This individual and the role of the risk manager are ever changing and will undoubtedly be more strategic under the current healthcare reform. Traditionally, risk managers have identified both internal and external threats and have developed control measures and monitoring systems to mitigate risk. There are many areas of risk to consider including: enterprise, business, clinical, technology, and operations. The risk manager also plays the role of champion, communicator, and referee between different aspects of the organization. A successful strategy includes a multidisciplinary approach with claims, quality improvement, patient safety, operations, finance, and leadership represented. It is the role of the ED leader to ensure the integration of these disciplines.