Risk Management Analyst

Hackensack Meridian Health - Red Bank, NJ

Full-time - Entry Level

Red Bank, NJ

Hospitals

About the position

The Risk Management Analyst (RMA) at Hackensack Meridian Health plays a crucial role in ensuring the safety and well-being of patients, visitors, and team members by investigating risk management events and analyzing data related to these incidents. The RMA is responsible for utilizing the ONElink event reporting system to review and analyze events, assisting with proactive risk management educational initiatives, and managing various insurance matters. This position requires a close collaboration with internal and external counsel, medical claims third-party administrators (TPA), and insurance broker representatives to effectively handle claims and litigation matters across multiple sites within the Hackensack Meridian Health Care System. In this role, the RMA will conduct legal research, manage discovery requests, and maintain comprehensive files and statistical reports. The analyst will interact with all levels of the organization and work alongside the Enterprise Risk Management team to enhance the quality and safety of healthcare services. The RMA is expected to present statistical data and trends to various audiences, making appropriate referrals to management and quality improvement teams to mitigate risks. This position is integral to the organization's mission of transforming healthcare and serving as a leader of positive change. The RMA will also be responsible for maintaining confidentiality and integrity in all work activities, auditing expenses, and processing payments as necessary. The role requires a proactive approach to investigating incidents, managing claims, and ensuring compliance with healthcare risk management standards. The RMA will participate in training initiatives and represent the Enterprise Risk Management Department on various committees, contributing to the overall effectiveness of the department and the organization as a whole.

Responsibilities

• 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 needed.
• 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.

Requirements

• 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.

Nice-to-haves

• 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.

Benefits

• Competitive benefits package including health insurance, retirement plans, and paid time off.