Hours of Work :8 a.m. to 5 p.m.
Days Of Week :Monday through Friday
Work Shift :Job Description :Summary. The Corporate Risk Manager will directly report to the AVP, Corporate Risk Management, will work in a collaborative and aligned manner with the Claims Manager and the attorneys in the Office of Legal Affairs, and will ultimately function under the direction and supervision of the Chief Legal Officer.
The Corporate Risk Manager role directly supports the Corporate Risk Management, claims and insurance functions for the enterprise and assists in the overall operations of the Office of Legal Affairs. The Corporate Risk Manager will be responsible to attend internal and external meetings, depositions and trials within the Dallas-Fort Worth Metropolitan area as well as at MHS's owned and/or operated facilities. The Corporate Risk Manager also supports the risk finance function at the request of the AVP, Corporate Risk Management. Under the supervision of the AVP, Corporate Risk Management, the Corporate Risk Manager will collaborate with the patient safety arm of the organization.
The Corporate Risk Manager will be expected to have a strong foundation in Risk Management principles. Insurance and claims management experience in a healthcare setting is preferred, along with a strong desire to acquire new knowledge. An in-depth knowledge of medico-legal terminology is preferred. A strong desire to expand their knowledge base to positively contribute to a strong, expert, and cohesive group is important. The Corporate Risk Manager will be required to use the Claims Management Systems, expense/billing and contract management systems, and their Microsoft Office skills to elevate the level of service the Office of Legal Affairs provides to the enterprise. Exceptional oral and written communication skills are required to support the department's mission and goals along with being detail oriented, logical, and an ability to methodically approach problem solving.
Job Specific and Unique Knowledge, Skills and Abilities:• Obtains (e.g., from Verge reports), organizes and evaluates potential claims events, including medical professional liability, employment liability, and general liability
• At the request of hospital and medical group risk managers, assists with patient complaints and grievances
• Responsible for effective and efficient hospital and medical group Bordereaus, including analyzing information obtained and strategizing as to risk management
• Responsible for the logging and the completeness of potential claims event files in RiskConnect
• Required to be a super user of the RiskConnect application and adept at generating reports, such as monthly loss runs
• Supports the Claims Manager as needed in:
o Investigating and evaluating complex medical professional liability, general liability, auto, property, and other liability claims while keeping the department leader apprised
o Interviewing medical providers, staff, witnesses, and other parties to obtain information used to assess liability exposure
o Participating in enterprise-wide organizational committees as requested by the AVP, Corporate Risk Management, including RCAs and performance improvement initiatives
o Conducting post-claim and post-settlement debriefing with department leaders and preparing after action reports to the Clinical Effectiveness & Patient Safety and medical group leaders
• At the request of hospital risk managers, and in collaboration with the Assistant General Counsel, Hospital Operations, provides support in certain governmental investigations and responses
• With attorneys in the Office of Legal Affairs, coordinates with external stakeholders, i.e. Prosecutor's Office, law enforcement agencies, Texas Medical Board actions, etc. in non-litigation requests for staff interviews and/or testimony
• Assists in responding to 3rd party non-litigation subpoenas, requests for information and or production of documents
• Has primary responsibility for analyzing, submitting to insurance carriers, administrating, and obtaining reimbursement for first party claims and losses, e.g., property losses
• Conducts non-litigation post-claim and post-settlement debriefing with department leaders and prepares after action reports regarding first party claims and losses
• Under the supervision of the Assistant General Counsel, Hospital Operations, leads policy development and review in accordance with MHS policy, especially Corporate Risk Management policies
• Monitors external stakeholder performance, i.e. defense counsel, insurance coordinators, agent/brokers and reports performance issues to department leaders
• Assists in problem-solving discussions with administrators, physicians, managers and clinical risk managers throughout the enterprise
• Explores, identifies, and leads Corporate Risk Management strategic improvements and initiatives
Minimum Job Qualifications:- Bachelor's Degree in Nursing preferred. Healthcare related field will be considered when paired with experience. Master's degree highly desirable
- 5 years clinical experience (Required)
- Minimum 3 years Risk Management experience or 2 - 3 years healthcare administration-hospital operations (preferred)
- Certified Professional in Healthcare Risk Management (CPHRM), Associate in Risk Management (ARM) preferred. Alternatively, must be willing to obtain certification within 6 months of eligibility
- Minimum 4 years of claims experience (medical malpractice preferred), insurance, or health care risk management insurance experience (preferred)
- Knowledge of medical, legal, and insurance terminology required
- Excellent assessment, communication, organization and teaching skills
