Insurance Risk Manager Jobs in Tennessee (NOW HIRING)

Job Description:
Summary:
The Manager, Risk Management is responsible for facility-wide risk management activities, that include risk management operations, loss prevention including patient safety, claims management, risk financing. The Risk Manager interfaces and assists Legal Counsel with the coordination and investigation of claims against the facility, administering the risk management program on a day-to-day basis, managing, analyzing, and reviewing risk management data with appropriate individuals and committees, coordination of sentinel event/adverse event and root cause analysis activities, reports Unusual Events to the Tennessee Department of Health, coordinates patient safety organization activities, coordinates risk management educational programs, complying with risk management related standards as required by The Joint Commission, CMS, FDA, and other regulatory agencies, assisting with policy and procedure development and review, assists as appropriate with the investigation and resolution of patient/family complaints and grievances, when appropriate notifies the liability carrier of all actual and potential claims, and other duties as assigned. The stress level of this position is relatively high, with the need to balance priorities. The ability to assess situations in an objective and non-judgmental manner is a crucial element of the job. Active participation in and the facilitation of interdepartmental functions are essential to successful performance. This position requires well-developed facilitation skills to promote management, physician and employee support in risk management and quality improvement efforts.
Operations: Develops, coordinates, and administers facility-wide systems for risk identification, investigation, and reduction, performs risk surveys and inspects patient care areas as needed, reviews facility to assess loss potential Participates on committees directed towards promoting patient safety issues. Maintains risk management statistics and files in compliance with the TJC, Department of Health, and Federal agencies. Collects, evaluates, and distributes relevant data regarding patient injuries. Informs Management staff of risk management findings, provides feedback to eliminate risk. Works with Legal Counsel to coordinate the investigation, processing, and defense of claims against the facility. Responds to professional liability and facility questions posed by physicians, nurses, and other personnel. Assists security on procedures to reduce the frequency and/or minimize the severity of property loss or assets. Provides assistance to departments in complying with TJC regarding risk management related standards. Recommends appropriate revisions to new or existing policies and procedures to reduce the frequency of future occurrences; recommends ways to minimize risks through system changes.
Loss Prevention/Patient Safety: Participates in the process of disclosure for medical errors. Analysis of patient safety and medical errors. Coordinates Sentinel Event Committee and Root Cause Analysis investigation and reporting of adverse events to the appropriate individuals. Monthly review hospital acquired conditions reports and validates conditions and takes appropriate action for risk reduction. Responsible for reporting Unusual Events to the Tennessee Department of Health. Maintains awareness of legislative and regulatory activities related to healthcare risk management. Complies with various codes, laws, rules, and regulations. Provides in-service training to team members to enhance their awareness of their role in reducing liability exposures. Participates on select committees related to the provision of patient safety. Notifies biomedical and materials management when notifies of product recalls.
Claims Management: Investigates and analysis actual and potential risks in the facility; assesses liability and probability of legal action for potential notification to insurance carriers. Informs administration of those incidents with claims potential; reports to a higher authority any serious event involving actual or potential injuries to patients or visitors. Assists appropriate management staff in the resolution of patient and/or family grievances.
Risk Financing: Notifies the liability carrier of all actual and potential claims. When necessary may act as a liaison with the insurance carrier; assists with surveys when needed. Provides insurance information to outside agencies. The stress level of this position is relatively high, with the need to balance priorties. The ability to assess situations in an objective and non-judgmental manner is a crucial element of the job. Active participation in and the facilitation of interdepartmental functions are essential to successful performance. This position requires well-developed facilitation skills to promote management, physician and employee support in risk management and quality improvement efforts.
Requirements:
Bachelor's degree in a health related field is preferred. A minimum of five years experience in a hospital setting is required, with a minimum of three years experience at a supervisory level. Supervisory experience should include hands on involvement with Human Resource management, goal setting, project management, and continuous quality improvement efforts. Strong management skills are needed in order to effectively plan and coordinate activities to be accomplished by others. Excellent verbal and written communication skills are essential for this position in performance standards to effectively carry out key education and communication functions. Formal presentation skills and experience are needed. Demonstrated excellent interpersonal skills and the ability to balance multiple priorities at once are essential for successful performance.
Work Requirements:
Shift: Day
On Call: No
Weekends: No
Travel Required: No Travel
Shift Details: Day
City/State: Johnson City, TN
Location:
Johnson City Medical Center