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Director, Insurance/Risk Management

Company: 21st Century Oncology
Location: Fort Myers
Posted on: September 17, 2020

Job Description:

Crawling: No

Risk Financing (Corporate Insurance):

Balancing: Yes

SUMMARY: The Director – Insurance/Risk Management is responsible for corporate risk management activities, which includes but may not be limited to a general knowledge of corporation insurance programs, managing claims against the facility, interfacing with defense legal counsel, overseeing professional liability litigation, administering the risk management program on a day-to-day basis, managing and analyzing risk management data, conducting risk management educational programs, complying with risk management related standards by other accrediting and regulatory agencies with the objective of enhancing patient safety, promoting patient safety, quality care, and minimizing loss to protect the assets of the corporation.. ESSENTIAL DUTIES/RESPONSIBILITIES:. Operations/Compliance:. Develop, coordinate and administer facility-wide systems for risk identification, investigation and reduction; maintain a network of informational sources and experts; review facility to assess loss potential. Participate in promoting patient safety issues and be on select committees that focus on the provision of patient care. Ensure the following information is accurate, available and secure: medical records, patient billing records, policies and procedures, incident reports, as well as any other date pertinent to a particular claim. Collect, evaluate, and distribute relevant data concerning patient injuries, claims profiles. Work with legal counsel to coordinate the investigation, processing, and defense of claims against the corporation; record, collect, document, maintain, and provide to defense attorneys any requested information and documents necessary to prepare testimony in pending litigation. Respond to professional liability and facility liability questions posed by physicians, nurses and other personnel. Recommend appropriate revisions to new or existing policies and procedures to reduce the frequency of future occurrences; recommend was to minimize risks through system changes. Review collated data to identify trends regarding accidents or occurrences, and recommends corrective action to management, if appropriate. Loss Prevention and Patient Safety:. Identify Exposures to Loss by reviewing prior professional liability, property and casualty, and workers’ compensation claims etc…. Determine the potential severity and loss associated with an identified risk and give priority to the areas that hold the greatest potential risk of financial loss. Develop formal and informal mechanisms for risk identification, such as incident reporting, medical record reviews, review of patient complaints, and review of pertinent quality improvement information. Develop and maintain collaborative relationships with key departments. Schedule Risk Management Orientation for all new physicians and cover topics such as Patient Care, Incident Reporting, Informed Consent, Medical Records Documentation, etc…. Investigate and handle patient complaints promptly and efficiently from all reportable sources such as: patient satisfaction questionnaire; patient complaints; notes from physicians; direct communication from patients etc…. Claims Management:. Manage the claims program; with input from legal, CEO and/or CFO, select and utilize actuarial firms, as needed and/or required. Promptly notify carriers of actual or potential claims. Work with insurance carriers to establish claim files and coordinate investigations. Work closely with Claim Adjusters or Loss Control Consultants. Ensure that administration is kept informed of high exposure cases and aggregate claims experience including its impact on the financial statement. Work with insurance brokers to direct and coordinate all aspects of insurance management for the institution, including developing alternatives such as self-insurance, excess insurance, and other risk-financing mechanisms. For property insurance, broiler and machinery insurance, inland marine, crime insurance, automobile insurance, and all other corporate purchased insurance, analyze value and verify that exposures are adequately insured; in the event of loss, prepare data required by brokers and carriers and mange process through the settlement of the claim. Upon each renewal for ALL policies, ensure at least a second quote/proposal is received and analyzed before binding and/or any other coverage option. Evaluate Coverage Limits, deductibles, and lines of coverage to ensure that exposures are adequate and cost-efficient. Other Duties (Physician Bonus/Incentive Payments):. Other Duties (Annual Audit):. Provide all the necessary documents to auditor. Promptly answer and respond to and questions from auditor. QUALIFICATION REQUIREMENTS:. Managerial experience in Health Care Systems, ability to communicate effectively and drive team-oriented results and outcomes. Ability to work in fast-paced environment and work well in teams and with executive leadership.. EDUCATION/EXPERIENCE REQUIRED:. Bachelor’s degree. Clinical experience and/or Juris Doctorate preferred.. CONFIDENTIAL AND SENSITIVE INFORMATION:. Must properly control the release of proprietary and confidential information. LANGUAGE SKILLS:. Must be able to fluently speak, write and understand English. Must possess excellent written and verbal communication skills. PHYSICAL REQUIREMENTS:. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.. Crouching: Yes. Pulling: Yes. Carrying: Yes. Grasping: Yes. Climbing: No. Kneeling: Yes. Standing: Yes. Lifting:Yes. The statements herein are intended to describe the general nature and level of work being performed by employees, and are not to be construed as an exhaustive list of responsibilities, duties, and skills required of personnel so classified. Furthermore, they do not establish a contract for employment and are subject to change at the discretion of the employer.. 21st Century Oncology - 5 days ago - save job. If you require alternative methods of application or screening, you must approach the employer directly to request this as Indeed is not responsible for the employer's application process.. Get job updates from 21st Century Oncology. Radiation Therapy Services (RTSI) operates almost 120 radiation treatment centers in several countries, including seven that involve hosp.... Thousands of employers search for candidates on Indeed

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Keywords: 21st Century Oncology, Fort Myers , Director, Insurance/Risk Management, Other , Fort Myers, Florida

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