Incomes looking up, but so are the hours you spend at work
Field still changing rapidly, demands improved skills
Incomes are up slightly for health care risk managers this year, but you may be staying much later at the office. Health care risk management is a rapidly evolving field, the experts say, and you must take the initiative to pursue the right path if your career is going to flourish. The exclusive 2003 Healthcare Risk Management Salary Survey was sent to about 1,200 readers in the June issue. The results were tabulated and analyzed by Thomson American Health Consultants, publisher of HRM. (To see charts outlining the results, click here.)
The median income for health care risk managers in this year’s survey is $70,000, up slightly from the $65,000 reported for the previous three years. In 2000, the median income was $62,500, the same as for 1999. Before that, the median income for directors of risk management was in the high-$50,000 range.
Though the salary figure has increased, respondents still report a median salary increase over the past year of only 1% to 3%, the same as last year. This year, 47% report increases in that range, up from last year’s 40% and 39% the year before. Another 26% report increases of 4% to 6%, down from 34% last year. Fifteen percent report no change in their incomes, compared to 10% last year, and 1% reported a decrease.
You’re still working long hours, maybe even more than last year. Last year, 35% reported that they work 46-50 hours per week, but this year only 26% reported that figure. Last year, 13% reported that they work 51-55 hours per week; but this year, that figure nearly doubled to 23%. Another 13% reported working 56-60 hours a week, and 6% reported working 61-65 hours.
Risk management positions probably aren’t going to be eliminated in any great numbers, but how prominent a role you play in the future is another question, says Jane J. McCaffrey, DFASHRM, MHSA, risk manager at Oconee Memorial Hospital in Seneca, SC, and president of the American Society for Healthcare Risk Management (ASHRM) in Chicago. If you continue with business as usual, she says, don’t expect to see a better income or more prominence in your organization.
Chances are good that your position has changed recently, and it’s likely you’ll see more change in the future, McCaffrey says. Many risk managers have seen a title change, most commonly to chief risk officer or patient safety officer. "They can be just changes in title, but sometimes it’s a substantive change as well," McCaffrey says. "If you become a chief risk officer, you could end up with a real change in duties with more financial responsibility, but sometimes that is more data collection, and the real decision making resides with the chief financial officer."
Higher compensation usually comes to risk managers when they are hired for a global risk management position and given a title such as chief risk officer, as opposed to the more traditional role of risk manager over one facility or organization, she says. "Legal or medical background also results in higher compensation, but the level of responsibility plays a key role also," McCaffrey notes. "Other-wise, most of us are just plodding along with the same salary levels we’ve had for a while. But I don’t see a reduction in positions, so I guess we can be thankful for that."
As for skill sets required by risk managers these days, she says the picture is clear: You must have skills in risk financing and patient safety if you expect to advance your career. Traditionally, the risk manager has been familiar with risk financing but not heavily involved, she says. That should change. "If you’re not the primary risk financing person, you need to make that a goal," McCaffrey says. "You have to get involved with the details of insurance, workers’ comp, fleet coverage and property coverage, and minimizing your premium. It’s an opportunity if you haven’t been doing it."
McCaffrey notes that involvement in risk financing will give you the opportunity to do risk assessments throughout your facility. The insurer may want to know how old your boiler is and what backup systems you have when determining your premium, for instance, and that’s information that should be valuable in any traditional risk assessment.
More involvement in risk financing gives you the opportunity to affect the employer’s bottom line, and that is always good for your career, McCaffrey says. "One of the best measures to the person who writes your paycheck is how much money you’ve been able to save them," she says. "Risk managers can make a good argument that they save money all the time, but the more you can show a direct impact, actual dollars you saved, the better you will fare."
The good news is that risk managers don’t have to pursue entirely new skills or education, McCaffrey says. You might find it necessary to sharpen your skills in some areas, particularly financial skills, but all the new demands and opportunities play off of the same skills that got you where you are today.
That idea is seconded by Monica Berry, BSN, JD, LLM, DFASHRM, CPHRM, regional director of risk management with SSM Health Care of Wisconsin in Madison, and past president of ASHRM. She says risk management is moving toward an "enterprise model," and you have to decide whether you want to come along. "A good number of risk managers are very focused and have interplay with a clinical risk model, but the enterprise model moves us beyond just that clinical perspective," Berry explains. "It takes us into the arena of the technical, the strategic, the human capital, legal, financial and regulatory. Not all risk managers have these skill sets to address these issues they need to appropriately assess the organization’s enterprise exposures."
The enterprise model encapsulates all the trends in risk management that changed your job so much in the past years, but it also promises many more changes, Berry says. The real effect of this approach to risk management is that it makes you more valuable to your employer, she says. But only if you have the skills to pull it off. "I’ve been advising risk managers to take a really hard look at their skill sets and see what you might need in terms of education and new skills," she says. "Look for a mentor in your organization who can provide you that additional education or experience."
For each of those areas in the enterprise model, you might have a different mentor. The chief financial officer might help you gain the right skills in that area, for instance. But that might not always be an option, Berry says. Then you might need to seek a more formal education in that area.
Berry cautions that she sees the potential for budget cuts and the elimination of risk management positions in the near future, so it is imperative to make sure you have skills that are valuable to the organization. Patient safety is one major focus that you can’t afford to ignore, she adds. "If you don’t have the skill sets to respond to patient safety concerns in a meaningful way, you need to jump on that bandwagon right away," Berry says. "We’re going to start seeing a huge focus among risk managers to the patient safety side, moving from a more traditional reactive mode to a more proactive stance."
So what does the future hold? Berry says that all depends on your skills and what you’re doing to improve yourself. If you stick with a traditional, clinically oriented approach to risk management, you’re probably not going to see much opportunity for advancement, she says. "It depends on how far you expand your role," she says. "The compensation should increase as your responsibilities increase, or at least you have a good argument for why it should. But if your duties stay the same while they find someone else to do these things, you can’t expect them to offer you more money."
Incomes are up slightly for health care risk managers this year, but you may be staying much later at the office.
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