Risk & Claims Manager – Hybrid

MedicalVirtual; York (York County); Hybrid; USD 90,000 - 130,000; Full time

Job summary

MedicalVirtual in York, Pennsylvania, offers a hybrid risk management role focused on claims oversight for system entities. The position involves evaluating risk, managing claims processes, and ensuring prompt handling in accordance with policy.

Responsibilities include root cause analyses, on-call risk management duties, investigations, staff education, coordination with outside counsel, and preparation of management reports for leadership.

Responsibilities

• Responds to questions concerning risk management and claims; conducts root cause analyses and risk assessments as needed.
• Participates in the WSH Accreditation/Risk Management on-call rotation.
• Reviews event reports daily; assists patient safety officer with investigations and regulatory reporting.
• Conducts educational sessions on risk issues for entities.
• Investigates allegations of inappropriate treatment/care causing injury and determines next steps.
• Drives efficiencies in claims processes to reduce litigation costs; tracks and analyzes litigated cases.
• Collaborates with leadership to develop reporting metrics and communicates litigation trends to leadership.
• Identifies, gathers, and preserves discovery items for investigations related to existing or potential litigation.
• Manages outside counsel on litigation, discovery matters, costs, negotiations, and settlements.
• Reviews and approves outside counsel invoices for correctness and follows up with questions.
• Directs preparation and maintenance of department reports; prepares periodic reports for top management.
• Provides management services to the WellSpan reciprocal Risk Retention Group, and coordinates activities of governing board, attorneys, and consultants.

Job description

MedicalVirtual in York, Pennsylvania, offers a hybrid risk management role focused on claims oversight for system entities. The position involves evaluating risk, managing claims processes, and ensuring prompt handling in accordance with policy.

Responsibilities include root cause analyses, on-call risk management duties, investigations, staff education, coordination with outside counsel, and preparation of management reports for leadership.