Risk Management Home Page

Welcome
Welcome to Risk Management for Optima Healthcare Insurance Services. Included in the following pages are risk management information to help you and your organization develop strategies to eliminate, mitigate, or manage risks and improve care, services, and patient safety.

Optima Risk Management Philosophy

Optima Risk Management Services believes that the development of a strong, system-wide, responsible, proactive risk management program by each insured is essential for the survival of both the individual member of the California Healthcare Insurance (CHI) program and the CHI program.

The purpose of Optima Risk Management Services is to mitigate potential risks and claims submitted to CHI by providing quality risk management services to CHI members that address both the needs of the CHI program and the specific needs of each CHI member.

Optima Risk Management Services Organization
Risk Management Services is staffed to ensure our comprehensive services are delivered effectively and efficiently.

The Senior Vice President of Risk Management Services manages the department. This position is responsible for ensuring claims coming into the CHI program are being mitigated through education and support, providing services within the established budget, and providing support to the Risk Management Committee of the Board of Directors. This position provides day to day support to some CHI members, and oversees publications generated by the department.

The Senior Risk Management Consultants are responsible for assisting CHI members in identifying exposures and developing strategies for eliminating, mitigating and managing these risks. The consultants contribute to CHI program strategies, education development, publications, and research.

The Education Specialist is responsible for the development and implementation of the annual education calendar, including the identification of claims trends, new developments and client requests that influence the choices of programs, selecting the speakers, and ensuring the programs run smoothly. This position also supports CHI member requests for education tools and resources, and works with IT and claims to monitor coding and generate specialized reports from the claims data base.

The various activities of Risk Management Services are coordinated by the Risk Management Services Coordinator. This position assists all the risk management staff, oversees network surveys, and assists with the logistics of offering education programs. In addition, this position supports the Leadership Team.

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