Healthcare Risk Management Analyst

District Medical Group • Phoenix, AZ

1d

About The Position

The Risk Management Analyst assists the Chief Risk Officer (CRO) with the development, implementation, coordination, maintenance, analysis, and monitoring of multiple activities within the Risk Management department.

Requirements

• Bachelor’s degree required
• 3+ years total healthcare risk management and/or insurance and MPL claims experience required

Nice To Haves

• Degree related to health sciences or the role of risk analyst preferred
• ARM, CPHRM, or similar certification in Risk Management preferred; required within two years of employment

Responsibilities

• Assists CRO with intake of legal matters (i.e., potential claims, lawsuits, board matters, fact witness testimony, etc.), assignment of outside legal counsel, oversight of civil and criminal case reviews, and coordinates and attends depositions and trials
• Attends and/or participates in confidential discussions with Associate General Counsel, General Counsel, the Third-Party Administrator (TPA), and other expert legal representatives in the defense of claims and settlement strategy.
• Assists with investigation of potential professional liability claims or risks pertaining to patient matters from DMG providers.
• Analyzes investigation results to assist the department with establishing a preliminary assessment of liability and recommends action plan (within scope of position and knowledge).
• Summarizes confidential discussions and findings in attorney-client privilege memos and documents in appropriate risk or claim files.
• Assists DMG employees with potential risks and recommends appropriate response and action plan (within scope of position and knowledge) to mitigate risks.
• Prepares summaries of information collected and provided.
• Ensures claim-specific and investigative information is accurately and efficiently maintained in the claim files.
• Serves as Risk Management Information System Administrator.
• Makes recommendations to the CRO about the management of claims and other liability situations based upon investigations carried out.
• Assists with the DMG Insurance Captive (DMGIC) activities, attending board meetings, developing and presenting the five-year premium comparisons for the DMGIC.
• Assists with updating and maintaining the DMGIC operations manual as needed and provides DMGIC invoices to captive manager for inclusion in the captive financials.
• Leads the Risk Management Committee meeting coordination and related materials (i.e., developing agenda/other meeting content, and reporting needs).
• Actively participates in claim discussions and strategy with the committee, legal counsel, TPA and CRO.
• Processes credential requests for provider claim loss history by reviewing and identifying claim history on the loss run reports.
• Requests credential summaries from legal partners when needed.
• Lead for subpoena management, processing subpoenas and other legal requests that are served other than through CT Corp, assigning them to the appropriate DMG department partners to respond.
• Develops and provides educational programs, policies, procedures, and training in risk prevention and risk control.
• Participates in discussions with insurance partners (i.e., carrier, broker, captive manager, actuary, DMG leadership) and assists with analyzing the insurance needs of the organization to provide optimal coverage.
• Gathers information for renewal of insurance policies and prepares renewal applications for submission to the broker/carrier.
• Collaborates with DMG partners to coordinate and obtain needed data/documents to include with application completion and submission.
• Participates in insurance and loss run audits and other interviews with outside insurance partners (i.e., external auditors, potential carriers/underwriters).
• Assists with collecting and analyzing data from multiple sources such as audits, claims, renewals, and financial reporting to demonstrate the performance of the Risk Management program.
• Participates in investigations, evaluations, claim reporting, and management of insurance claims (i.e., property, cyber, general liability, etc.).
• Makes recommendations to the CRO about the management of claims and other liability situations based upon investigation findings or outcomes.
• Process DMG, DMGIC, and Employee Health invoices for payment, captive approval, and to request inclusion on the loss runs (as applicable).
• Tracks and maintains detailed financial files related to legal case expenditures.
• Participates and represents the Risk Management department in assigned DMG committees.
• Provides administrative support to the Risk Management department.
• Compiles data into reports as directed.
• Initiates requests for office supplies, materials, and repairs as needed.
• Other duties as assigned.

Benefits

• A strong Healthcare benefits package inclusive of Medical, Dental and Vision– Employee eligibility effective DAY ONE
• A rich 401(k) with employer match, increasing annually up to 6%
• Flexible Spending Account plan
• Generous Paid Time Off plan (3 weeks year one)
• 10 paid holidays annually
• Paid Sick Time and more

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 501-1,000 employees