Job Details

Risk / Claims Manager

Job ID 1059

  • Sunrise, FL, 33313
  • Fulltime
  • 3 - 5 years experience
  • 80000 - 100000 Annual
  • 16/08/2017
  • Medical , Healthcare , Hospitals
  • 1 of Openings
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Job description

Client has grown from a single medical practice to a trusted health solutions partner with more than 10,000 employees and a presence in 50 states. Through our family of companies, we provide:

physician services spanning the continuum of patient care

revenue cycle management solutions

performance improvement consulting

Responsibilities

    • Receive and investigate adverse occurrences and potential compensatory events, medical malpractice claims, patient complaints and highly sensitive billing dispute and analyze for risk liability exposure.
    • Manage medical malpractice claims and collaborate with TPAs and defense attorneys on strategy recommendations.
    • Collaborate with our Clinical Services Division and Chief Medical Officers with tracking/trending of adverse outcomes and medical malpractice claims in order to improve quality of care and advance patient safety.
    • Prepare materials and participate in claims committee meeting, carrier meetings, and divisional meetings, as assigned.
    • Evaluate medical malpractice claims history of healthcare professionals through the New Hire, Re-credentialing or Due Diligence process.
    • Conduct Risk Management orientation training as needed. Develop and make recommendations for educational Risk Management programs based on needs assessment.

     

    Qualifications

    • 3-5 years risk management experience in a healthcare or large medical group practice or with medical malpractice claims and case management is required.
    • LNC or prior medical malpractice claims adjusters will also be considered.
    • Strong verbal/written communication skills required, along with proficiency with computer software systems.
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