Associate Risk Manager

WellSpan Health
  • PA
    23 days ago

    Job Description

    Duties and Responsibilities

    Essential Functions:

    • Responds to questions concerning risk management and claims that may arise. Conducts and participates in Root Cause Analyses and risk assessments such as PRAs, FMEAs, etc. upon request and as needed.
    • Participates in the WSH Accreditation/Risk Management on-call rotation.
    • Reviews event reports daily. As requested, assists the entity patient safety officer in the event of investigation and in decisions concerning regulatory reporting issues.
    • Conducts educational sessions on risk issues for the various entities as necessary.
    • Investigates allegations of inappropriate treatment/care which results in injury (or alleged injury) to a patient/visitor and determines next steps.
    • Drives proficiencies in claims processes and investigations to reduce litigation costs by tracking, reviewing, and analyzing newly litigated cases. Determines the complexity and value of litigated claims for possible resolution, attending trial as needed. Reviews and analyzes initial case assessment and legal strategy and assists in the development of litigation strategy.
    • Collaborates with leadership to develop reporting metrics (for example, reporting metrics packet) and develops reports and communicates results of current and potential litigation trends to leadership, including, but not limited to, communicating updates such as pre-trial reminders, daily trial updates, and summaries of cases where an increase in indemnity reserves is being requested, as well as any other critical updates.
    • Identifies, gathers, and preserves discovery items, or items requested by defense counsel that will assist with an investigation, related to existing or potential litigation.
    • Manages and oversees outside counsel on litigation, discovery matters, litigation costs, negotiations, and settlement agreements by identifying and assigning counsel to handle claims.
    • Reviews and approves outside counsel invoices to ensure billable hours are appropriate for each case and rejects incorrect invoices and follows up with outside counsel when there are questions with respect to such invoices.
    • Directs the preparation and maintenance of department reports. Prepares periodic reports for top management, as required.
    • Provides management services to the WellSpan reciprocal Risk Retention Group, and coordinates activities of governing board, attorneys, and consultants.

    Common Expectations:

    • Maintains established policies and procedures, objectives, quality assessment, and safety standards.
    • Maintains appropriate records, reports, and files as required.
    • Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.
    • Works collaboratively with Risk Management, Accreditation and Licensure, and key stakeholders to address organization risks.

    Travel Requirements:

    • Estimated Amount: - Some travel required within WellSpan Health geographic service area.

    Numbers & Facts

    LocationPA

    Skills

    • Analysis Skillsunmatched
    • Billingunmatched
    • Claims Processingunmatched
    • Contract Negotiationunmatched
    • Cost Controlunmatched
    • Customer Support/Serviceunmatched
    • Financial Managementunmatched
    • Healthcareunmatched
    • Leadershipunmatched
    • Legalunmatched
    • License Keysunmatched
    • Litigationunmatched
    • Metricsunmatched
    • On Callunmatched
    • Patient Safetyunmatched
    • Policy Developmentunmatched
    • Procedure Developmentunmatched
    • Record Keepingunmatched
    • Regulatory Reportsunmatched
    • Reporting Skillsunmatched
    • Riskunmatched
    • Risk Analysisunmatched
    • Risk Managementunmatched
    • Root Cause Analysisunmatched
    • Safety Standardsunmatched
    • Strategic Planningunmatched
    • Team Playerunmatched
    • Training/Teachingunmatched
    • Willing to Travelunmatched

    Be found by employers

    5,500+ employers search our resume database daily. Add yours to get found by recruiters looking for candidates like you.

    Level up your application

    Professional resume templates

    Browse dozens of recruiter approved resume templates, layouts and formats. Choose your favorite and make it your own in minutes.

    Free resume templates

    Free resume builder

    Improve your existing resume or start from scratch and create a standout, ATS-friendly resume. Add job-specific content, download and apply.

    Free resume builder