Risk Manager
Remote Worker - N/A
Job Type
Full-time
Description

This is a remote position.


GENERAL SUMMARY 


The Risk Manager plays a crucial role in ensuring patient and employee safety, minimizing liability, and maintaining operational efficiency. The Risk Manager is responsible for insurance company reporting and oversight, loss prevention, and claims management, amongst other duties as assigned.   



Requirements

ESSENTIAL JOB FUNCTION/COMPETENCIES 

The responsibilities and duties described in this job description are intended to provide a general overview of the position. Duties may vary depending on the specific needs of the affiliate or location you are working at and/or state requirements. Responsibilities include but are not limited to:


  • Develop Enterprise loss prevention and control policies.
  • Design and implement comprehensive risk management plans and safety protocols.
  • Analyze and identify potential risks within Enterprise to ensure patient safety and minimize liability.
  • Negotiate, approve and manage Property and Casualty Insurance for the Enterprise. This includes but is not limited to medical malpractice actions, directors and officers lawsuits, property claims, general liability, auto, umbrella, and cyber liability incidents. Oversee and approve settlements and negotiate claims resolution with carriers. Manage relationships with insurance brokers, Property and Casualty underwriting community, and other third-party administrators. Maintain a database of all insurance policies, certificates of insurance, claims history, and ensure timely renewal.
  • Chair the Enterprise Claims Committee.
  • Oversee the finances over the Captive Insurance Company including forecasting, development and ongoing management of invest plan, dividends, an inter-company loan programs. Create and maintain the Captive’s Business Plan and provide updates to regulatory authorities on changes as needed.
  • Perform regular audits of Enterprise and procedures to identify areas for improvement. Conduct annual carrier exposure true up s and confirm additional premiums due.
  • Train staff on risk management and safety procedures to ensure compliance with all healthcare regulations, laws, and standards.
  • Coordinate and oversee investigations into incidents that could result in exposure to liability.
  • Ensure the Enterprise complies with all relevant healthcare regulations, laws, and standards, including but not limited to ADA and OSHA compliance.
  • Prepare reports and statistical data for Enterprise leadership on risk management issues and strategies, monthly claims reporting, and annual regulatory filings.
  • Work closely with legal, compliance, procurement, insurance professionals, on risk-related matters; provide ongoing risk management support and assistance as needed.
  • Serve as the primary point of contact for brokers, facilitating communication and addressing inquiries related to Workers' Compensation.
  • Manage binders for caption policies and ensure proof of coverage is provided as needed.
  • Oversee and manage all legal matters related to Workers' Compensation, including handling lawsuits and coordinating with legal teams to ensure proper resolution.
  • Address and respond to Workers' Compensation-related requests, providing necessary guidance and resolution in a timely manner.
  • Oversee the Workers' Compensation annual audit and assist in situational audits, ensuring compliance with regulatory standards and best practices in collaboration with Human Resources (HR).
  • Provide guidance on ensuring proper coding of Workers' Compensation codes in payroll, ensuring compliance with state regulations.
  • Assist with the day-to-day operations of Workers' Compensation, collaborating with HR to address any issues that arise, ensuring smooth management of claims and compliance.
  • Assist Human Resources with the communication and coordination of contact information for new affiliates joining the Workers' Compensation program.
  • Collaborate with Human Resources to facilitate and monitor Treo portal access for claims and reporting, ensuring accurate and timely updates are available for all relevant stakeholders.
  • Performs other position related duties as assigned.
  • Employees shall adhere to high standards of ethical conduct and will comply with and assist in complying with all applicable laws and regulations. This will include and not be limited to following the Solaris Health Code of Conduct and all Solaris Health and Affiliated Practice policies and procedures; maintaining the confidentiality of patients' protected health information in compliance with the Health Insurance Portability and Accountability Act (HIPAA); immediately reporting any suspected concerns and/or violations to a supervisor and/or the Compliance Department; and the timely completion the Annual Compliance Training.


CERTIFICATIONS, LICENSURES OR REGISTRY REQUIREMENTS


  • Insurance Producer License and ARM, CRM, or CPCU.


KNOWLEDGE | SKILLS | ABILITIES


  • Strong leadership, interpersonal, analytical, and technical skills. Proficiency in RMIS systems.
  • Thorough understanding of healthcare regulations, standards, risk management principles, insurance and reporting requirements.
  • Knowledge of commercial insurance programs, self-insured funding, retention structures.
  • Excellent verbal and written communication skills.
  • Excellent organizational skills and attention to detail.
  • Ability to work independently and manage deadlines.
  • A demonstrated understanding of compliance programmatic elements and best practices.
  • Skill in using computer programs and applications including Microsoft Office.


EDUCATION REQUIREMENTS


  • A Bachelor's degree in risk management, healthcare administration, business administration, accounting, or finance, or a related field required; Master's degree preferred.


EXPERIENCE REQUIREMENTS


  • 10+ years of previous experience in healthcare risk management or a related field. Has deep knowledge of commercial insurance programs, self-insured funding, retention structures.


REQUIRED TRAVEL


  • N/A


PHYSICAL DEMANDS


Carrying Weight Frequency

1-25 lbs. Frequent from 34% to 66%

26-50 lbs. Occasionally from 2% to 33%

Pushing/Pulling Frequency

1-25 lbs. Seldom, up to 2%

100 + lbs. Seldom, up to 2%

Lifting - Height, Weight Frequency

Floor to Chest, 1 -25 lbs. Occasional: from 2% to 33%

Floor to Chest, 26-50 lbs. Seldom: up to 2%

Floor to Waist, 1-25 lbs. Occasional: from 2% to 33%

Floor to Waist, 26-50 lbs. Seldom: up to 2%