Basic Function and Responsibilities:
The Chief Clinical Risk Officer (CCRO) serves as a strategic leader responsible for developing comprehensive clinical risk management programs and procedures to address medical malpractice claims arising from clinical care delivery. This executive role combines strategic vision with operational excellence, requiring both short-term tactical solutions and long-term enterprise risk planning.
Working with minimal supervision, the CCRO collaborates across multiple departments?including operations, legal, quality, patient safety, compliance, finance, and information technology?to ensure an integrated approach to risk management. The position demands expertise in risk assessment, data analysis, regulatory compliance, and malpractice claims management to develop proactive risk mitigation strategies tailored to our enterprise's unique challenges and values. Michigan Medicine is widely recognized as a national pioneer in adopting a communication and resolution program for adverse patient events that emphasizes honesty, transparency, and a commitment to learning from medical mistakes.
Organizational Relationships
- The CCRO reports to the Chief Medical Officer, University of Michigan Health. The Chief Clinical Risk Officer partners closely with the Office of General Counsel, Compliance, Patient Safety, Security, Nursing Leadership, Office of Patient Experience, Office of Clinical Affairs and the Insurance and Claims Administration Office. The CCRO provides functional supervision of all members of the Clinical Risk Department.
- The CCRO oversees and administers centralized shared services to the Ann Arbor-based and UM Health regional systems in partnership with the health system and regional leadership teams. These centralized services include, but are not limited to:
o Clinical Risk
o Acute Event Response - The CCRO oversees and administers additional services specific to the Ann Arbor campus as well as the region, including services and direct reports such as:
o Patient Relations
o Risk Analytics
o Medical Malpractice Claim Histories for Credentialing purposes
o Secondary Patient Safety Reporting System oversight - The CCRO serves as a clinical risk and patient relations content expert and representative of UM Health to external partners such as the Michigan Hospital Association, Vizient and other similar entities in support of UM Health system priorities.
Characteristic Duties and Responsibilities
- The CCRO will directly manage the leaders in the Department of Patient Relations and Clinical Risk and will be responsible for their performance and development.
- The CCRO will ensure that all members of the Patient Relations and Clinical Risk Department are aligned, empowered and held accountable for improving the safety and reliability of patient care directly in partnership with key stakeholders throughout the organization, the University, local community, and our statewide partners.
- The CCRO will design and oversee a coordinated and comprehensive clinical risk management system to continually measure, monitor, and improve performance.
- The CCRO will partner with clinical and operational leaders to implement risk reduction standards, guidelines, practices, and care delivery models to enhance Safety across the organization, with an emphasis on High Reliability principles.
- Partner with patient safety when appropriate to review, investigate and analyze incidents for risk and adverse event identification, loss prevention and claims management purposes, including both potential and actual patient injury. Recommend interventions which will enhance the safety and well-being of patients, staff and organization.
- Shared responsibility as a member of the regional and system senior leadership team for monitoring and supporting the implementation of diversity, equity and inclusion initiatives.
- Understand industry leading practice and innovative approaches to Clinical Risk in partnership with the Insurance and Claims Administration Office investigation, processing, presentation and negotiation of patient grievances and medical malpractice claims.
- Responsible for the establishment and development of daily operational procedures for all regional complaints, grievances, and medical malpractice claims activity and responsible for evaluation of compensable events, including negotiating with families and external legal counsel on Michigan Medicine and Veritas covered claims.
- In coordination with the Claims Manager, this position sets medical malpractice claim reserves, supervises the workflow of claims investigation and the negotiation of all risk claims work.
- Coordinates with the Administrative Directors to evaluate and handle acute events related to patient care issues and clinical issues as they arise, in Ann Arbor and the Regional clinical areas.
- Representation on Regional Committees as needed.
Essential Functions
The essential functions listed are typical examples of work performed by positions in this job classification. They are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Employees may also perform other duties as assigned. Employees must abide by all Joint Commission and CMS Requirements including but not limited to sensitivity to cultural diversity, patients? rights and ethical treatment, safety and security of physical environments, emergency management, teamwork, respect for others, participation in ongoing education and training, communication and adherence to safety and quality programs, sustaining compliance with National Patient Safety Goals, HRO principles, licensure and health screenings.
Must perform all duties and responsibilities in accordance with the Service Excellence Standards of Michigan Medicine.
- Collaborates with the Claims Manager and Office of General Counsel assigned to oversee medical malpractice litigation in the OGC to recommend and implement both tactical and strategic decisions to resolve medical malpractice claims. This requires preparation for and participation in regular meetings with Senior Administration and Faculty for each clinical site for purposes of reporting on and recommending strategies for the handling and resolution of medical malpractice claims and acute events.
- Participates in the investigation, strategic supervision, presentation and negotiation of specific medical malpractice cases.
- Provides periodic presentation of continuing education to insured providers at all clinical sites as well as to internal office staff. Working in partnership with the CMO, Assist Department Chairs and regional CMOs in designing clinical risk management and loss prevention programs within their departments.
- Oversee management of early claims resolution process including all service recovery, appropriate billing write-offs and within delegated authority, settlements of clinical claims, ensuring timely and principled approaches.
- Responsible for and maintains oversight of the data and quality control for the patient safety event reporting system, for Professional and Patient reports, as well as the claims database.
- Directs and oversees the investigation of all events that could lead to financial loss in the area of medical professional liability.
- Under the direction of OGC, answer inquiries of faculty, staff, and administrators regarding emergent patient care issues and loss control with 24 hour on-call coverage.
- Assure compliance with affirmative, diversity and safety programs.
- Successfully manages Administrative Directors for Clinical Risk teams, as well as Departmental Managers for Core Functions, Data and Analytics and Patient Relations.
- Monitors claim activities, daily office workload, grievance responses per CMS regulations and all service recovery solutions. Works with the Claims Manager to evaluate Early Claims Management Program across the Regional Enterprise. Keeps current with new regulatory issues and risk management industry changes.
- Develops annual clinical risk goals with data reporting across the enterprise.
- Actively participates in Health System Committees such as, Corporate Compliance Committee, Patient Safety Committee, Health Information Management, Clinical Care Review Committee, Claims Management Committee, Annual Veritas Board Meeting and other regional Committees.