Clinical Risk Management Manager

Foundation Risk Partners, one of the fastest growing insurance brokerage and consulting firms in the US, is adding a Clinical Risk Management Consultant to their Cornell Insurance Services team in the Edison, NJ office.

Job Summary

The Clinical Risk Management Consultant is focused on identifying, assessing, and mitigating clinical risks for healthcare providers within an insurance brokerage firm, utilizing their medical expertise to analyze potential claims, advise clients on risk reduction strategies, and work with underwriters to secure appropriate coverage based on clinical risk factors.

Essential Functions

Clinical Risk Assessment

Review medical records, incident reports, and claims data to identify potential clinical risks associated with patient care, including medication errors, standard of care compliance risks, and diagnostic errors.

Detect and manage risk exposure

Maintain and update an organization's policies

Improve documentation practices

Seek ways to reduce the legal exposure of the organization

Create and maintain risk audit databases

Identify for clients’ ways to take the steps needed to prevent data breaches

Investigate any events that result in death or injuries

Trend Analysis

Analyze clinical data to identify trends and patterns of risk within a healthcare provider's practice, allowing for proactive risk mitigation strategies.

Risk Mitigation Consulting

Advise clients on clinical best practices, quality improvement initiatives, and risk reduction strategies to minimize potential claims.

Claims Review and Analysis

Evaluate clinical aspects of claims, including medical necessity and appropriateness of treatment, to identify areas for improvement and potential cost savings.

Underwriting Support

Collaborate with underwriters to assess clinical risk profiles of healthcare providers, informing coverage recommendations and premium calculations.

Education and Training

Develop and deliver clinical risk management training programs for healthcare providers, including staff on topics like informed consent, documentation best practices, and patient safety.

Regulatory Compliance

Stay updated on relevant healthcare regulations and industry standards to ensure clients are adhering to appropriate clinical risk management practices.

Competencies & Qualifications

Clinical Background

Registered Nurse (RN), Physician Assistant (PA), or other relevant healthcare professional license with significant clinical experience.

Risk Management Knowledge

Understanding of risk management principles, including risk identification, assessment, mitigation, and transfer.

Analytical Skills

Ability to analyze complex medical data and identify potential risk factors.

Communication Skills

Effective communication skills to interact with healthcare providers, underwriters, and clients, explaining complex clinical issues in a clear and concise manner.

Problem-Solving Skills

Ability to identify root causes of clinical incidents and develop practical solutions to mitigate risk.

Note: The specific responsibilities of an insurance broker clinical risk management role may vary depending on the size and focus of the brokerage firm, as well as the healthcare provider clientele they serve.

Education & Experience

Bachelor’s degree in Nursing, or other health related science

Master's preferred

3-5 years Risk Management experience preferred

Skilled Nursing Facility experience preferred in the geriatric field

RN, NP or P.A. or allied health professional licensure

CPHRM preferred

This range represents the estimated low and high end of the salary range for this position. Actual salaries will vary and may be above or below the range based on factors including but not limited to performance, location, and experience. The range listed is just one component of FRP's total compensation package for <employees.Pay> Transparency Range$100,000—$125,000 USDDisclaimer:

While this job description is intended to be an accurate reflection of the job requirements, management reserves the right to modify, add, or remove duties from particular jobs and to assign other duties as necessary.

Equal Employment Opportunity (EEO)

FRP provides equal employment opportunity to qualified persons regardless of race, color, sex, religion, national origin, age, sexual orientation, gender identity, disability, veteran status, or any other classifications protected by law.

Benefits

FRP offers a comprehensive range of health-related benefit options including medical, vision, and dental. We offer a 401(k) with company match, company paid life insurance, STD, LTD and a generous PTO policy starting at 18 days per year plus 10 paid holidays & 2 floating holidays!