Clinical Risk Management Manager

Foundation Risk Partners•Edison, NJ

9h•Onsite

About The Position

Foundation Risk Partners, one of the fastest growing insurance brokerage and consulting firms in the US, is adding a Clinical Risk Management Manager to their Cornell Insurance Services team in the Edison, NJ office. The Clinical Risk Management Manager is focused on identifying, assessing, and mitigating clinical risks for healthcare providers within an insurance brokerage firm, utilizing their medical expertise to analyze potential claims, advise clients on risk reduction strategies, and work with underwriters to secure appropriate coverage based on clinical risk factors.

Requirements

Registered Nurse (RN), Physician Assistant (PA), or other relevant healthcare professional license with significant clinical experience.
Understanding of risk management principles, including risk identification, assessment, mitigation, and transfer.
Ability to analyze complex medical data and identify potential risk factors.
Effective communication skills to interact with healthcare providers, underwriters, and clients, explaining complex clinical issues in a clear and concise manner.
Ability to identify root causes of clinical incidents and develop practical solutions to mitigate risk.
Bachelor’s degree in Nursing, or other health related science
RN, NP or P.A. or allied health professional licensure

Nice To Haves

Master's preferred
3-5 years Risk Management experience preferred
Skilled Nursing Facility experience preferred in the geriatric field
CPHRM preferred

Responsibilities

Review medical records, incident reports, and claims data to identify potential clinical risks associated with patient care, including medication errors, standard of care compliance risks, and diagnostic errors.
Detect and manage risk exposure
Maintain and update an organization's policies
Improve documentation practices
Seek ways to reduce the legal exposure of the organization
Create and maintain risk audit databases
Identify for clients’ ways to take the steps needed to prevent data breaches
Investigate any events that result in death or injuries
Analyze clinical data to identify trends and patterns of risk within a healthcare provider's practice, allowing for proactive risk mitigation strategies.
Advise clients on clinical best practices, quality improvement initiatives, and risk reduction strategies to minimize potential claims.
Evaluate clinical aspects of claims, including medical necessity and appropriateness of treatment, to identify areas for improvement and potential cost savings.
Collaborate with underwriters to assess clinical risk profiles of healthcare providers, informing coverage recommendations and premium calculations.
Develop and deliver clinical risk management training programs for healthcare providers, including staff on topics like informed consent, documentation best practices, and patient safety.
Stay updated on relevant healthcare regulations and industry standards to ensure clients are adhering to appropriate clinical risk management practices.