Insurance Risk Manager at Mosaic Health

Fort Myers, Florida, United States -

Full Time

Start Date

Immediate

Expiry Date

23 May, 26

Salary

140513.0

Posted On

23 Feb, 26

Experience

10 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Insurance Program Evaluation, Risk Assessment, Coverage Placement, Contract Negotiation, Claims Management, Litigation Support, Underwriting Information, Loss Prevention, Compliance Policy Development, Data Gathering, Risk Exposure Identification, Certificate Issuance, Financial Analysis, Problem Solving, Planning And Organizing, Teamwork

Industry

Hospitals and Health Care

Description

Job Description Summary ‎ Insurance Risk Manager ‎ How will you make an impact & Requirements ‎ Job Description – Insurance Risk Manager Job Title: Insurance Risk Manager Department: Accounting/Finance Supervisor: Susan Dusenbery, Director, Insurance and Risk Management FLSA Status: Exempt Prepared By: SLD Prepared Date: 2/17/2026 Approved By: Approved Date: Summary The Insurance Risk Manager will have responsibilities relating to all aspects of the insurance and risk management programs. This will include a wide range of aspects from understanding and evaluating insurance programs and coverage enhancements, assisting in the assessment of risks that can be covered by insurance, compiling underwriting information and coverage placement, as well as assisting in the structuring, negotiating, purchasing and day-to-day management of our insurance programs. This position will report to the Director, Insurance and Risk Management, but will include close working relationships with the Treasurer of Mosaic Health as well as occasional interactions with the Chief Compliance Officer, Chief Financial Officer, Business Development and Credentialing teams of the Business Units. Essential Duties and Responsibilities include the following. Other duties may be assigned. Manages the Medical Malpractice claims process directly after claim submission through litigation, settlement, and/or trial, and consults and/or may participate in negotiations, conferences and mediations with adjusting companies, outside legal counsel, staff, claimants, and other involved parties. Assists with the gathering of insurance policy renewal data for all insurance policies. Assists in insurance procurement for newly acquired and existing business units, assists in the development and implementation of risk management and compliance policies/procedures, and assists with claims and litigation. Acquisition support and onboarding. Reporting of insurance claims for all lines except for Medical Malpractice, General Liability and Workers’ Compensation. Manage Medical Malpractice tail tracking and payment collection for departed providers. Works with the company’s insurance brokers to respond to requests for certificates of insurance and claims history document. Identifies potential risk exposures, recommends solutions, implements approved programs, policies and procedures, promotes loss prevention, and updates and monitors compliance as it relates to Medical Malpractice. Supervisory Responsibilities None. To perform the job successfully, an individual should demonstrate the following competencies: Analysis/Problem Assessment – Securing relevant information and identifying key issues and relationships from a base of information; relating and comparing data from different sources; identifying cause-effect relationships. Coaching - Facilitating the development of other’s knowledge and skills; providing timely feedback and guidance to help them reach goals. Compassion - The responsibility to put a patient’s or person’s interests first, including the duty not to harm, deliver proper care, and maintain confidentiality. Compliance - Employee has satisfactory completed employers required compliance training. Employee is able to demonstrate an understanding of employers Code of Conduct. Communication - Expressing ideas effectively in individual and group situations (including nonverbal communication); adjusting language or terminology to the characteristics and needs of the audience. Good listening skills. Delegation of Authority and Responsibility - Allocating decision-making authority and task responsibilities to appropriate direct reports; utilizing direct reports’ time, skills and potential effectively. Developing Organization Talent - Developing direct reports’ skills and competencies by planning effective development activities related to current and future jobs. Follow-up - Consistently maintaining a high activity or productivity level; sustaining long work hours. Individual Leadership/ Influencing - Using appropriate interpersonal styles and methods to inspire and guide individuals (direct reports, peers, and supervisors) toward goal achievement; modifying behavior to accommodate tasks, situations, and individuals involved. Initiative - Making active attempts to influence events to achieve goals; self-starting rather than accepting passively; taking action to achieve goals beyond what is required; being proactive. Practices self-development. Integrity - Maintaining and promoting social, ethical, and organizational norms is conducting internal and external business activities. Judgement/ Problem Solving - Recognizes problems and responds, systematically gathers information, sorts through complex issues, seeks input from others, addresses root cause of issues, makes timely decisions, can make difficult decisions, uses consensus when possible, and communicates decisions to others. Maximizing Performance - Establishing performance/development goals, coaching performance, providing training, and evaluating performance. Patient Service Orientation - Proactively developing patient/customer relations by making efforts to listen and understand the customer and their needs (both internal and external); anticipating and providing solutions to customer needs; giving high priority to patient/customer satisfaction. Ensures appropriate follow up and is their advocate in determining solutions. The employee uses a variety of communication techniques to effectively express thoughts and ideas and to understand or influence. Planning and Organizing/ Work Management - Establishing a course of action for self and/or others to accomplish a specific goal; planning proper assignments of personnel and appropriate allocation of resources. Results Driven & Execution - Accountable for meeting or exceeding individual and/or department goals and objectives. Committed to producing results that will achieve company objectives. Sets priorities and organizes time to meet or exceed goals, follows up, and takes personal responsibility for results whether they are positive or negative. Teamwork/ Collaboration - Working effectively with team/work group or those outside formal line of authority (e.g., peers, senior managers) to accomplish organizational goals; taking actions that respect the needs and contributions of others; contributing to and accepting the consensus; subordinating own objectives to the objectives of the organization or team. Listens to others and values opinions. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience Bachelor’s degree in Business, Legal, Finance, Accounting, or Risk Management required. 10+ years of insurance and risk management experience required. Professional certifications, such as a Certified Professional in Healthcare Risk Management (CPHRM), would significantly enhance qualifications Moderate accounting, financial analysis and reporting background preferred. Ability to work on a broad range of insurance risk management projects simultaneously. Language Skills Ability to read, analyze, and interpret contracts, general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, procedure manuals, and prepare metrics. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public. Mathematical Skills Basic level of mathematical skills required. Reasoning Ability Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Computer Skills To perform this job successfully, an individual should have advanced knowledge of MS Office applications (Outlook, Word, Excel, PowerPoint, etc.) Certificates, Licenses, Registrations Professional risk management designations or licenses not required but would enhance qualifications. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms; climb or balance and talk or hear. The employee is frequently required to stand and walk. The employee is occasionally required to stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate depending on business activity of the office. Receipt and Acknowledgement I acknowledge and understand that: • Receipt of the job description does not imply nor create a promise of employment, nor an employment contract of any kind, and that my employment is at-will. • The job description provides a general summary of the position in which I am employed, that the contents of this job description are job requirements and, at this time, I know of no limitations which would prevent me from performing these functions with or without accommodation. I further understand that it is my responsibility to inform my supervisor at any time that I am unable to perform these functions. • Job duties, tasks, work hours and work requirements may be changed at any time. • Acceptable job performance includes completion of the job responsibilities as well as compliance with the policies, procedures, rules and regulations of the Corporation. • I have read and understand this job description. Print Employee Name: ______________________________________ Employee Signature: _______________________________________ Date:________________ ‎ Compensation: $93,675.00 to $140,513.00 Beware of fraudulent job postings: While Mosaic Health job advertisements may be found on many sites, our current openings page and its associated Workday account are the only places we accept applications for open roles. If you suspect a job post is fraudulent, please let us know at recruiting@apree.health. Mosaic Health is a national care delivery platform focused on expanding access to comprehensive primary care for consumers with coverage across Commercial, Individual Exchange, Medicare, and Medicaid health plans. Learn More about Mosaic Health Learn More about Millennium Physician Group Learn More about CareMore Health Learn More about Castlight Health Learn More about Vera Whole Health

Responsibilities

The Insurance Risk Manager will manage all aspects of insurance and risk management programs, including evaluating coverage, assisting in risk assessment, and structuring, negotiating, and managing insurance programs. Essential duties involve directly managing Medical Malpractice claims from submission through resolution, assisting with insurance renewal data gathering, and supporting insurance procurement for business units.