Clinical Risk Management Analyst - Hackensack Meridian Health

Our team members are the heart of what makes us better.

At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community.

Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.

The Risk Management Analyst (RMA) is responsible for investigating risk management events, reviewing and analyzing events in the ONElink event reporting system, assisting with proactive risk management educational initiatives, working on various insurance matters, as well as assisting with claims and litigation matters on a day-to-day basis for the various lines of coverage for multiple sites within the Hackensack Meridian Health Care System. The RMA is responsible for legal research, discovery requests, and maintenance of files and statistical reports. The RMA will work closely with internal and external counsel, the medical claims TPA, and insurance broker representatives.

A day in the life of a Risk Management Analyst (RMA) at Hackensack Meridian Health includes:

• Investigates risks involving actual or potential injury to patients, visitors and team members.
• Assists with the review, investigation, follow up and closure of ONElink event reports.
• Prepares and provides statistical data, graphs and various other reports from the ONElink system/other systems for Enterprise Risk Management and other ad hoc requests; presents and explains relevant trends, data, and outcomes to a variety of audiences.
• Makes appropriate referrals to Managers, Internal Quality Improvement teams, Peer Review Committees for appropriate follow-up to reduce risk of recurrence.
• Responsible for additions and deletions of team member access and updates in the ONElink system.
• Assists in the process of accepting Subpoenas, and Summonses and Complaints.
• Investigates and analyzes claims/litigation and potential claims upon receipt.
• Obtains and sequesters evidence.
• Obtains visit history and pertinent medical records.
• Notifies the liability insurance carrier of actual and potential claims.
• Obtains insurance information and partners with insurance team to determine coverage analysis.
• Processes claims with the appropriate carrier(s) and broker within policy period.
• Obtains coverage determinations, and partners with the risk leader to resolve unfavorable determinations.
• Coordinates day-to day discovery (document production, interrogatories, scheduling interviews and depositions).
• Maintaining a positive working relationship with the hospital's professional and general liability insurance carrier and general counsel.
• Working in coordination with the Director of Risk Management reply to requests from the hospital's legal counsel.
• Obtains reimbursement from carriers as appropriate on first party claims(eg., auto and property).
• Maintains current knowledge of status of all claims and litigation matters and keeps Risk Management leaders/team apprised of changes.
• Performs legal research as needed.
• Keeps abreast of healthcare risk management issues, assisting with implementation of new or revised guidelines and practices.
• Maintains the confidentiality and integrity of all information encountered during work activities.
• Audits expenses and processes payments as needed.
• Maintains up-to-date claims run at all times and updates relevant parties on a quarterly basis and as neede.
• Maintains appropriately organized litigation files; including electronic and paper claim files.
• Prepares materials for quarter claim and steering committee meetings.
• Acts as a liaison with insurance brokers for requests from various departments.
• Assists the Corporate Insurance Department with the professional liability insurance coverage process which includes collaboration with the Medical Staff Office, Human Resources and our insurance broker.
• Assists Corporate Insurance Department with the Due Diligence process and works with Physician Enterprise to assure appropriate documentation is received and reviewed.
• Notifies insurance broker of terminations/resignations of healthcare providers.
• Investigates all incidents related to vehicle and property claims in conjunction with insurance manager.
• Receives and investigates recall reports of medical device and product problems in collaboration with the Purchasing Dept.
• Represents the Enterprise Risk Management Department on various medical center committees as assigned.
• Participates in training of team members and in-services provided by the Enterprise Risk Management team.
• Adheres to HMH Organizational competencies and standards of behavior.
• Must work independently with general guidance on a wide variety of special projects.
• All other duties and projects as assigned to assist the Enterprise Risk Management Department to maintain daily activities of the departments.

Education, Knowledge, Skills and Abilities Required:

• Minimum of Associates degree in Business, Insurance or related field or at least 5 years of related work experience in Risk, Paralegal, Insurance, or other related field.
• Proficient in Google Suite.
• Strong analytical and communication skills.
• Knowledge of legal and medical terminology.
• Excellent technological skills and organizational skills.

Education, Knowledge, Skills and Abilities Preferred:

• A minimum of 1 to 3 years of experience in risk management, claims, and/or insurance experience is preferred.
• Experience working with Insurance Brokers and representatives preferred.

If you feel that the above description speaks directly to your strengths and capabilities, then please apply today!