RISK MANAGER

 General Summary/Responsibilities:

The incumbent is the organizational expert in operational and clinical risk management and has the primary responsibility to protect and preserve the assets and resources of Premier Health.  

This is accomplished through (a) proactive, clinical and operational risk management and (b) responsive loss control through claims management and litigation management.

The incumbent functions as a critical risk management resource in an integrated healthcare delivery system by facilitating processes that minimize patient, staff and visitor injury.  The incumbent works with in-house, outside counsel and Risk Management leadership to strategize the resolution of claims in a fair and just manner that minimizes loss to the organization.  The incumbent collaborates with the Director of Risk Management and Insurance and System Vice President/Chief Legal Officer to appropriately reserve/fund claims to minimize the financial impact to the organization. The role focuses on collaboration, change management, education, claims management and litigation management.

In addition to supporting the Premier Health hospitals and subsidiaries, the position includes activities that support Premier Health International Insurance, Ltd., a wholly-owned captive insurance company.

Essential Duties & Functions:

o   The Risk Manager assists Premier Health and its subsidiaries in preserving the assets of the organization and through (a) proactive clinical and operations risk management and (b) claims and litigation management.

o   In the performance of proactive clinical and operations risk management, the Risk Manager is responsible for loss prevention, risk management education and activities within assigned entities.  The incumbent interacts with all employees, including staff, managers, department heads, residents, physicians, administrators and system executives.  The incumbent is responsible for collaborating with the Quality Innovation department to facilitate proactive loss prevention through process improvement based upon identified risks.  The Manager serves on various hospital committees including but not limited to Quality Improvement, Sentinel Events, Environment of Care, Credentials, and Department Directors.  The incumbent plays a key role in all root cause analyses and intense analyses performed.  The Manager provides regular reports of trends regarding incidents and claims to the assigned entities.

o   The Manager acts as an internal consultant to the organization on specific issues, policy development, disclosure of unanticipated patient outcomes, sentinel events, management of significant events and participate on teams performing root cause analyses and intense assessments.  

o   In the performance of claims management and litigation management, the Manager, Risk Management is responsible for the identification, prevention and management of claims.  This involves, but is not limited to claim investigation, creating/maintaining current electronic and paper files, determining exposure of various parties and making recommendations for disposition of the claims and corresponding with claimants and defense counsel.  In certain circumstances the position is responsible for communicating with and making referrals to outside insurance companies for employed individuals, such as physicians, that do not have professional liability insurance coverage by the wholly owned captive insurance company. The Manager is involved in identification of trends and reporting this information to leaders, executives and Quality Innovation. The manager participates in routine claims review meetings with the risk management and insurance leadership, in-house counsel and Premier Health executives.

o   The Manager is responsible for litigation management which includes but is not limited to consultation with the Director for indemnity and expense reserve setting and adjustment, working with outside counsel to prepare staff for meetings, depositions, pre-trial hearings and trials.  The Manager facilitates the discovery process by working with outside counsel to gather information in response to interrogatories and other discovery requests; is responsible for maintaining current files on each lawsuit and making recommendations regarding the resolution of the complaint (e.g., mediation, trial, etc.).

o   The Manager acts as a liaison between the wholly-owned captive insurance company and defense counsel on all matters related to litigation. 

Other Duties & Functions:

The above duties and responsibilities may be essential job functions subject to reasonable accommodations. All job requirements listed include the minimum knowledge, skills, and/or ability deemed necessary to perform the job proficiently. This job description is not to be constructed as an exhausted statement of duties, responsibilities, and requirements. Employees may be required to perform any other job-related instructions as requested by their supervisor, subject to reasonable accommodations.