CLIN RISK MANAGEMENT SPECIALIST - CORP
Location: Houston, Texas
Description: Memorial Hermann Healthcare System is currently seeking to employ CLIN RISK MANAGEMENT SPECIALIST - CORP right now, this vacancy will be depute in Texas. For complete informations about this vacancy opportunity please give attention to these descriptions. BASIC FUNCTION: Responsible for managing a portfolio of claims including medical records reviews, claims investigation, an! d assessment of liability exposure and standard of care issues. Utilizes multiple data management systems including Risk Management Information System (RMIS) for investigation and claims administration. Works collaboratively with risk management attorneys, outside counsel, and facility-based risk management liaisons in claims investigation and claims resolution. Provides broad clinical risk management expertise to the organization in order to proactively address enterprise clinical risk issues and improve quality of care.
MINIMUM QUALIFICATIONS:
1. Bachelor's degree in Nursing required
2. Current State of Texas license to practice professional nursing
3. Minimum ten (10) years of progressive Clinical experience in a hospital setting
4. Minimum ten (10) years experience in risk management in a hospital-based environment or as a nurse paralegal in a law firm
5. Certified Professional Healthcare Risk Management (CPHRM) de! signation or obtain within two (2) years of placement in role !
6. Ability to work collaboratively with health professionals at all levels to achieve established goals
7. Computer proficiency
8. Demonstrated interpersonal, organizational, and communication skills.
9. Demonstrates commitment to the Partners-in-Caring process by integrating our culture in all internal and external customer interactions; delivers on our brand promise of "we advance health" through innovation, accountability, empowerment, collaboration, compassion and results while ensuring one Memorial Hermann.
PRINCIPAL ACCOUNTABILITIES:
1. Responsible for management of a portfolio of claims as assigned.
2. Responsible for claims investigation, medical records review and chart summaries and timelines, liability assessment and evaluation of standard of care issues.
3. Responsible for managing and resolving claims via communications with claimants, families, and counsel within approved authority limit! s.
4. Acts as a liaison between outside counsel and the organization in development of a claim, through discovery and resolution.
5. Serves as a representative of the organization as needed for mediations or at trials.
6. Provides backup coverage for risk management issues as needed to support facility-based risk management liaisons including after-hours on-call risk management support.
7. Provides clinical risk management counsel and support to facility-based Risk Management Liaisons.
8. Proactively monitors clinical claims trend data to provide appropriate loss prevention or mitigation recommendations, advice and counsel.
9. Participates in proactive enterprise clinical risk assessments in collaboration with other functional areas to improve the identification of risks and to use as a basis for prioritization of risk management initiatives.
10. Provides clinical risk management to the organization to address e! nterprise risk issues.
11. Interfaces with insurance function ! as needed to assure timely notification of claims as necessary and with the loss prevention and mitigation function for continued quality improvement and risk mitigation
12. Works collaboratively with loss prevention, quality and patient safety functions in the development and implementation of clinical risk management education initiatives
13. Other duties as assigned
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If you were eligible to this vacancy, please send us your resume, with salary requirements and a resume to Memorial Hermann Healthcare System.
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This vacancy starts available on: Thu, 21 Mar 2013 05:15:59 GMT
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