AdventHealth University

Manager of Risk Management Operations

AdventHealth University • $83K — $155K *
Littleton, CO 80120In-Person
Healthcare
Less than 5 years of experience
Today
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Job Overview by Ladders

Qualifications

  • Bachelor's degree in a healthcare-related field or equivalent experience
  • 2+ years of experience in Risk Management, Quality, and Patient Safety
  • Knowledge of insurance claims management and hospital-related reporting requirements
  • Experience in medical records and evidence review
  • Preferred: Certified Professional in Healthcare Risk Management (CPHRM)

Responsibilities

  • Support Risk Management and outside attorneys in lawsuits and claims preparation
  • Conduct medical records and HFACS-RCA2 reviews to aid in defense efforts
  • Manage the initiation of claim files and coordinate document collection
  • Collaborate with Risk Management Claims Manager and outside counsel
  • Develop risk reduction strategies and assist in grievance resolution
  • Lead initiatives aimed at reducing claims costs for hospitals
  • Oversee the Risk Management Information System (RMIS) and establish operational guidelines

Benefits

  • Comprehensive health insurance options
  • Retirement plan with employer match
  • Paid time off and holidays
  • Continuing education and professional development opportunities
  • Supportive work environment focused on team collaboration
Full Job Description
Schedule:
Full time

Shift:
Day (United States of America)

Address:
6061 S Willow Dr

City:
Greenwood Village

State:
Colorado

Postal Code:
80111

Job Description:

  • Provides support to AdventHealth Corporate Services Risk Management and outside attorneys for lawsuits, claims and Potential Compensable Events (PCEs) in preparation and ongoing of defense of claims.
  • Performs medical records review, HFACS-RCA2 review and other evidence to support the defense of the organization.
  • Initiates the claim file, secures documents, litigation holds and manages discovery requests, team member interviews, and deposition support.
  • Coordinates efforts between the AdventHealth Corporate Services Risk Management Claims Manager and outside attorneys.
  • Assists in the development of risk reduction strategies for the region including supporting the grievance resolution process to resolve them quickly and effectively.
  • Provides leadership and facilitation to the annual initiatives to reduce claims costs for the hospitals and clinics.
  • Provides local/Regional oversight of the Risk Management Information System (RMIS) establishing guidelines related to standardized scoring of incidents, access to the system and management of departments and reviewers for the region.
  • Provides requested reports and analysis of data.
  • Coordinates with AdventHealth Corporate Services Risk Management to ensure the appropriate procurement and maintenance of insurance coverage for the facilities, clinics and any leases within the region and the issuance of Certificates of Coverage as needed.
  • Assists facilities and clinics in crisis intervention on serious risk incidents providing guidance on immediate, short term and long term interventions to reduce risk.
  • Oversees the monthly claims review meetings, identifying incidents for discussion and identification of PCEs.
  • Provides updates to the Quality teams on open claims and lawsuits for their entity.
  • Provides support to the Director by providing back up to the Patient Safety Evaluation System, ensuring compliance with the PSQIA and protections of Patient Safety Work Product.
  • Provides education on identified topics to team members and leadership across the region to improve awareness of identifies risks.
  • Performs other duties as assigned.

Knowledge, Skills, and Abilities:
  • Knowledge of insurance, workers' compensation, HPL, GL claims management, and state/federal hospital-related reporting requirements. [Required]
    Education:
  • Bachelor's [Required]
    Field of Study:
  • Healthcare related field
    Work Experience:
  • 2+ years of Risk Management, Quality and Patient Safety experience [Required]


Additional Information:
  • An equivalent combination of education and relevant work experience may be considered in lieu of the stated degree requirement:
  • Bachelor's and 2+ years of Risk Management, Quality and Patient Safety experience [Required] OR
  • Associate's and 4+ years of Risk Management, Quality and Patient Safety experience [Required] OR
  • High School Grad and 6+ years of Risk Management, Quality and Patient Safety experience [Required]
    Licenses and Certifications:
  • Certified Professional in Healthcare Risk Management (CPHRM) [Preferred]
    Physical Requirements: (Please click the link below to view work requirements)
    Physical Requirements - https://tinyurl.com/23km2677


Pay Range:

$83,366.40 - $155,084.80

About AdventHealth University

AdventHealth University is a private university in Orlando, Florida. It was founded in 1992 and is affiliated with the Seventh-day Adventist Church. The university offers undergraduate and graduate degree programs in various fields including nursing, radiography, and sonography. AdventHealth University is accredited by the Southern Association of Colleges and Schools Commission on Colleges.
Learn more about AdventHealth University
Size
1,000 employees
Industry
Healthcare
* Ladders Estimates

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