• Supervise agency's Risk Assessment Department, which includes Quality Improvement specialist, Utilization Management specialist, Compliance Officer, Contract specialist, Medical Records personnel, and Court Services department for a Joint Commission accredited behavioral health facility.
• Investigate HIPAA, abuse/neglect, process concerns, and all areas of agency risk to reduce organizational exposure and control potential losses.
• Coordinate and guide employees in interpretation of state, federal, and Joint Commission mandates as well as interpretation of legal statute.
• Oversee all Utilization Management and Quality improvement plans, audits, and priorities.
• Oversee agency's court services department for all Court Ordered members and the Title 36 program for those individuals involuntarily committed to the agency's psychiatric hospital.
• Oversee education of staff on policies, procedures and compliance related issues.
• Conduct facility inspections and quality assessments to ensure client safety and regulatory compliance.
• Oversee agency incident reporting, internal complaints, as well as the grievance and appeal process.
- Director of Risk Management at Risk Assessment Department
- Director of Risk Management at The Guidance Center
- Director of Utilization Management at The Guidance Center
- Director of Admissions at community Detox/Stabilization Unit
1 year, 2 months at this Job
- MS in Psychology - Psychology
- BA in Psychology - Psychology
93, Paris Area, France Public healthcare organization of 1,800 employees serving 1.7 million people in the Paris suburb of Seine-Saint-Denis. EXECUTIVE DIRECTOR OF RISK MANAGEMENT 2013-2016 Responsible for the analysis of the healthcare expenses for the disease prevention department (3.2 billion euros/year on both in/out patient care), and the design and the deployment of initiatives to curb waste and improve the quality of services. Managed a multi-disciplinary staff of 100. * Developed innovative action plans on major healthcare issues including drug usage, hospital care, cash sickness benefits, and medical transport. * Partnered with local authorities on public health issues to establish a common strategy for 2015-2017. * Directed disease prevention initiatives (diabetes, asthma), health promotion (e.g. nutrition, heart health, back health), therapeutic patient education, and organized cancer screening. * Implemented a pioneer program to enhance the return home of women after giving birth. * Managed contractual relations with the nine local healthcare unions to attain the highest quality and cost-efficient care delivery. * Supervised the payment of hospital expenses totaling 1 billion euros/year.
- EXECUTIVE DIRECTOR OF RISK MANAGEMENT at CPAM
- DIRECTOR, HUMAN RESOURCES at
- HUMAN RESOURCE MANAGER at CPAM
4 years at this Job
- certificate - Organizational Behavior
- Master - Social Policy and Health Insurance Management
- Master and Bachelor - Government and Political Science
• Responsible for the Risk Management Program and plan for 519 bed licensed facility
• Scope of services provided by organization include acute care, surgical services, outpatient therapy and clinics, acute rehab, and mental health
• Responsible for Patient Relations department including complaints/grievances
• Adverse event investigations/follow-up
• Facilitation of Root Cause Analysis in response to adverse events
• Claims management in collaboration with corporate legal department
• Member of many multidisciplinary committees including Bioethics, Environment of Care, Falls Steering Committee, and Patient Safety Committee
• Fiscal management of budget for the department
• Provide employee mentoring, coaching, and evaluations
• Consultative for challenging patient and family situations
• Provides education on risk management strategies for staff and organizational leadership on an on-going basis
• Conducts pro-active risk assessments to identify areas of risk and develop strategies to reduce
• Works directly with medical staff in relation to patient safety and quality matters
• Collaboration with Director of Clinical Quality, Compliance, and Patient Safety to ensure regulatory requirements and patient safety goals met.
• Knowledgeable in state regulations, CMS conditions of participation, EMTALA, and Joint Commission standards
• Responsible for facility event reporting system including analysis and tracking/trending
- Director of Risk Management at Saint Francis Hospital Memphis
- Director of Risk Management and Patient Relations at Kaweah Delta Healthcare District
- Clinical Risk Manager at Kaweah Delta Healthcare District
- Nurse Manager at Kaweah Delta Healthcare District
3 years, 11 months at this Job
- Masters of Science in Nursing - Nursing
- Bachelor's in Science of Nursing - Science of Nursing
- Associate Science degree - Nursing
• Reduced overall insurance premiums by 20.2% at first renewal.
• Settled $1.2M water damage claim caused by a broken sprinkler line.
• Negotiated five year service fee agreement with a major international brokerage firm resulting in a 12.5% reduction in fees.
• Prepared budgets for FY18 and FY19 insurance premiums and established reserves of $1.2M for losses.
• Maintain and monitor $1.1B property program for buildings, business interruption, business personal property which includes high-tech research equipment, and the Big Bear Solar Observatory in California.
• Perform risk management presentations to all university members in order to sell risk management as a customer service department and provide information as it relates to university operations and best practices.
• Maintain fleet, mobile equipment and driver's lists. Established guidelines, qualification requirements, and remediation procedures for employee and student use of university owned and non-owned vehicles.
• Increased university awareness and compliance with contractual and certificate of insurance obligations.
- Director of Risk Management at NEW JERSEY INSTITUTE OF TECHNOLOGY - NJIT - Public Research University
- EASTON COACH COMPANY at Motorcoach and Para-Transit Transportation Company
- Managing General Partner at HAHN DEVELOPMENT
- Risk Manager at JUST BORN INC
2 years, 4 months at this Job
- M.B.A. degree - Management
- B.S. degree - Management
● Developed Cyber Breach Response, Safety, and Loss Prevention Working Groups
● Developed and implemented risk, security, and safety guidelines and training for field operations
● Created the Customer Service Protocol and Escalation Plan for field operations
● Successful integrated 4 franchisee acquisitions to the corporate portfolio
● Partnered with Law Enforcement across the country which resulted in several criminal indictments Responsibilities:
● Coaches field leadership teams regarding claims, safety, security, and loss prevention
● Purchases insurance for Property, Casualty and Management Liability lines of coverage
● Selects and manages Broker and Third Party Claims Administrator relationships
● Conducts investigations relative to serious incidents, losses reported, robberies, thefts, and employee policy violations
● Manages all claims and litigation from inception to closure
● Provides guidance to Executive Team in order to reduce the financial risk and exposure to the company
● Oversees all perimeter access, physical security, alarms and CCTV systems in order to protect company assets
- Director of Risk Management at Security and Loss Prevention
- Global Claims Support General Liability Manager, Legal Team at Whole Foods Market
- Manager of Claims, Corporate Risk Department at Safway Group Holding LLC
- Regional Claims and Safety Specialist, Rocky Mountain Region at Whole Foods Market
1 year, 8 months at this Job
- Bachelor of Science - Business Management
Director of Business Strategy & Analytics Department responsible for credit risk model development & analysis of financial risk to ensure profitable growth. Designed and launched a product for the Western Funding Buy
Program(TM), an automated credit scoring system that controls lending decisions for a $150 million portfolio.
Western Funding is a subsidiary of Westlake Financial Services. Responsibilities and Achievements
• Manage team of analysts in Business Strategy & Analytics department.
• Work with Data Science department to develop credit risk model.
• Design policy and procedures to minimize risk and maximize efficiencies in various departments.
• Analyze and integrate third party services like LexisNexis FraudPoint and Clarity Clear Fraud into credit risk model to improve pricing precision.
• Analyze profitability and capture rate of different segments of the portfolio and implement adjustments to credit risk model optimize growth while maintaining profitability.
• Develop business planning model to forecast corporate growth and required staffing.
• Develop and manage level-yield accounting model responsible for calculating key inputs into balance sheet and income statement.
• Work with software development team to implement updates to Underwriting and Servicing systems.
- Director of Risk Management at Western Funding, Inc
- Senior Risk Manager at Westlake Financial Services
8 months at this Job
- Bachelor's - Business Administration
- Bachelor's - Earth and Environmental Science
Manage Third Party Administration (TPA) Risk Team. Developed and administered an effective risk management cycle, to identify measure, evaluate, respond, monitor and report on risks on an on-going basis. Oversee operational risk reporting, RCSAs, Deep Dive assessments, KRIs, and reporting efforts. Ensures timely delivery of management information and advice stakeholders including the Board, Executive and Senior Management levels, giving a view of the enterprise risks and control environment. Report to the Head of Governance, Risk and Compliance.
• Developed and implemented TPA Risk Policy and Methodology in line with client's TPA risk appetite.
• Assisted with the drafting and implementation of the TPA Operating Model and Manual.
- Director of Risk Management at Tata Consultancy Services
- Head of Operational Risk & Controls-Life & Retirement at AIG, Dallas
- at AIG, Dallas
- Head of Operational Risk Management-Consumer and LAC Region at AIG, Dallas
8 months at this Job
- BA - Political Science
- - Principles of Written English
- Paralegal Certification
- - Project Management
Serving as a risk manager, clinical consultant, and trainer at a 45-bed psychiatric facility
- Director of Risk Management at Department of Mental Health
- Adjunct Faculty at Salve Regina University
- Content Specialist at Addictions Technology Transfer Center
- Adjunct Faculty at Rhode Island College
3 years, 2 months at this Job
- Master of Arts - Clinical Psychology
Program Coordinator III/Director of Risk Management 4/2013 - Present
• Oversight of Risk Management for Cape Cod DMH sites services including Hospital, Day Hospital, Emergency Services, Case Management, Residential Services and Contracted Vendor Programs
• Coordination of all activities to ensure compliance with Joint Commission Accreditation, Centers for Medicaid and Medicare and Massachusetts Department of Public Health standards
• Oversight of Human Rights Complaint process for all Cape Cod DMH sites, including fact finding, assignment of complaints for investigation, review corrective action plans related to substantiated complaints, staff training and technical assistance to programs
• Coordinate all Performance Improvement and Quality Assurance activities for the Site, including monitoring contracted services, recommending and developing PI projects, conducting Root Cause Analyses, FMEA processes and analysis of Patient Satisfaction and related data;
• Assist in deploying DMH resources in responding to behavioral health needs for the Cape Cod and Islands community, including suicide prevention and post- vention, community education, liaison to community groups and other stakeholders
• Prepare statistical information, reports and analysis of data for the center's standing committees (Protocol, Environment of Care, Restraint Reduction, Leadership)
- Program Coordinator III/Director of Risk Management at Community Mental Health Center
- Neurobehavioral Rehabilitation Program Director at Kindred Healthcare
- Human Relations Manager at Berkshire Healthcare Systems, Inc
- at Social Justice Mediation
5 years, 11 months at this Job
- Master's Degree in Public Policy and Administration - Areas of Research Interest
Florida - a local transit company offering 5 service types and 1,000 employees (some Union)
• Oversight of risk management programs to include insurance broker, third party claims administrator and self- insured programs for all lines of property and casualty and public officer's risk
• Project Lead for an RFP for Third Party Claims Administrator and Claims Legal Defense services
• Draft Scope of Work for Third Party Claims Administrator and Legal Services
• Draft Standard Operating Procedures for Worker's Compensation
• Manage insurance premiums, claims fees, loss payments and legal fees to contracted budgets
• Manage and develop a team to include a claims manager, claims technician and risk management coordinator
- Deputy Director of Risk Management at Central Florida Regional Transportation Authority
- Manager at Risk Management, Darden Restaurants, Inc
- Director at
- Sr. Claims Manager at Risk Management, HD Supply, Inc
1 year, 2 months at this Job
- Associate in Risk Management and Associate in Claims - Risk Management and Associate