Manager Risk Services

Job Description

Purpose & Scope:

The Manager of Risk Services under the direction of the Assistant Vice President of Enterprise Risk Management (“AVP ERM”) performs duties in line with organizational and loss prevention goals and objectives, coordinates data analysis, including application, interpretation, and implementation of comparative reporting, and litigation support. The Manager performs comprehensive evaluation and investigation of complaints and claims allegations, claims management activities including capture of data, reviews of litigation and expert witness reports, coordination with outside counsel, and performs data analytics on matters to identify trends and tracking of matters using analytical tools and skills to conduct studies, collects and interprets data from a wide variety of internal and external sources, and make associated recommendations regarding resolution of claims and operational efficiency and performance improvement. The Manager works closely with the AVP ERM to identify and evaluate risks system wide as a means to reduce injury to patients, staff members, and visitors within the organization and works to proactively prevent incidents or to minimize the damages following an event to accomplish the organization’s goals.
Responsible for coordinating all active litigation and potential litigation/claims by working with attorneys, paralegals and support staff. This includes the use of litigation support software to create new files, capture data, and review of information for discovery, reviews of litigation and expert witness reports, and performs data analytics on matters to identify trends and tracking of matters. Performs evaluation of adverse events, works with assigned legal counsel and assists with the production of information for discovery, including polices, copies of medical records, and case-related documents. Additionally, includes support of administrative law investigations by public entities, verifying physician’s entries into public database, and verifying practitioner claims history upon request by credentialing agencies.

Education:

Master's degree in a related field or Juris Doctor (JD) is required.

A bachelor's degree in nursing or a healthcare related field is required and a master's degree in an approved related field is preferred.

Experience:

Two years of healthcare/medical - nursing/patient care experience is preferred.

Certification/Licensure:

Licensed as a Registered Nurse by the Virginia Department of Health Professions or compact state licensure in nursing is preferred.

CPHRM certification is preferred.

Other Qualifications