Sr Risk Management Analyst

Location: 
Category: 
Job Type: 

With a career at HMSHost, you really benefit! We Offer

  • Health, dental and vision insurance
  • Generous paid time off (vacation, flex or sick)
  • Holiday pay
  • Meal and Transportation Benefits
  • *401(k) retirement plan with company match
  • *Company paid life insurance
  • *Tuition reimbursement
  • Employee assistance program
  • Training and exciting career growth opportunities
  • Referral program – refer a friend and earn a bonus

*Benefits may vary by position so ask your recruiter for details.

Airport Location: Corporate Human Resources 
Advertised Compensation: $83,200.00 to $112,000.00 

Summary: 

The Sr Risk Management Analyst is responsible for providing oversight to HMSHost Workers’ Compensation claims and acting as a liaison between Third Party Administrators and field operations. The position will also be responsible for providing field training on various aspects of safety and Workers Compensation compliance; and performing all other responsibilities as directed by the business or as assigned by management.  

 

This is an exempt position and reports to the Director Risk Management. 

 

Essential Functions: 

  • Provides direction as necessary to drive claims to a timely and appropriate resolution through appropriate compensability determination, reserving, and settlement evaluation. 

  • Monitors Third Party Claims Administrators expenses regarding assignment of outside claim 

  • investigators, Nurse Case Management, Physician Reviews, Medicare/SCHIP Set-Asides. 

  • Directs field management on claim reporting, claim management and return-to- work procedures. 

  • Coordinates complex claim resolution with the Legal Department; including claims that have an ADA, EEOC or FMLA component to the Worker’s Compensation claim. 

  • Provides oversight of Third-Party Administrator by conducting annual claim reviews, audits and other claim related projects. 

  • Manages State Funded Workers’ Compensation (Ohio and Washington State) oversight vendor 

  • regarding uploads to Third Party Administers claim system, quarterly premium payments, and outside attorney assignment and expenses. 

  • Identifies claim trends and recommend training programs, procedures or actions to reduce claim costs. 

  • Develops and maintains state required in-network physician panels. 

  • Assists the Director Risk Management to achieve Risk Management goals. 

  • Monitors 24/7 Nurse Triage program and encourages location participation. 

  • Updates knowledge base on claim practices, case law and industry claim trends. 

 

Minimum Qualifications, Knowledge, Skills, and Work Environment: 

  • Requires a Bachelor’s degree or related experience 

  • Requires 5 years technical claims experience with a carrier or TPA; preferably with working knowledge of a multi-location service industry’s business and associate needs 

  • Requires knowledge of state-specific Workers’ Compensation regulations and understanding of technical claims procedures, medical protocols and best practices 

  • Requires proficiency in Microsoft Office and other Claim Management Systems 

  • Requires demonstrated attention to detail, good time management, prioritization skills, project 

  • management and organization skills 

  • Requires excellent logical thinking, analytical, and problem-solving skills 

  • Requires a strong team player able to handle multiple tasks in tight timeframes with minimal supervision 

  • Requires the ability to use discretion and understand confidentiality issues 

  • Requires excellent oral, written, and interpersonal skills

Equal Opportunity Employer (EOE) Minority/Female/Disabled/Veteran (M/F/D/V) Drug Free Workplace (DFW)


Nearest Major Market: Washington DC