Risk Coordinator - Hybrid - 140251
University of California, San Diego
Risk Coordinator - Hybrid
This position supports the daily operations of the Risk Management Department by coordinating activities across the Clinical Risk and Claims programs. Responsibilities include support of incident management, investigative activities, patient management processes, claims administration, litigation support, and departmental reporting functions. The position serves as a primary operational resource for incident reporting systems, claims-related workflows, subpoenas, records requests, deposition coordination, patient dismissal processes, and patient concerns. Responsibilities also include administration of Risk Management databases, dashboards, trackers, and reporting tools used to support regulatory compliance, operational oversight, workload management, and organizational risk reduction efforts. The position supports investigations, claims activities, process improvement initiatives, and other departmental priorities through coordination with internal and external stakeholders. This role requires strong organizational, analytical, and communication skills with the ability to manage multiple competing priorities, maintain confidentiality, and coordinate complex administrative and operational processes across the health system.
Description of Job Responsibilities:
- Supports development, coordination, and maintenance of departmental education, resources, and knowledge-sharing initiatives related to risk management, claims, patient safety, and enterprise risk topics. Assists the Risk Management team with development of educational materials, tools, and program content as needed.
- Serves as primary intake and coordination point for subpoenas, warrants, court orders, records requests, deposition requests, and other administrative, legal, and regulatory requests for testimony and/or documents. Processes requests appropriately and coordinates with Risk Management leadership, Legal, Health Information Management, and other stakeholders as needed. Assists with document collection, tracking, and production activities.
- Coordinates and supports operational activities related to professional liability, employment practices liability, general liability, and property claims programs, including certificates of insurance requests, critical claims dates, documentation management, communications, tracking, reporting, and other claims administration functions.
- Oversees administration and operational support of Risk Management systems, databases, and reporting platforms, including iReport, Teams, and other departmental tools. Supports incident reporting workflows through intake management, report routing, triage, escalation tracking, user support, data integrity monitoring, reporting activities, workflow optimization, and system enhancement efforts.
- Coordinates and supports patient management activities, including patient dismissal requests, patient conduct matters, patient experience escalations, and related documentation, tracking, and communication processes.
- Develops, maintains, analyzes, and reports data related to Risk Management operations, claims activity, incident reporting, and departmental workloads. Assists with the creation and maintenance of dashboards, report templates, and analytics tools utilizing Teams, Excel, Tableau, and/or similar software to support operational visibility, trend analysis, workload assessment, hotspot identification, and executive reporting needs. Monitors, analyzes, and interprets data trends, patterns, and operational metrics across Risk Management activities to identify opportunities for proactive risk assessment, workload planning, process improvement, and enterprise risk mitigation.
- Coordinates logistics, preparation, scheduling, documentation, and follow-up support for Risk Management reviews, meetings, committees, significant event discussions, adverse event reviews, root cause analyses (RCAs), and related activities as assigned.
- May support review, data gathering, documentation, or preliminary analysis related to incidents, patient care concerns, loss control issues, claims matters, or other Risk Management activities as needed.
- Assists with development, maintenance, and revision of departmental policies, procedures, workflows, internal resources, SharePoint/website content, and operational tools as needed.
- Supports departmental priorities, special projects, program goals, process improvement initiatives, and evolving operational needs across clinical risk, claims, and enterprise risk activities.
- Participates in meetings, conferences, training, and professional development activities as appropriate to support departmental operations and role responsibilities.
- Performs other duties as assigned.
Minimum Qualifications:
- Seven (7) years of related experience, education/training, OR a Bachelor's degree in related area plus three (3) years of related experience/training. Related experience may include healthcare risk management, claims administration, healthcare operations, legal or regulatory support, insurance, data analytics, or related operational environment; preferably within a healthcare organization or academic medical center.
- Experience with and thorough knowledge of healthcare risk management practices, claims administration, and data analysis skills. Demonstrated ability to assess, monitor, investigate, and report.
- Thorough knowledge of healthcare risk management practices, claims administration, and data analysis skills. Applies knowledge to assess, monitor, investigate, report.
- Knowledge of risk management, medical center, and UC policies and processes. Thorough knowledge of relevant risk management federal, state, and local laws and regulations to identify potential compliance risks, clinical and operational implications.
- Strong technical skills to analyze and identify potential risks. Ability to produce high quality work and keep commitments. Productive in work volume, speed, quality and consistency.
- Proven ability to manage a project through to completion while performing a wide variety of tasks, adapting to changing priorities, deadlines and directions.
- Interpersonal skills to maintain professional relationships with peers, physicians, multidisciplinary team members, and management.
- Strong skills to evaluate issues and identify solutions within defined procedures and policies. Proven ability to address problems and suggest solutions through critical thinking process.
- Verbal and written communication skills to explain technical risk management concepts and articulate reasoning behind own opinions.
- Ability to perform all commonly applicable functions in word processing and spreadsheet software. Comprehensive knowledge of organization's risk management application programs to teach others.
- Strong teaching skills. Ability to break down complex concepts in an understandable way.
- Thorough knowledge of data management and documentation methods used in risk management.
Preferred Qualifications:
- Current Certified Professional in Healthcare Risk Management (CPHRM) certification.
- Experience supporting claims administration, subpoenas, records requests, litigation support, legal/regulatory requests, certificates of insurance, or related operational workflows.
- Experience supporting healthcare claims administration, subpoenas, records requests, depositions, litigation support activities, legal or regulatory requests, certificates of insurance, incident management processes, patient management activities, or related operational workflows.
- Experience with data analysis, dashboard creation/maintenance, operational reporting, workload tracking, trend analysis, or executive-facing reporting.
- Experience with data analysis, dashboard development and maintenance, operational reporting, workload tracking, trend analysis, performance metrics, and executive-level reporting.
- Experience utilizing incident reporting, case management, or operational systems such as iReport, EPIC, Tableau, Power BI, SharePoint, Teams, or similar platforms.
- Experience with process improvement, workflow development, systems administration, project coordination or operational optimization initiatives.
- Working knowledge of healthcare risk management principles, claims administration, incident management processes, patient safety activities, healthcare operations, and/or healthcare reporting systems.
- Demonstrated analytical, organizational, and problem-solving skills, including ability to collect, assess, analyze, trend, and report operational, claims, and incident-related data.
- Demonstrated ability to manage multiple priorities, coordinate complex workflows, facilitate communication among diverse stakeholders, and maintain sensitive and confidential information.
- Demonstrated proficiency with Microsoft Office applications, including Excel, Word, PowerPoint, and Teams.
Special Conditions:
- Must be able to work various hours and locations based on business needs.
- Employment is subject to a criminal background check and pre-employment physical.
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