Insurance Risk Manager Jobs in Massachusetts (NOW HIRING)

Under the direction of the Director of Patient Safety & Risk Management, the Risk Manager is a member of the Patient Safety & Risk Management team of the Dana-Farber Cancer Institute’s (DFCI) Quality and Patient Safety (QPS) Department is responsible for identification, evaluation, and mitigation of risk at DFCI, including outpatient clinics at DFCI-Longwood, all DFCI Network locations, and the DFCI inpatient hospital. Provides leadership in risk management by promoting the highest level of quality care to the patients, ensuring regulatory compliance and mitigating malpractice risk through loss prevention. Plays an integral role in regulatory and accreditation readiness by assisting with the implementation of the Patient Care Assessment Plan and the Quality Improvement Plan consistent with Board of Trustee approved goals and regulatory and standard setting agencies. Performs as an internal compliance consultant by maintaining current knowledge of hospital regulations including the Department of Public Health (DPH), BRM, The Joint Commission, Centers for Medicare and Medicaid Services (CMS), and Food and Drug Administration (FDA). Develops external and internal relationships to ensure compliance with applicable regulations.

Located in Boston and the surrounding communities, Dana-Farber Cancer Institute is a leader in life changing breakthroughs in cancer research and patient care. We are united in our mission of conquering cancer, HIV/AIDS, and related diseases. We strive to create an inclusive, diverse, and equitable environment where we provide compassionate and comprehensive care to patients of all backgrounds, and design programs to promote public health particularly among high-risk and underserved populations. We conduct groundbreaking research that advances treatment, we educate tomorrow's physician/researchers, and we work with amazing partners, including other Harvard Medical School-affiliated hospitals.
 

Primary Duties and Responsibilities:

• Risk Assessment and Analysis:  Conducts comprehensive risk assessments to identify potential risks to patients, staff, and the organization. Analyzes incident reports, claims, and other data to identify trends and areas for improvement.
• Policy Development and Implementation:  Develops and updates risk management policies and procedures in compliance with regulatory requirements and industry best practices. Ensures effective implementation of risk management strategies across the organization.
• Incident Management:  Reviews submitted patient-safety event reports, investigates when necessary, and escalate serious safety events and near misses to leadership as defined by policy and protocol. Leads investigations into adverse events, near misses, and other incidents. Collaborates with clinical and administrative staff to develop corrective action plans and prevent recurrence.
• Education and Training:  Designs and delivers training programs to educate staff on risk management practices and promote a culture of safety. Stays informed about industry trends and regulatory changes to ensure ongoing compliance and risk mitigation.
• Regulatory Compliance:  Prepares and submits potentially compensable events (PCEs) to DFCI medical malpractice insurer to ensure compliance with healthcare regulations and standards, the organization must adhere to guidelines set by The Joint Commission, OSHA, the Massachusetts Department of Public Health, the New Hampshire Department of Health and Human Services, and other relevant regulatory bodies. Collaborates with the QPS Quality & Regulatory Compliance team to maintain continuous survey readiness and participates in regulatory surveys as needed. Additionally, prepares and submits required reports to regulatory agencies and reporting PCEs to the DFCI medical malpractice insurer, such as CRICO.
• Collaboration and Communication:  Communicates risk management activities and participates in various institute committees and outcomes to senior leadership and other stakeholders. Collaborates with attorneys from the Office of General Counsel on legal matters when requested and works closely with clinical, legal and administrative teams related to risk/safety issues. Collaborates with other members of the Patient Safety team, QPS staff and leadership, to support and advance the goals of the department and Institute, providing consultation and education.
• Continuous Improvement:  Fosters a proactive approach to risk management by encouraging reporting and open communication. Participates in, or facilitates, improvement projects related to patient safety and risk mitigation, including monitoring of effectiveness of programs and initiatives.

Knowledge, Skills and Abilities:

• Ability to engage, build trust, and collaborate effectively with diverse teams and stakeholders comprised of multiple levels of hospital staff and administration. Outstanding leadership and team-building skills, with the ability to influence both with and without authority.
• Ability to manage multiple priorities and responsibilities simultaneously, operate effectively in situations of ambiguity, confront uncertainty, resolve conflict, and adapt to change.
• Organizational skills to facilitate small task forces for problem investigation and solving.
• Knowledge of hospital administrative and medication policies.
• Knowledge of The Joint Commission standards and regulations from Occupational Safety and Health Administration (OSHA), Centers for Disease Control and Prevention (CDC), Department of Public Health (DPH), BORIM (Board of Registration in Medicine) and CLIA (Clinical Laboratory Improvement Amendments).
• Clinical judgment and critical thinking to work with confidential patient information and evaluate findings in medical record review. Ability to identify resources to obtain needed information.
• Excellent verbal, written, and interpersonal communication skills and public speaking abilities.
• Knowledge of PC computer programs (e.g., Microsoft Word, Excel, PowerPoint, and Outlook), and ability to learn and use DFCI safety reporting system.

Minimum Job Qualifications:

Bachelor's Degree in Healthcare Administration, Nursing, Public Health or related field required. Master's degree preferred. 5 years of experience in patient safety, quality, compliance, or related field. Prior experience in a clinical role (e.g., RN, NP, PA, PharmD) required.Risk-management experience preferred.

License/Certification/Registration Required:

Certification in risk management (CPHRM) preferred. Certification in Patient Safety/Quality (CPPS, CPHQ) preferred.

Supervisory Responsibilities:

None

Patient Contact:

None

Special Working Conditions:

Hybrid

At Dana-Farber Cancer Institute, we work every day to create an innovative, caring, and inclusive environment where every patient, family, and staff member feels they belong. As relentless as we are in our mission to reduce the burden of cancer for all, we are committed to having faculty and staff who offer multifaceted experiences. Cancer knows no boundaries and when it comes to hiring the most dedicated and compassionate professionals, neither do we. If working in this kind of organization inspires you, we encourage you to apply.

Dana-Farber Cancer Institute is an equal opportunity employer and affirms the right of every qualified applicant to receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, national origin, sexual orientation, genetic information, disability, age, ancestry, military service, protected veteran status, or other characteristics protected by law.  

EEO Poster.

Pay Transparency Statement

The hiring range is based on market pay structures, with individual salaries determined by factors such as business needs, market conditions, internal equity, and based on the candidate’s relevant experience, skills and qualifications.

For union positions, the pay range is determined by the Collective Bargaining Agreement (CBA).

$120,100.00 - $138,200.00