Risk Management Analyst Ambulatory

Risk Management Analyst Ambulatory

West Des Moines, IA

Monday-Friday 

Full Time Benefits

Risk Management Analyst-Ambulatory provides coordination Risk Management Program. Supports the risk management department and risk management program while performing standard, advanced and confidential work. Supports claim and insurance processes for insured providers.

Why UnityPoint Health? 

• Commitment to our Team – For the third consecutive year, w e're proud to be recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare for our commitment to our team members .  
• Culture – At UnityPoint Health, you matter. Come for a fulfilling career and experience a culture guided by uncompromising values and unwavering belief in doing what's right for the people we serve.  
• Benefits – Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you’re in.  
• Diversity, Equity and Inclusion Commitment – We’re committed to ensuring you have a voice that is heard regardless of role, race, gender, religion, or sexual orientation.  
• Development – We believe equipping you with support and development opportunities is an essential part of delivering a  
• remarkable employment experience.  
• Community Involvement – Be an essential part of our core purpose—to improve the health of the people and communities we serve.  

Visit to hear more from our team members about why UnityPoint Health is a great place to work.

Risk Liability Events and Claims
• Develop and maintain administrative office procedures and systems including telephone triage, filing systems, scheduling, document processing and distribution/routing systems, integrity of department shared drive content and processes, and memorialization of risk management activities.
• Maintain current and accurate Risk Management legal files.
• Review, log and process subpoenas received on behalf of the organization and insured providers. Coordinate contact with relevant parties and facilitate communication necessary to respond to subpoenas.
• Facilitate obtaining data reports and providing risk management analytics for trending and risk assessment prioritization.
• Assist with developing presentations specific to risk management activities.
• Maintain, revise and update risk management intranet site for content and timeliness of material posted. Maintain UPC clinic/department database for employed providers.
• Work to coordinate between UnityPoint Health corporate, Market/Affiliate and third-party administrator on reporting new incidents, claims, and updates on all open claims on a quarterly basis.
• Review, coordinate, and process self-insured medical malpractice and commercial insurance policy endorsements and extended reporting endorsements, quotes, certificate requests, claims history requests and other related tasks. Assist with annual insurance renewal data collection.
• Notify Business Office when patient accounts need adjustment.
• Manage Lawson and On-Base data systems for Risk Management and Compliance; process payment and settlement requests and maintain financial records for lawsuits and claims.
• Maintain the data information system for Event Reports, claims, and follow-ups.
• Provide administrative and technical support for new and current users of Event Reporting system. Serve as “admin lite” of the Event reporting system.
• Pull data and prepare informational reports as needed from the Event Reporting system.
• Review, assess, update and close Event and Feedback files.
• Coordinate lawsuits administratively, including processing summons, complaints, interrogatories, production and discovery requests, deposition scheduling, and other attorney requests as needed.
• Assist with record production in response to professional licensure, payor and other inquiries.
• Assist with review of attorney requests/inquiries, patient terminations from all ambulatory sites and risk management related questions and concerns.
• Serve as back-up in the Risk Management office for administrative issues.
• Serve as a member of the Corporate Risk Management team and RL User Team.
• Manage the Subpoena database, along with the duty of notifying staff.
• Manage the Claims database.
• Provide computer/clerical support for Risk Management and Compliance as needed
Basic UPH Performance Criteria
• Demonstrates the UnityPoint Health Values and Standards of Behaviors as well as adheres to policies and procedures and safety guidelines.
• Demonstrates ability to meet business needs of department with regular, reliable attendance.
• Employee maintains current licenses and/or certifications required for the position.
• Practices and reflects knowledge of HIPAA, TJC, DNV, OSHA and other federal/state regulatory agencies guiding healthcare.
• Completes all annual education and competency requirements within the calendar year.
• Is knowledgeable of hospital and department compliance requirements for federally funded healthcare programs (e.g. Medicare and Medicaid) regarding fraud, waste and abuse. Brings any questions or concerns regarding compliance to the immediate attention of hospital administrative staff. Takes appropriate action on concerns reported by department staff related to compliance.

Education

High School diploma or equivalent
Experience

Previous technical training in work processing/computer required.
License(s)/Certification(s)

Valid driver’s license when driving any vehicle for work-related reasons.
Knowledge/Skills/Abilities

• Familiarity with general risk identification and reduction methods
• Strong verbal and written communication skills
• Able to assess complex issues, strong analytical and problem solving skills, and exhibit good judgement
• Strong time management skills
• Knowledge and understanding of hospital and other relevant policies and procedures related to patient care and safety
• Knowledge of healthcare delivery system
Other

Use of usual and customary equipment used to perform essential functions of the position.