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Organization TypePublic Interest
Years of Experience
Date Last Verified
ProfileRisk Specialist Duties: Provides day-to-day risk management, patient safety and legal support across the organization. Performs a variety of duties related to managing claims against the facility, interfacing with defense legal counsel, providing Risk management educational programs and newsletters, researching legal issues related to patient care and professional liability, and maintaining risk management policies. Mentors and supports other Risk Management Staff. Provides legal guidhance to Risk Managers, and Workers Compensation Coordinator in the performance of their duties. Assists practices in the identification of trends, timely resolution of incomplete, unresolved reports, and the development of meaningful action plans. Provides advice, consultation and support to staff and providers on legal and risk issues. Manages Risk Management internal and corporate policies. Recommends appropriate revisions to new or existing policies and procedures to prevent future occurrences; recommends ways to eliminate risk through organization, equipment or other changes; reviews and revises risk management policies and other organizational policies and procedures. Drafts risk management newsletter on issues relating to Risk Management. Provides in service training to providers and staff on topics relating to risk management. Works with legal counsel to coordinate the investigation, processing and defense of claims against the organization and providers. With the Manager of Risk, gathers and provides defense attorneys with requested information and documents necessary for pending litigation. Handles new summons and complaints as well as complaints from regulatory bodies and insurance companies served on providers and staff. Participates in evaluation of claims for settlement; assists defense counsel in preparing releases and obtaining settlement checks; participates in allocation of settlement process. Reviews patient complaints that may be the source of potential legal action; discusses and offers solutions when possible, including payment of incidental expenses, to resolve with patient and/or family any grievances relating to potentially compensable events. Manages the patient disclosure program, including recommendations for disclosure candidates, scheduling of meetings and maintaining the disclosure database. Manages the expert witness procedure outlined in the expert witness policy, including interacting with patients and their attorneys relative to requests for expert testimony and narrative reports. Performs legal research and responds to legal inquiries posed by providers and staff. Provides direction and advice to medical staff in connection with medical malpractice litigation and medico-legal matters. Maintains awareness of legislative updates and case law updates that impacts healthcare risk management and provider liability. Assists providers in legal proceedings when subpoenaed by patients to provide fact witness testimony in court or at depositions as requested. With the Manager of Risk Management, directs and coordinates release of records and information in response to subpoenas, court orders, attorney requests, state and federal agency investigations and other inquiries from outside sources. Evaluates correspondence from attorneys, patients and other outside sources and formulates responses as necessary. Actively participates in a variety of committees as required or directed. Prepares and maintains standardized claim files. Reviews insurance carrier information reports such as open/closed claims reports and loss runs for accuracy and trends. Collaborates with the manager and director to proactively identify risk reduction opportunities and to design and implement risk mitigation interventions. With manager and director, reviews all PCEs, recommending reporting requirements and follow-up analysis. Assists with completing and filing reports to the DPH, BRM, CMS, FDA and medical device manufacturers as necessary.
Qualification and Experience
Qualifications: BA/BS in Nursing or related discipline preferred and 3-5 years medical malpractice or risk management experience. JD Degree required. Demonstrated leadership abilities. Proficient in the use of various software packages such as Microsoft Word, PowerPoint, Basic Excel Spreadsheets. Ability to prioritize, develop and implement programs related to Claims, Risk and Quality Improvement with flexibility. Ability to multitask and respond to changing priorities based on needs. Proficient presentation skills for a variety of audiences. Working knowledge of basic regulatory issues such as HIPAA and other relevant state and federal regulations. Excellent organization, interpersonal and communication skills.
Requisition ID: 2018-5325
Reliant Medical Group
630 Plantation St.
Worcester, MA 01605