Insurance and Risk Management Director jobs in Edison, NJ

Overview

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.

Provide basic and complex preventive risk management assessment of processes, procedures, and programs, including in-service education, consultation, liaison activities, and on-call emergency assistance to all acute care facilities within the region and providers. Formulates and recommends safety policies, practices and procedures. Initiate, coordinate, and manages all investigational and evaluation activities associated with professional and general liability occurrences and claim pre-litigation files. Provides Risk Management oversight to the Site Leaders of Risk Management as directed by Sr. VP and Chief Risk Officer.

This position requires on site work based out of Riverview Medical Center in Red Bank, New Jersey.

Responsibilities

A day in the life of a Director, Risk Management at Hackensack Meridian Health includes:

• Provides prompt notification to the network office upon receipt of claim or lawsuit. Assist network Litigation Management leadership and external counsel in defense of the claims as instructed.
• Provides leadership, counsel, and support to the site leader of Risk Management with the region.
• Escalates significant risk issues to the SVP, Chief Risk Officer and legal counsel as appropriate.
• Collaborates with site patient safety/quality improvement and patient experience leadership to respond to patient grievances. Uses decision making ability to analyze and recommend disposition strategies. Oversee and direct occurrence reporting process for site. Ensures timely data entry of reports received. Completes necessary trend analysis of occurrence reports.
• Collects data for risk exposures and provides feedback to the involved departments. Ensure identified risk management strategies are undertaken by affected areas.
• Direct Social Work/Case Management department on Guardianship application procedures, ensure timely and comprehensive completion of application, and obtain authorization to proceed with Guardianship through Network Risk Management offices (Sr. VP Risk or designee).
• Work with outside counsel to obtain necessary documentation and resolution.
• Provide on-call assistance for emergent/urgent risk management issues to all Team Members and Medical/Dental Staff. Investigates, evaluates and documents occurrences and claims as appropriate.
• Responds to site Team Members and Medical/Dental staff on risk related issues and offers risk management guidance to resolve or manage situations.
• Develops a safety culture where reporting is encouraged and use of the Onelink adverse event reporting system is monitored, with interventions to address issues as needed.
• Provide in-service education on risk management topics, both standard basic education and complex focused topics as needed and/or requested by team members, hospital leadership; medical and dental staff; or system leadership.
• Provide Risk Management reports to stakeholder groups as necessary such as administration, leadership, etc.
• Provide timely monthly reports to Sr. VP & Chief Risk Officer of activities at site.
• Create and implement new programs to foster a culture of safety and safe environment for patients, visitors, Team Members and customers of the facility.
• Provide statistical analysis for review by appropriate committees as requested.
• Lead or co-lead the facility Environment of Care (EOC) Committee; Emergency Preparedness Committee and other committees as requested. Ensure data flows through committee and RCA/ACA/PI efforts are monitored and reviewed regularly. Participates as a member of RCA/ACA/PI teams. Participate as an active representative on the system Safety Event Classification group; Patient Safety Committee; Safety Council and other committees as assigned. Represent the Corporate Risk Management Department on various site facility and network committees as required.
• Manage Team Member Safety. Create and implement new programs or process improvements to foster a culture of safety and safe environment for Team Members and Visitors by serving as Chair or Co-Chair of site Safety Committee and serving as Safety Officer.
• Investigates Team Member events as requested by SVP and Chief Risk Officer or Occupational Health. Provide data and statistical analysis for review by appropriate leadership, committees or departments as requested.
• Provides Risk Management services to HMH affiliated companies (i.e Physician Practices, Post-Acute Care Organizations) as directed by Sup & Chief Risk Officer.
• Assist Manager, Insurance with data gathering for insurance renewals.

Qualifications

Education, Knowledge, Skills and Abilities Required:

• Bachelor's degree in Nursing, Business Management or related health field.
• 10 years of experience in progressively responsible experience in the healthcare industry.
• 3-5 years of Healthcare Risk Management experience required.
• Patient Safety experience preferred.
• Strong understanding of
  • Process Review.
  • Root Cause Analysis.
  • Department of Health and Joint Commission requirements familiarity.
  • Emergency Management.
  • Regulatory Compliance.

Education, Knowledge, Skills and Abilities Preferred:

• Master's degree in Nursing, Business Management or related health field.
• Risk Management Certification Preferred.

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

Our Network

Hackensack Meridian Health (HMH) is a Mandatory Influenza Vaccination Facility

As a courtesy to assist you in your job search, we would like to send your resume to other areas of our Hackensack Meridian Health network who may have current openings that fit your skills and experience.