Job Type
Full-time
Description
OVERVIEW: Provide risk management consultation and support to physician members and insureds.
Essential Duties and Responsibilities:
- Act as resource to physicians and their staff regarding risk management and other current issues regarding physician/medical practice liability. Manage complex and sensitive issues as they relate to risk reduction strategies for physician practices.
- Provide risk management advice to Hotline and e-mail requests from physicians and their staff. Participate in rotating after-hours (evenings, weekends, & holidays) Hotline coverage.
- Organize, plan, and conduct virtual, or on-site, physician practice risk assessments to promote patient safety practices and to minimize malpractice risk.
- Function as an RMPS resource to other CAP department staff
- Analyze claims data and other data sources. Identify trends and develop risk reduction strategies utilizing current best practices.
- Develop risk management practice guides, templates, educational materials, and other resources for physicians and their staff focusing on patient safety and risk management.
- Research and write professional RMPS articles.
- Create and present educational programs on risk management topics and strategies to physicians and other healthcare related groups.
- Participate in RMPS Departmental and organizational meetings, goals, projects, committees
- Participate in Risk Assessment Peer Review meetings, including review of materials, drafting case summaries and minutes
- Staff CAPCares Unit as assigned, including:
- Counsel, guide and coach members/member entities referred to CAPCares hotline in real time or post-adverse patient event with clinically tailored advice specific to the nature of the case.
- Identify and manage Adverse Patient Outcome cases subject to intervention with Patient Assistant Services (PAS).
- Evaluate subpoenas and requests for deposition, appearances, etc., route requests to appropriate CAP departments or provide guidance to Members as needed.
Requirements
Education and Experience:
- Bachelor's degree in a healthcare related field required; master's degree preferred
- RN, RN/JD, or clinical license preferred
- Five years' experience in healthcare risk management or equivalent experience in a healthcare related environment
- Professional liability experience highly desirable
- Physician office management or ambulatory care experience preferred
- Experience and participation in patient safety/risk management and quality improvement (QI/QA) activities or committees
- Knowledge of root cause analysis (RCA), adverse event management, responding to grievances and complaints, advance directives and release of protected health information
- Experience identifying educational and learning needs/gaps of healthcare professionals or physician office practices and developing education and providing training to address the needs
- Experience writing articles, healthcare educational material, and professional business correspondence
- Experience in public speaking, e.g., creating and providing presentations to medical personnel or teaching classes
Other Skills and Abilities:
- Excellent verbal and written communication skills
- Excellent customer service skills
- Ability to work independently and collaboratively
- Strong organizational skills
- Maintain a valid California driver license to travel to physician offices or other venues
- Ability to travel to practice locations within California, with occasional overnight stays, when requested
- Computer skills including Microsoft Office, Word, Excel, PowerPoint
Preferred Knowledge of the Following:
California and federal laws and regulations pertaining to the practice of medicine and healthcare, including MICRA; medical risk management techniques; professional liability coverage; hospital and medical office policies and procedures; social behavioral and educational research techniques and evaluation; and medical, legal, insurance databases.
