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Claims Risk Manager Jobs in Ohio (NOW HIRING)

Rumpke

Risk and Claims Manager

Cincinnati, OH · On-site

The Risk and Claims Manager is responsible for the oversight and activities of a team of claims professionals in our Loss Control department. This position will also be responsible for monitoring and ...

HR4Me

Risk Analyst

Cincinnati, OH · On-site

Support claims management, documentation, and resolution * Assist with renewals and insurer submissions Financial & Operational Risk Analysis * Analyze project financial data to identify cost, margin ...

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Claims Risk Manager information

How does a Claims Risk Manager typically collaborate with other departments to minimize organizational risk?

A Claims Risk Manager works closely with departments such as underwriting, legal, compliance, and operations to identify potential risk exposures and implement effective mitigation strategies. They often participate in cross-functional meetings to review claims trends, share insights, and develop risk management policies. This collaborative approach ensures that the organization proactively addresses risks, maintains regulatory compliance, and continually improves claims processes for better outcomes.

What is the difference between Claims Risk Manager vs Claims Adjuster?

AspectClaims Risk ManagerClaims Adjuster
CredentialsTypically requires a bachelor’s degree in risk management, insurance, or related field; certifications like CPCU or ARM are commonRequires a high school diploma or bachelor’s degree; insurance licenses may be needed depending on state
Work EnvironmentOffice-based, strategic planning, risk assessment, policy developmentField or office-based, investigating claims, assessing damages, negotiating settlements
Industry UsageUsed across insurance companies, risk management firms, and large corporationsPrimarily in insurance companies, adjusting claims for auto, property, or health insurance

The Claims Risk Manager focuses on identifying and mitigating risks related to claims, developing policies, and overseeing risk strategies. In contrast, a Claims Adjuster handles the day-to-day investigation and settlement of individual claims. Both roles are essential in the insurance industry but differ in scope and responsibilities.

What are the key skills and qualifications needed to thrive as a Claims Risk Manager, and why are they important?

To thrive as a Claims Risk Manager, you need expertise in insurance claims processes, risk assessment, and regulatory compliance, typically backed by a bachelor’s degree in a relevant field and experience in claims management. Familiarity with claims management systems, risk modeling software, and certifications such as CPCU (Chartered Property Casualty Underwriter) or ARM (Associate in Risk Management) are often required. Strong analytical thinking, attention to detail, and effective communication skills help you investigate claims and collaborate with stakeholders. These skills enable accurate risk evaluation, minimize losses, and ensure the organization’s compliance and financial stability.

What does a Claims Risk Manager do?

A Claims Risk Manager is responsible for identifying, assessing, and managing risks associated with insurance claims within an organization. They analyze claims data to detect patterns, prevent fraudulent activity, and develop strategies to minimize financial losses. Additionally, they work closely with claims adjusters, legal teams, and other departments to ensure compliance with regulations and to optimize claims processes. Their goal is to protect the company from unnecessary losses while ensuring legitimate claims are handled efficiently.
What are popular job titles related to Claims Risk Manager jobs in Ohio? For Claims Risk Manager jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Claims Risk Manager jobs in Ohio look for? The top searched job categories for Claims Risk Manager jobs in Ohio are:
What cities in Ohio are hiring for Claims Risk Manager jobs? Cities in Ohio with the most Claims Risk Manager job openings:
Claims Risk Manager jobs near you
Assistant General Counsel - Claims, Risk Management, and Insurance

Assistant General Counsel - Claims, Risk Management, and Insurance

UC Health

West Chester, OH • On-site

Full-time

Posted 19 days ago

UC Health (Cincinnati) rating

6.8

Company rating: 6.8 out of 10

Based on 146 frontline employees who took The Breakroom Quiz

493rd of 890 rated healthcare providers

Job description

Job Description
At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering.
As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors.
UC Health is an Equal Opportunity Employer.
The Assistant General Counsel, Claims, Risk Management, and Insurance (AGC-RMCI) serves as counsel supporting the Director of Risk Management in claims, risk management and insurance functions. The AGC-RMCI will work closely with corporate risk management, clinical quality, and safety teams across the organization to (i) identify potential areas of risk and exposure related to legal claims and (ii) to coordinate the effective mitigation or elimination of such risks, (iii) manage litigation, (iv) analyze insurance policies to determine proper coverage and (v) provide education/training programs on relevant risk management topics across the organization. The AGC-RMCI will also work closely with the Enterprise Risk Management team on activities as directed by the Vice President of Audit & Compliance.
Responsibilities
Litigation/Claims Management
  • Managing all aspects of company claims function, including but not limited to overseeing the reporting of claims to the appropriate carrier for other insurance lines.
  • Reporting and liaising with key stakeholders (internal and external) on litigation/claims issues.
  • Proactively monitoring claims and providing support for the strategy for defending claims.
  • Developing, updating, and maintaining internal policies and procedures for the claims function.

Risk Management
  • Managing legal aspects of risk management functions, including establishing training programs for clinical staff in preventing adverse outcomes, limiting potential liability, and managing/mitigating risk.
  • Monitoring and making legal recommendations for improvements in patient care and safety.
  • Creating, updating, and maintaining legal protocols for the handling of adverse events.
  • Communicating effectively with stakeholders upon the occurrence of an adverse event.
  • Supporting the Director of Risk Management in insurance procurement activities.
  • As appropriate and as assigned, supervising risk managers and other support staff.
  • Overseeing the delivery of risk management services and resources to accomplish company goals, strategies, and priorities, including coordinating with outside counsel and other advisors.
  • Other duties as assigned by leadership in the Office of General Counsel.

Enterprise Risk Management & Audit
  • As directed by the Vice President of Audit & Compliance, facilitate risk assessments with departments across the organization to identify threats and vulnerabilities that could adversely impact the organization.
  • Maintain a central record of organizational risks, including risk descriptions, likelihood, potential impact and mitigation strategies.
  • Work with leaders and other key stakeholders to develop and track corrective action or mitigation plans for identified risk.
  • Prepare risk reports as requested to leadership, including but not limited to the Audit & Compliance committee.
  • Ensure enterprise risk management activities aligns with corporate risk management activities in furtherance of organizational goals and strategic objectives.
  • Conduct targeted reviews in areas susceptible to fraud, waste or abuse.
  • Other duties as assigned by leadership in the department of Audit and Compliance.

Qualifications
  • Juris Doctorate Degree (JD) from an accredited law school required
  • Bachelor's Degree in Nursing or another clinical area required
  • Licensed to practice law in Ohio required
  • Minimum five (5) years of law practice required
  • Ability to travel to depositions, witness interviews, and attend trials, as necessary
  • Experience working as a clinician and/or risk manager preferred
  • Excellent communication and interpersonal skills, with the ability to interact effectively with all levels of the organization and external parties

What UC Health (Cincinnati) employees say

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About UC Health

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We believe in something different: a focus on the individuality of every person. In big ways and small, we exist to improve the extraordinary lives of all those we serve. As Colorado's largest and most innovative health care system, we as a team deliver on the commitment to provide the best possible experience for our patients and their families. We foster a true human connection and give people the freedom to live extraordinary lives. A career at UCHealth is more than a job, it's a passion.

Company size

10,000+ Employees

Headquarters location

Cincinnati, OH, US

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