appointed by the President of the VUMC facility in consultation with the Chief Compliance Officer or assigned VUMC Office of Compliance & Corporate Integrity Team Lead. The FCO will report directly to the President of the facility for purposes of performance evaluations and compensation reviews.
Ability to work under limited supervision and to follow written and oral instructions.
Familiar with organization and functions of departments and committees of the hospital.
Ability to demonstrate effective communication skills and positive regard toward all patients, coworkers, and medical staff members.
Works to meet established goals and objectives.
Must possess a positive working relationship with the Medical Staff, Department Leaders, and Hospital Staff throughout the facility
Compliance with organization requirements including policies, procedures, risk management, legal and regulatory standards and guidelines.
Must follow and enforce accepted safety practices for patients and hospital staff.
Must report safety hazards and initiate appropriate action
Must participate in quality, safety and infection control instructional programs.
Must observe excellent customer service skills when dealing with patients, families and/or significant others, outside vendors, co-workers and physicians.
Functions as the Patient Safety Officer
Coordinates, analyzes and inputs data for the Premium Credit Program
Coordinates the Veritas program through monitoring, analysis and follow up
Coordinates the Risk Management activities which include assisting with the management of general and professional liability claims against the facility, interfacing with Risk Management and Legal Departments.
Administrates the clinical risk management program on a day to day basis,
Manages and analyzes risk management data including the ERS system
Facilitates systems analysis to promote and improve patient safety
Conducts and facilitates risk management educational programs based upon availability and identified needs, and compliance with The Joint Commission's standards relating to risk management and patient safety.
Other duties as assigned.
Monitor and support the implementation of the VUMC Compliance Program for the FCO's individual facility and all affiliates.
Personally present compliance training at facility new hire orientation or supplement Learning Management System (LMS) or other training assigned by VUMC Office of Compliance & Corporate Integrity.
Communicate immediately with the assigned VUMC Chief Compliance Officer (or designee) upon learning of a matter of potential concern or upon receiving an allegation of non-compliance.
Assist with the investigation and reporting of findings for all facility-related Integrity Line complaints received for the facility or its affiliates.
Maintain timely and thorough documentation and status updates to ensure complete documentation of all reported concerns.
Work with the Office of Compliance & Corporate Integrity to investigate reports of alleged non-compliance to final resolution.
Interact regularly with and report to the VUMC Chief Compliance Officer (or designee) regarding the organization's compliance-related activities, including training, auditing and corrective actions taken in response to reports of alleged non-compliance.
Notify the VUMC Chief Compliance Officer (or designee) regarding any contact from a government health oversight agency (i.e., CMS, OIG, TBI, OCR etc.).
Assist in the development and implementation of Corrective Action Plans when areas of non-compliance are identified.
Assist in the preparation of facility-specific components of the annual VUMC Compliance Work Plan in conjunction with the VUMC Chief Compliance Officer (or designee) for the facility and affiliated business units delineating areas identified for auditing and ongoing monitoring.
Review and coordinate implementation of new VUMC Compliance Policies and Procedures. Recommend additional policies and/or policy language to help build a comprehensive and effective compliance program at the facility, as necessary.
Coordinate and/or Chair (as requested by the Facility President) the facility Compliance Committee; ensure relevant topics are discussed and reported at each meeting of the Compliance Committee to ensure the facility has adequate and appropriate coverage of facility-specific compliance issues and concerns. Prepare minutes of such committee meetings.
Facilitate auditing and monitoring engagements set forth by the VUMC Office of Compliance & Corporate Integrity or other VUMC entities evaluating compliance with laws, regulations, company policies and managerial guidelines (this may include the Office of Legal Affairs (OLA); Risk Management; Human Resources; Quality, Safety and Risk Prevention, and other areas).
Collaborate with Human Resources (and or the VUMC Compliance Educator) and all Department Directors to ensure all relevant staff complete new hire and annual compliance training and all training is appropriately documented.
Assist with the implementation and ongoing monitoring of staff and referring providers for sanctions which may impair their ability to work for the company, provide services or refer patients for services.
Promote an environment in which employees and others are free to report instances of non-compliance confidentially and without fear of retribution.
Attend VUMC-led educational events and regularly scheduled Office of Compliance & Corporate Integrity Meetings (in person or electronically).
Pursue opportunities to improve knowledge of healthcare compliance principles.
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Discover Vanderbilt University Medical Center:
Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery and patient care, VUMC is a community of individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded and your abilities challenged. It is a place where your diversity -- of culture, thinking, learning and leading -- is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt's mission is to advance health and wellness through preeminent programs in patient care, education, and research.
Vanderbilt Harton Hospital:
Our 135-bed facility is accredited by The Joint Commission and features an accredited Chest Pain Center.
Acquired by Vanderbilt Health in 2021, the hospital has served Tullahoma, Coffee County, and surrounding counties for more than 50 years. With more than 100 doctors and 500 hospital staff, Vanderbilt Tullahoma-Harton Hospital delivers personalized, high-quality health care close to home, offering a comprehensive range of services in a modern, patient-friendly environment
Our goal is to create an exceptional experience for our patients and their families: keeping them safe, delivering evidence-based medicine, and treating them with kindness and respect.
Because we are committed to providing the best in patient care, education and research, we are proud of our recent accomplishments:
US News & World Report: #1 Adult Hospital in Tennessee and metropolitan Nashville, named to the Best Hospitals Honor Roll of the top 20 adult hospitals, 10 nationally ranked adult specialty programs, with 3 specialties rated in the top 10 nationally, Monroe Carell Jr. Children's Hospital at Vanderbilt named as one of the Best Children's Hospital in the nation, with 10 out of 10 pediatric specialties nationally ranked.
Healthcare's Most Wired: Among the nation's 100 "most-wired" hospitals and health systems for its efforts in innovative medical technology.
Becker's Hospital Review: named as one of the "100 Great Hospitals in America", in the roster of 100 Hospitals and Health Systems with Great Oncology Programs and to its list of the 100 Hospitals with Great Heart Programs.
The Leapfrog Group: One of only 10 children's hospitals in the to be named at Leapfrog Top Hospital.
American Association for the Advancement of Science: The School of Medicine has 112 elected fellows
Magnet Recognition Program: Received our third consecutive Magnet designations.
National Academy of Medicine: 22 members, elected by their peers in recognition of outstanding achievement
Human Rights Campaign Healthcare Equality Index: 6 th year in a row that Vanderbilt University Medical Center was a Leader in LGBTQ Healthcare Equality.
Vanderbilt University Medical Center is home to Vanderbilt University Hospital, The Monroe Carell Jr. Children’s Hospital at Vanderbilt, the Vanderbilt Psychiatric Hospital and the Vanderbilt Stallworth Rehabilitation Hospital. These hospitals experienced more than 61,000 inpatient admissions during fiscal year 2015. Vanderbilt’s adult and pediatric clinics treated nearly 2 million patients during this same period. Vanderbilt University Hospital and the Monroe Carell Jr. Children’s Hospital at Vanderbilt are recognized again this year by U.S. News & World Report’s Best Hospitals as among the nation’s best with 18 nationally ranked specialties. Vanderbilt University Medical Center is world renowned because of the innovation, work ethic and collegiality of its employees. From our health care advances to our compassionate care, Vanderbilt owes its accomplishments and reputation to staff and faculty who bring skill and drive and innovation to the medical center day after day. World-leading academic departments and comprehensive centers of excellence pursue scientific discoveries and transformational educational and clinical advances across the entire spectrum of health and disease.As t...he largest employer in middle Tennessee, we welcome those who are interested in ongoing development in a caring, culturally sensitive and professional atmosphere. Most of us spend so much of our lives at work, we want to be part of maintaining a workplace in which people support one another and encourage reaching for excellence. Many high-achieving employees stay at Vanderbilt because of the professional growth they experience and because of their appreciation of Vanderbilt’s benefits, public events and discussions, athletic opportunities, beautiful setting and, above all, sense of community and purpose.Vanderbilt and its employees share a set of mutual expectations that have been created with productivity, legality, fairness and safety always in mind. We believe that our investment in training and compensating employees multiplies in value when we enable individuals to deliver their best performance for the benefit of us all.