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Coordinator Claims Risk Management Jobs in Michigan

The Risk & Claims Manager is the person who ensures that every F&B team member with an active ... management system. * Coordinates with the workers' compensation carrier or TPA on claim status ...

The Risk & Claims Manager is the person who ensures that every F&B team member with an active ... management system. * Coordinates with the workers' compensation carrier or TPA on claim status ...

The Risk & Claims Manager is the person who ensures that every F&B team member with an active ... management system. * Coordinates with the workers' compensation carrier or TPA on claim status ...

The Risk & Claims Manager is the person who ensures that every F&B team member with an active ... management system. * Coordinates with the workers' compensation carrier or TPA on claim status ...

The Risk & Claims Manager is the person who ensures that every F&B team member with an active ... management system. * Coordinates with the workers' compensation carrier or TPA on claim status ...

Works collaboratively with stakeholders in the management of claims * Coordinates with attorneys ... in Risk/Patient Safety Required Certifications/Licensure: NA Required Course(s) Training: NA ...

Coordinates and directs internal/external audits. * Creates and fosters an environment that ... What we're looking for Risk Management Director: * Education: Bachelor's Degree in related field ...

Coordinates and directs internal/external audits. * Creates and fosters an environment that ... What we're looking for Risk Management Director: * Education: Bachelor's Degree in related field ...

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Coordinator Claims Risk Management information

What cities in Michigan are hiring for Coordinator Claims Risk Management jobs?

Cities in Michigan with the most Coordinator Claims Risk Management job openings:

Risk Management Director (Quality), Full Time

Holland, MI • On-site

Full-time

Posted 6 days ago


Holland Hospital rating

6.5

Company rating: 6.5 out of 10

Based on 33 frontline employees who took The Breakroom Quiz


Job description

CURRENT HOLLAND HOSPITAL EMPLOYEES- Please apply through Find Jobs from your Workday employee account.

Working under the supervision of the Senior Vice President for Nursing Services, Risk Management, and Quality, provide strategic development, oversight, and management of the organization's Enterprise Risk Management Program and risk portfolio. Maintain extensive knowledge of healthcare risk management, compliance, legal, and regulatory/accreditation principles and trends; risk assessment methodologies; excellent leadership skills; and the ability to develop, implement, and measure effective risk management strategies.
Minimum Required
BA or BS in risk management, healthcare administration, or a related field
Preferred
Masters degree or Juris doctorate degree
EXPERIENCE
Minimum Required
Proven experience (10 years) in a senior health care risk management role
In-depth knowledge of Enterprise Risk Management (ERM) domains and risk management principles, methodologies, and best practices
Strong analytics skills and the ability to assess complex risk scenarios and make data-driven, risk-stratified decisions
Demonstrated experience in developing and implementing risk management frameworks, policies and procedures, and Internal Audit programs
Strong knowledge of health care-related regulatory, accreditation, and legal standards (CMS, DNV/ISO, OSHA, OCR, OIG, etc.)
Proficiency in risk management software systems and tools
Extensive experience with insurance program management & professional liability claims management
Excellent leadership, communication, and interpersonal skills, with the ability to effectively collaborate and influence stakeholders at all levels within the organization as well as external stakeholders
Proven change management skills
Ability to thrive in a fast-paced environment and effectively manage multiple priorities and deadlines
Strong problem-solving skills and the ability to think strategically while also managing fine detail

Strategic development, oversight, and management of the system-wide Enterprise Risk Management (ERM)/Patient Safety Programs, to include the following

A. ERM Program Management

  • Lead the organization in identifying and conducting risk assessments & Root Cause Analyses and identifying potential risks and vulnerabilities
  • Collaborate with organizational leadership and senior management to develop risk mitigation strategies, corrective action plans, and monitoring strategies
  • Establish key ERM risk indicators and develop systems to monitor and report on risk exposure, industry trends, and internal & external stakeholder requirements
  • Stay abreast of industry trends, regulatory developments, and emerging risks to ensure the system remains compliant and proactive in managing risks
  • Provide consultation, guidance, and support to leadership, medical staff, and organizational staff in implementing risk management best practices and ensuring adherence to policies and procedures
  • Act as a liaison with external stakeholders, including regulatory agencies, auditors, insurers, and other third parties, to ensure compliance and effective risk management
  • Lead the adverse event and crisis management efforts, including coordinating responses to adverse events and managing communication with stakeholders
  • Continuously evaluate and enhance the system's risk management framework and processes to adapt to changing healthcare, business, and patient safety needs as well as risk landscapes
  • In conjunction with Quality Leadership, strategically manage the system-wide Quality Management System (QMS)
  • Function as key liaison with organizational legal counsel
  • Lead system-wide functional committees (Cyber Security, EMTALA, etc.)

B. Claims Management

  • Establishment of risk reserves & oversight of risk retention/transfer recommendations
  • Coordination and defense/settlement of insurance claims, to include professional liability & general liability claims
  • Coordinate activities of system-wide Claims Committee

C. Insurance Program Management

  • Provide strategic direction to system with regard to insurance portfolio (policy acquisition, claims management)

D. System-wide Education, Training, and Policy Development

  • Develop and implement ERM-based policies, procedures, and protocols to identify, assess, mitigate, and monitor risks across the system
  • Develop and deliver ERM-based training programs to enhance risk awareness and competency across the system

Strategic Development, Oversight, and Management of the System-Wide Patient Relations (Grievance) and Recipient Rights Functions

  • Oversee compliance with accreditation, regulatory, and legal requirements relative to system-wide grievance process and Michigan Mental Health Code-driven Recipient Rights programs

Oversight and Management of the System-wide Regulatory Affairs/Accreditation and Environment of Care (environmental) Safety Functions

  • Ensure compliance with regulatory and legal expectations, including CMS, DNV, ISO, FDA, OSHA, Safe Medical Device Act, etc.
  • Oversee accreditation and continuous readiness activities in support of accreditation/regulatory compliance
  • Oversee Environment of Care (EOC) functions (including educational programming & initiatives)

Holland Hospital is an Equal Opportunity Employer, please see our EEO policy


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