Manager of Risk Management

2 weeks ago

Rockford, United States Mercy General Health Partners Full time
Overview

The Manager of Risk Management, under the general direction and supervision of the Chief Financial Officer and in collaboration with the Legal department, is responsible for Mercyhealth's enterprise risk management program. Key responsibilities include providing support and direction for Mercyhealth's risk management, vetting and procurement of appropriate insurance coverage, insurance claims management; and risk identification, evaluation, and mitigation. The Manager of Risk Management assists with risk management strategy and optimization for operational leadership and the administration and operation of risk activities for the health system, including assisting in quality reviews and root-cause analysis, litigation management and liability claims management. The Manager of Risk Management has supervisory responsibility for identified department personnel and works closely with clinical and administrative departments in the management of current risk items and also in the proactive detection and prevention of potential risk cases. Performs other duties as assigned.

Responsibilities

ESSENTIAL DUTIES AND RESPONSIBILITIES
  • Is accountable for the work of the department and also facilitates professional development for clinical and administrative professionals in collaboration with other Department leaders to reduce risk and manage current risk issues.
  • Manages and supports insurance claims, including serving as first point of contact and working closely with the employee partners, insurance representatives, Mercyhealth leadership, and coordinating and working with the internal Legal department and external litigation specialists, Finance department, and the executive team for litigation management and liability claims management.
  • Investigates, analyzes, tracks, trends, and evaluates alleged risk events, reporting potential compensable events as appropriate.
  • In collaboration with Mercyhealth Finance, works to bid and award insurance products; negotiates with the awarded vendors to assure the best price/coverage for Mercyhealth for both new and existing vendors; and reviews all related invoices for submission of payment approval.
  • Assists in collaboration with the appropriate departments new and evolving risk assessments and mitigation strategies such as cyber security, new laws and regulations that enhance risk management, and any new developments in the legislative and judicial divisions for both nationally and state based impacts.
  • Manages distribution of Certificates of Insurance to outside sources; manages internal review and archival of Certificates of Insurance provided to Mercyhealth from outside sources.
  • Promotes awareness of and provides education and updates to key stakeholders on risk, risk mitigation and other assigned subject area(s).
  • Ensures Department of Motor Vehicles eligibility checks are conducted on all employees who drive Mercyhealth owned or provided vehicles.
  • Assumes responsibility for assigned performance measures, including but not limited to those related to Legal Department efficiency and cost-savings.
  • Performs leadership accountabilities such as interviewing, selection, evaluation and coaching/discipline of assigned staff members.
  • Assists in developing and implementing strategic initiatives including those relating to enterprise risk management. Responsible for strategic problem solving of myriad issues.
  • Collaborates and partners with clinical leadership and the physician leadership team to review insurance coverage levels and strategies for the requirements of Illinois and Wisconsin as it relates to risk management and liability trends and statutes.
  • Participates in developing and obtaining approval of department budget and is responsible for department performance to budget and objectives.
  • Works collaboratively as a team member of the Department.
  • Completes rounds in patient care areas and administrative departments to demonstrate he/she is accessible and approachable resource for physicians, nurses, managers and other partners.
  • Participates in Mercyhealth's Legal/Risk or Administrator On Call schedule. Serves on assigned Mercyhealth committees, providing both technical and strategic advice as appropriate. Represents Mercyhealth in external community or industry organizations.
  • Is regularly available during business hours. Must be available for emergencies during non-business hours by phone or e-mail, including in exceptional circumstances during authorized absences such as vacations or illnesses.


CULTURE OF EXCELLENCE BEHAVIOR EXPECTATIONS

To perform the job successfully, an individual should demonstrate the following behavior expectations:

Quality - Follows policies and procedures; adapts to and manages changes in the environment; Demonstrates accuracy and thoroughness giving attention to details; Looks for ways to improve and promote quality; Applies feedback to improve performance; Manages time and prioritizes effectively to achieve organizational goals.

Service - Responds promptly to requests for service and assistance; Follows the Mercyhealth Critical Moments of service; Meets commitments; Abides by MH confidentiality and security agreement; Shows respect and sensitivity for cultural differences; and effectively communicates information to partners; Thinks system wide regarding processes and functions.

Partnering - Shows commitment to the Mission of Mercyhealth and Culture of Excellence through all words and actions; Exhibits objectivity and openness to other's views; Demonstrates a high level of participation and engagement in day-to-day work; Gives and welcomes feedback; Generates suggestions for improving work: Embraces teamwork, supports and encourages positive change while giving value to individuals.

Cost - Conserves organization resources; Understands fiscal responsibility; Works within approved budget; Develops and implements cost saving measures; contributes to profits and revenue.

EDUCATION and EXPERIENCE

Bachelor's Degree in appropriate discipline including Business, Risk Management, Legal or related field is required. Three or more years of experience in Legal and/or paralegal services, Risk Management, Claims management and/or settlement, preferably in a health care setting and five or more years in active manager or higher level supervisory role.

CERTIFICATION/LICENSURE

Certification as Professional Healthcare Risk Manager preferred.

ADDITIONAL REQUIREMENTS

Passing the Driver's License Check and/or Credit Check (for those positions requiring).

Passing the WI Caregiver Background Check and/or IL Health Care Workers Background Check.

Must be able to follow written/oral instructions.

OTHER SKILLS AND ABILITIES

Ability to effectively communicate on very sensitive subject matter, with a variety of individuals, for example Physicians, outside agencies, governmental agencies, insurance vendors and attorneys. Able to analyze data and complex materials.

WORK ENVIRONMENT

Occupational Exposure: Category C - No partners in the specified job classification have occupational exposure.

AGE OF PATIENTS SERVED

Non-Specific Task (N/A)

INFORMATION ACCESS

Partner may access patient care information, financial data, human resource data and strategic and planning data needed to perform their job duties as directed by the Vice President.

WORK CONTACT GROUP

Partners, physicians, patients/family, visitors, vendors, governmental agencies, attorneys

SPECIAL PHYSICAL DEMANDS

The Special Physical Demands are considered Essential Job Functions of the position with or without reasonable accommodations.

While performing the duties of this job, the employee is regularly required use hands to finger, handle, or feel. The employee is frequently required to sit, feel, talk, and hear. The employee is occasionally required to stand and walk. Specific vision abilities required by this job include close vision, distance vision, color vision, depth perception, and the ability to adjust focus. This partner must be able to exert up to 25 pounds of force occasionally.
Must be able to travel from site to site, communication both orally and in writing.

LEVEL OF SUPERVISION

Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems; employee adherence to annual education and certification requirements

SUPERVISES

Directly supervises assigned staff and responsibilities are conducted in accordance with directives of management, the organization's policies, and applicable laws.

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