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4 weeks ago

Job Summary

We are seeking to recruit a Risk Manager who will be responsible for identifying, assessing, and mitigating risks associated with healthcare insurance operations within the company. The Risk Manager collaborates with cross-functional teams to establish risk management policies, procedures, and controls in compliance with regulatory requirements and industry standards. Experience in an insurance company is desirable.

  • Minimum Qualification: Degree
  • Experience Level: Senior level
  • Experience Length: 7 years

Job Description/Requirements

Responsibilities:

  • Identify and assess risks inherent in healthcare insurance operations, including underwriting, claims processing, provider contracting, and regulatory compliance.
  • Conduct risk assessments, scenario analyses, and trend analyses to evaluate the likelihood and potential impact of identified risks on the organization.
  • Develop and implement risk mitigation strategies and control measures to minimize exposure to identified risks, including insurance coverage, contractual risk transfer, and risk avoidance strategies.
  • Analyze claims data and loss trends to identify patterns, root causes and provider relations teams to implement loss control measures, improve claims handling processes, and minimize claims leakage and fraud.
  • Review insurance policies, contracts, and agreements to identify and evaluate potential risks, liabilities, and exposures.
  • Provide risk analysis and recommendations to underwriting and contracting teams regarding risk transfer mechanisms, indemnification clauses, and insurance coverage adequacy.
  • Develop and implement incident response plans and crisis management protocols to effectively respond to emergencies, disasters, or adverse events impacting the organization.
  • Coordinate with internal stakeholders, external partners, and regulatory agencies to manage crises, mitigate reputational risks, and minimize business disruptions.
  • Prepare risk management reports, dashboards, and presentations for executive management, board of directors, and regulatory authorities, summarizing key risks, trends, and mitigation efforts.
  • Facilitate communication and collaboration between risk management, compliance, internal audit, and other relevant departments to ensure alignment of risk management initiatives with organizational goals and objectives.


Requirements:

  • Minimum academic qualification of a Bachelor's degree in any discipline
  • 7 years of working experience

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