CPR Risk Management

Risk: An ongoing or upcoming concern that has a significant probability of adversely affecting the success of major milestones.

Our Mission

Our mission is to combine our knowledge of insurance, risk management, and medical best practices in order to assist our clients in evaluating and assessing risk from a business and medical perspective.

Our Services

Risk Assessments

CPR provides an independent assessment of medical risk for stop loss and fully insured products. CPR can work as the only resource for risk projections or can provide backup to clients with nursing staff to cover sick days and overflow during the busy times of the year. CPR has national clients, so able to identify trends and costs more so than a single entity with only their information. Our nurses are trained in both medical cost projections and insurance.

Reserve Assessments

CPR provides reserve assessments. The reserves are entered directly into the client’s system and updated as requested by the client.

50% Trigger Reviews

Notices are sent to CPR and reviewed by our nurses, providing important feedback to our clients for claimants of concern.

Medical/Peer Reviews

We offer medical review services prospectively and retrospectively when a medical service or claim requires review for appropriateness by CPR’s Medical Director. These services can be utilized to determine if a treatment is experimental or investigational, off-label usage of medications, the standard of care, and many other types of treatment or claim evaluations, including peer-to-peer reviews.

Our Management Team

Mary Pozuelo RN, CMS

President/CEO

Mary Vanek Pozuelo, RN, CMS is the Founder and President/CEO of CPR Risk Management, servicing clients in medical risk assessments, reserve assessments, and 50%/Trigger review assessments. She has over 28 years of nursing, operation and management, and marketing experience in the healthcare... and health insurance industries. Her expertise in the medical field, along with her business experience brings a risk management flare unique to this organization. She is a member of the Self Insurance Institute of America. Mary’s experience includes a variety of roles and responsibilities in various health care fields. Prior to CPR Risk Management, Mary was partner and co-founder of CP Risk Solutions, servicing clients in medical underwriting and medical risk assessments, claim management, product development and program management, audits, contract and treaty wording, and broker relations. She also worked in the reinsurance field and was an assistant vice president at Platinum Underwriters Reinsurance, Inc., responsible for underwriting Platinum’s Accident and Health business including stop loss, fully insured, carve-out programs, and short term medical. She was responsible for both financial and medical underwriting, claims assessments, marketing, program management and implementation. She helped establish benchmark treaty wording and underwriting guidelines. Mary was a second vice president and senior account executive in the Group Marketing Division of Gen Re Life. She was responsible for marketing and coordinating health reinsurance to insurance carriers. She worked in the managed care field and was vice president of Marketing and Customer Service and Pre-certification/Utilization Review of Strategic Health Development Corporation. She managed a staff of 53 nurses and intake coordinators for utilization review, quality control, and work-site risk management. Mary was clinical supervisor for a home health agency in Tampa, Florida and also worked as an oncology nurse at Moffitt Cancer Center in Tampa, Florida.

Danielle Johnson, RN, BSN

SR. Management

Danielle Johnson, RN is the National Manager and Corporate Trainer for CPR Risk Management Inc. A passion to help others drove Danielle to start a career in healthcare, which spanned over 10 years with critical care in addition to clinical nursing experience. Danielle graduated from The University of South... Florida with a Bachelors in Nursing. Danielle put her training and passion for service into action when she started her nursing career with Bayfront Health in St. Petersburg Florida in 2005. While working for Bayfront Health Danielle worked as a critical care nurse where she was self-directed and effective in providing exceptional nursing care to patients. Danielle worked collaboratively with physicians to create care plans for the patients under her care leading to a management role as a Charge Nurse in the Critical Care step down unit. As a charge nurse Danielle combined managerial acumen with clinical nursing while developing and implementing educational programs motivating the nursing staff to be successful. Danielle left clinical nursing and began her career with CPR Risk Management in 2014 where she handles national accounts as a registered nurse working alongside underwriters to provide risk assessments for stop loss and fully insured prospective and renewal groups, along with other CPR services. She is also involved with internal peer nursing reviews. Understanding the insurance and medical aspects of risk, Danielle supports her team by being the point of contact for both staff and clients. As the Corporate Trainer for CPR Danielle ensures the staff is current on new trends and up and coming drugs/treatment. Danielle is an intricate part of the Business Development team and an active member of Self Insurance Institute of America Inc. (SIIA).

Alex Johnson, MD, FACC

Medical Director

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Our Client Feedback

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❝

I enjoy working with CPR and value their input on my submissions. 4th quarter turnaround times can be tight at times, but CPR always tries to accommodate my requests in a timely manner, which I appreciate.

❝

I’m extremely satisfied with the service. I wouldn’t change a thing.

❝

Mary and her staff do a tremendous job at servicing all of our medical review needs. The nursing team is very thorough with their reviews and do not hesitate to inform us that additional information would be helpful for more accurate risk projecting. Turnaround times are second to none.

Contact Details

(203) 667-8093

mpozuelo@cpr-rm.com