Fraud Risk Manager Jobs in Ohio (NOW HIRING)

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 Apply.