Insurance Risk Manager Jobs in Springfield, VA (NOW HIRING)

Risk Manager

Job Code: RM1505

ABOUT US

We are ushering in a new era of healthcare where achieving good health is just the beginning. At UVA Community Health, part of the world-class UVA Health academic health system, we are committed to caring for the whole person by building meaningful connections with our patients in the local setting of UVA Health's community hospitals, outpatient locations, and provider offices. By combining our team's talent and expertise, the breadth of capabilities across the entire UVA Health system, and our dedication to community wellness, we are bringing expert care close to home.

 As a member of the UVA Community Health team, individuals contribute to patient care decisions, support advanced medical technologies, and experience the satisfaction of making a difference in people's lives every day.

JOB TYPE

Classification: Exempt

Supervises Positions: No

JOB SUMMARY

The Risk Manager is responsible for providing proactive identification, assessment, mitigation, and monitoring of risks across UVA Community Health. The Risk Manager partners with stakeholders across functions to proactively identify risks, escalate identified risks, and develop and support implementation of risk mitigation strategies. Additionally, the Risk Manager supports risk initiatives and strategy across UVA Community Health through education and other program development. The Risk Manager reports directly to the Director, Risk Management and Insurance Operations. 

Responsibilities and Duties

• Provides risk management services to UVA Community Health facilities, team members, and functions as assigned; 
• Identifies risks proactively and conducts risk assessments and analyses, incident investigations, and other root cause analyses, while escalating identified risks appropriately;
• Uses incident, complaint, and claims-related information to identify trends and support risk mitigation efforts;
• Develops and provides education on various risk-related topics and trends to various stakeholders across UVA Community Health; 
• Develops risk workflows and process standardization efforts across UVA Community Health;
• Collaborates and works with representatives from various departments to address identified risks and develop risk mitigation and management strategies; 
• Supports claims reporting to ensure timely reporting of potential or pending claims to insurance carriers;
• Supports claims defense as assigned, including by interfacing with external and internal legal counsel and insurance claims representatives;
• Drafts and reviews policies, processes, and procedures that support risk mitigation and strategy;
• Maintains collaborative and cooperative relationships among UVA Community Health, UVA Health, and related entities; 
• Participates in professional development activities and maintains professional affiliations;
• Completes other projects and tasks as assigned by the Director of Risk Management and Insurance Operations.

Competencies:

• Demonstrates critical thinking and problem-solving skills.
• Breaks down problems and issues into sub-components and assesses the benefits and risks of various options and identifies recurring patterns, trends, and/or vulnerabilities. 
• Gathers relevant facts, records, and witness input and develops accurate timelines.
• Uses appropriate investigative methods.
• Applies appropriate regulatory, legal, and compliance framework.
• Demonstrates a high level of independence and accountability to directly manage and lead assigned projects.
• Demonstrates effective written and oral communication skills.
• Actively listens, provides constructive feedback, and demonstrates respect for differing views.
• Tailors communications to diverse audiences and maintains good working rapport with various stakeholders.
• Translates risk concerns into practical operational recommendations.
• Handles sensitive and confidential conversations with discretion and professionalism.
• Builds trusted partnerships with key stakeholders.
• Works constructively with various stakeholders and within the Risk team, including by seeking input from relevant disciplines and stakeholders.
• Participates effectively in coordinated team responses to support risk identification and mitigation strategies.
• Works collaboratively with other stakeholders and influences change.
• Understands the importance of quality service and meeting the needs of stakeholders.
• Adjusts and adapts service delivery to diverse customer needs and sensitivities.
• Demonstrates strong organizational and time management skills.
• Updates professional skills by participating in educational opportunities annually.
• The incumbent may be asked to perform additional duties as assigned.

QUALIFICATIONS

Education: 4 Year/Bachelor's Degree required - BSN or comparable clinical degree. 

Experience: Minimum of 5 years of clinical experience. Minimum of 3 years of experience in risk management, quality, clinical operations, or healthcare leadership preferred. Experience in acute care hospital setting and related service lines preferred. Refer to the Life Support Training Policy for additional details.

Licensure: RN or other clinical certification or licensure in applicable state required.

Additional Skills/Requirements Required: Strong computer skills in Microsoft Office suite, including Outlook, Word, Excel, and Power Point. 

Additional Skills/Requirements Preferred: Epic experience preferred. Certified Professional in Healthcare Risk Management (CPHRM) or willingness to obtain certification preferred. 

PHYSICAL DEMANDS

Physical Demand Code:

Sedentary to Light Physical Demand: The job requires frequent sitting, standing, walking, and bending/stooping. Frequent repetitive body movements. Proficient communicative, auditory, and visual skills. Attention to detail and ability to write legibly. Ability to lift/push/pull up to 20 lbs. occasionally. This job description may not include all assigned duties, responsibilities, or aspects of the job described. It may be amended at any time at the sole discretion of UVA Community Health.

OTHER

May require the use of safety equipment, such as HEPA mask, for infection prevention: Yes

On call responsibilities as directed: No

Ability to travel between campus buildings, remote facilities, and out of town as needed: Yes