Risk Manager Management

**/**** - **/**** ****** Risk Manager

Smile Brands, Costa Mesa, CA

Managed all Worker's compensation claims, as well as working with defense counsel and advising of settlement authority. Attended depositions and reviewed surveillance. Pursued subrogation when applicable. Tendered general liability, property and auto claims to broker with supporting documentation. Ensured insurance renewal applications were completed and submitted to brokers on all lines of insurance. Prepared loss reports for board presentation. Provided safety training. Investigated all incident reports and prepared a root cause analysis. Responded to employee and patient concerns.

06/2016 - 06/2017 Performance Risk Manager

Anaheim Global Medical Ctr, Anaheim, CA

Provided root cause analysis of all incidents to include all hospital departments. Monitored quality measures with reporting to the board and CMS, IQR. Attended and responded to The Joint Commission on site inspection. Responded to patient complaints in person with empathy and knowledge to satisfy patient. Inspected patient rooms for safety concerns. Prepared incident summary reports to trend frequency and severity. Developed safety analysis for training. 05/1996 - 05/2016 Director Risk Management

Caremore Health Plan, Cerritos, CA

Regional Manager responsible for ten medical offices to include all aspects of operations. Promoted to Risk Manager with responsibility for all medical and corporate offices. Promoted to Director of Risk Management, Compliance and HIPAA Privacy Officer. Trained in ergonomics and standardized ergonomic supplies to assure appropriate continuity. Performed ergonomic evaluations that resulted in less claims thereby reducing the experience modification than then reduced the insurance premium. Provided in-person safety training to offices n the field. Worked with paneled counsel to litigate malpractice claims. Attended and gave depositions leading to dismissals and defense verdicts. Audited charts for completion and provided physician training with audit findings. Continued safety and compliance duties, as well as attending and reporting all executive board meetings for CareMore Health Systems. Responded to all HIPAA concerns. Ensured all risk, safety, Melanie Gomez HRM

14439 CERECITA DR, WHITTIER, CA 90604

Phone: 562-***-****

Email: **********@*****.***

Summary

Experience with Microsoft products, Word, Excel, and Outlook as well as PowerPoint. Good communication among staff and otter management teams Multitasking

Teamwork skills

Data entry experience

Project managing and meeting planning/scheduling

Managerial experience, such as training

Job Objective

Currently, seeking employment in risk management where I can utilize my skill set and experience in this job field, however open to new opportunities where my skills are applicable. Experience

compliance and HIPAA responsibilities were followed and acted as the liaison for all CareMore business entities.

General High School Curriculum

High School Diploma

Whittier High School, Whittier, CA

Health Care Risk Management

Vocational School Certificate

Finch University, Chicago, IL

Available to start work immediately.

Education

Skills

Additional Comments

Detailed References

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