• Risk Manager - RN (Registered Nurse)

    Location US-NY-New York
    Posted Date 1 month ago(2/19/2019 4:46 PM)
    Job ID
    # Positions
    205 Lexington Avenue
    Experience (Years)
    Work Days Per Week
    Shift Start Time
    Shift End Time
    # Hours
  • Overview

    Provide leadership, knowledge, and advice. Develop and maintain an effective working relationship with insurance broker, insurance carriers and other business partners to facilitate the highest level of customer service, and prompt action to protect the institutions and their resident, members, patients and staff from fortuitous loss. Work closely with the Vice President of Finance in development and implementation of strategies and policies to reduce general and professional liability claims and lower insurance premium costs in ways which also support our Guiding Values in the treatment of our Care Members.


    Specific Activities

    • Manage claims program, which contains the following components:
    • Reporting procedures
    • System maintenance
    • Detailed claims investigations
    • Confer directly with physicians, employees, broker, insurance carriers and attorneys
    • Direct investigation activities
    • Assist in developing, implementing and monitoring the Patient Safety plan
    • Coordinate all risk management activities with quality management, performance improvement and infection control initiatives
    • Plan for creative ways to assist in enhancing patient safety
    • Monitor internet and professional journals and publications to remain abreast of current projects and initiatives regarding patient safety
    • Lead and monitor root cause analyses at service lines and facilities when indicated.
    • Investigate patient complaints and medical malpractice claims, which includes analyzing incidents to determine potential trends in order to recommend areas of improvement
    • Educate staff on properly filling out incident reports and monitor performance to determine areas of improvement.
    • Work with ArchCare’s broker and insurance company on claims in order to determine areas for improvement.


    Loss Control (Clinical and Non-Clinical)

    • Plan and implement a system-wide program for clinical and non-clinical loss control, including working the Human Resource department to ensure a comprehensive orientation program.
    • Review medical records for liability issues
    • Conduct risk-management training programs
    • Research and report on medical and legal topics pertinent to the organization.
    • Direct and conduct educational sessions on risk management
    • Conduct system analyses to uncover and identify patterns that could result in a compensable event.
    • Develop, implement and manage the event reporting system
    • Research, write and recommend changes to the departmental and facility policies and procedures that affect liability exposures.
    • Provide senior management with summary reports of incidents and claims

    Human Resources

    • Will collaborate closely with Safety and Workers Compensation Manager to ensure safety policies and procedures are consist system-wide.


    Education Requirements

    • Bachelor’s Degree

    Education Desired

    • Master's Degree

    Experience Requirements

    • 5 years’ experience within a role providing general and professional claims management and/or oversight whether in a carrier/claims administrator environment, or employer setting. Experience working closely with managers and staff to ensure effective coordination of claims management strategies. Experience resolving claim issues. General knowledge of general and professional insurance principles, law, regulations and procedures. Knowledge of company and departmental policies and procedures. Experience in root cause analysis and identification of local, system-wide and industry trends.

    Experience Desired

    • Experience in management and/or oversight of general and professional insurance claims and coordination of risk management/safety programs. NY claims experience preferred. Experience in a large unionized health care facility or a multi-divisional health care system is an advantage. Experience in occupational safety matters, OSHA, and injury prevention in a healthcare setting is desirable.

    Skill Requirements

    • Proven ability to maintain the highest level of confidentiality. Ability to work independently, with a strong attention to detail. Exceptional interpersonal and intuitive skills


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