Sr Risk Management Analyst
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:
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Provides direction as necessary to drive claims to a timely and appropriate resolution through appropriate compensability determination, reserving, and settlement evaluation.
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Monitors Third Party Claims Administrators expenses regarding assignment of outside claim
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investigators, Nurse Case Management, Physician Reviews, Medicare/SCHIP Set-Asides.
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Directs field management on claim reporting, claim management and return-to- work procedures.
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Coordinates complex claim resolution with the Legal Department; including claims that have an ADA, EEOC or FMLA component to the Worker’s Compensation claim.
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Provides oversight of Third-Party Administrator by conducting annual claim reviews, audits and other claim related projects.
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Manages State Funded Workers’ Compensation (Ohio and Washington State) oversight vendor
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regarding uploads to Third Party Administers claim system, quarterly premium payments, and outside attorney assignment and expenses.
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Identifies claim trends and recommend training programs, procedures or actions to reduce claim costs.
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Develops and maintains state required in-network physician panels.
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Assists the Director Risk Management to achieve Risk Management goals.
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Monitors 24/7 Nurse Triage program and encourages location participation.
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Updates knowledge base on claim practices, case law and industry claim trends.
Minimum Qualifications, Knowledge, Skills, and Work Environment:
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Requires a Bachelor’s degree or related experience
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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
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Requires knowledge of state-specific Workers’ Compensation regulations and understanding of technical claims procedures, medical protocols and best practices
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Requires proficiency in Microsoft Office and other Claim Management Systems
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Requires demonstrated attention to detail, good time management, prioritization skills, project
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management and organization skills
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Requires excellent logical thinking, analytical, and problem-solving skills
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Requires a strong team player able to handle multiple tasks in tight timeframes with minimal supervision
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Requires the ability to use discretion and understand confidentiality issues
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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