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Insurance Attorney in Beverly Hills, CA

Cedars-Sinai Medical Center Sep 13,2016 Jul 01,2016 Location USA Beverly Hills CA
This job is expired...

In-House

Attorney

Insurance Coverage

Litigation - Whistleblower - CFTC

Min 5 yrs required

Profile

Manager, Risk Management DUTIES: Provide risk management consultation to physicians and staff as needed. Assist in the review and summarization litigation cases, maintaining litigation files. Develop a comprehensive risk management program, including clinical and administrative policies and procedures for loss prevention, loss control, and loss mitigation. Review organizational wide policies and procedures, when requested, for compliance to applicable Federal, California State Law, regulatory and court mandates as well as compliance to Accrediting bodies and HMOs. Supports risk management activities for all providers and staff regarding high risk issues; including the following: Collect information to respond to subpoenas in a complete and timely manner. Assist in preparing physicians for depositions and court appearances prior to attorney involvement. Assisting clinicians to meet legal obligations to patients including consent, non-compliance warnings, and appropriate documentation. Intervene as directed to resolve issues directly with patients and family. Assist in obtaining compliance with statutory reporting including abuse and suspicious injury reporting. Develop dashboards to trend litigations over time and develop preventive programs accordingly in collaboration with Quality Management. Collaborates with Quality Management regarding claims denials trends for the prevention of potential litigation. Provide assistance to operations managers in dealing with adverse events and difficult patients. Provide training to all staff and physicians to ensure compliance with California Privacy and HIPAA regulations. Review and manage all claimed privacy breaches by physicians responding to regulatory agencies as required. Coordinate and participate in quarterly malpractice-carrier litigation claims review. Supports Operation management in reviewing administrative processes to ensure regulatory compliance and patient safety. Collects information to support brokers in insurance placement for professional liability, general liability, directors and offices coverage, fiduciary liability, managed care errors and omissions, and workers compensation for Affiliated Groups. Collects information for the initial processing of first aid and workers compensation claims for physician groups. Conducts appropriate orientation/ training of new staff and physicians. Perform other related duties as assigned. Participate in teams of appropriate stakeholders to assess new technologies to identify and mitigate risk to the organization.

Qualification and Experience

Qualifications: California RN license and Bachelor of Science degree in Nursing or related field is recommended. JD Degree and advanced degree in health care-related field is required. 5 years of management and managed care experience, preferably in a medical group/IPA or health plan setting. Prior professional liability insurance risk management experience preferred. Strong verbal and written skills a must; must be able to interact effectively via telephone and in person with patients, medical personnel, clinical and administrative staff and health plan representatives. Must be able to react professionally under pressure and possess and utilize mature and independent judgment. Must be able to travel and possess reliable transportation. Must have knowledge of Continuous Quality Improvement, Credentialing, Peer Review and Risk Management processes. Must have working knowledge of compliance with health related California health regulatory boards and processes. Must have basic computer skills and the ability to expand skill sets.

Additional info

Requisition #: M11081

Company info