Insurance Risk Manager Jobs in West Virginia (NOW HIRING)

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Assists leadership in development and implementation of strategies for enterprise-wide risk management and performance improvement. Assists in developing, coordinating and administering systems for risk identification, investigation, and reduction. Collaborate with Quality/Patient Safety and healthcare teams as appropriate to develop, implement, monitor, and evaluate the health systems Event Reporting System.
MINIMUM QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. Bachelor's degree.
EXPERIENCE:
1. Seven (7) years of experience in a healthcare setting.
2. Three (3) years of experience directly working for or with professional liability insurance carriers or captives.
3. Five (5) years of experience in claims and related legal proceedings.
PREFERRED QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. Master's degree in nursing or medical-related field.
2. Certified Professional in Health Care Risk Management (CPHRM).
EXPERIENCE:
1. Five (5) years of experience directly working for or with professional liability insurance carriers or captives.
CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.
1. Provides support to leadership, including development of system reports within the Incident Reporting System. Continuously monitors reported events and near misses, follows up with Risk Managers, and escalates events, as necessary to leadership.
2. Is responsible for data management, investigation & reporting. Supports the education components of the Risk Management Program. Promotes the organizations patient safety initiatives
3. Navigates system wide modules for risk identification, investigation, and reduction
4. Conducts case findings by daily review of reported events and other information retrieved from other sources (verbal report, phone report, electronic submissions) and initiates appropriate follow-up
5. Demonstrates strong ability to identify, analyze, and solve problems
6. Competent in data display and analysis
7. Assists in coordinating intervention and education related to risk management issues to promote safe work practices and quality care and services.
8. Proactively manages assigned risk management program on a day -to day basis through the analysis of patient safety and medication error processes.
9. Assists in the investigation and analysis of root causes, patterns, or trends that could result in compensatory or sentinel events. Trends RCA Themes, patterns; identifies/articulates opportunities for improvement to proactively manage Risk Management Program across the health system or at local entity.
10. Assesses risks and individual adverse occurrences and near misses. Provides assistance with investigation and oversight of significant adverse events that occur in the clinical setting and result in patient harm.
11. Actively participate in, or facilities, committees related to clinical risk management, patient safety, and quality improvement. May oversee and manage patient grievance process.
PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
1. Must have manual dexterity to operate keyboards, telephones and other business equipment
2. Must have reading and comprehension ability and visual acuity must be within normal range
3. Ability to sit for extended periods of time
4. Long periods of standing or walking may be necessary
5. Some travel to other WVUHS hospital/entity locations
WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. General office-like setting, with occasional travel required to other WVUHS facilities in West Virginia and the surrounding region.
SKILLS AND ABILITIES:
1. Skilled in analyzing data to identify risks, gaps, root causes, patterns, or trends.
2. Skilled in communication and collaboration.
3. Presentation skills.
Additional Job Description:
Scheduled Weekly Hours:
40
Shift:
Exempt/Non-Exempt:
United States of America (Exempt)
Company:
STJ St. Joseph's Hospital
Cost Center:
405 STJ Quality Management
Address:
1 Amalia Drive
Buckhannon
West Virginia
Equal Opportunity Employer
West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.