Description:
OVERVIEW: Provide risk management consultation and support to physician members and insureds.
Essential Duties and Responsibilities:
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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.
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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.
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Organize, plan, and conduct virtual, or on-site, physician practice risk assessments to promote patient safety practices and to minimize malpractice risk.
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Function as an RMPS resource to other CAP department staff
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Analyze claims data and other data sources. Identify trends and develop risk reduction strategies utilizing current best practices.
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Develop risk management practice guides, templates, educational materials, and other resources for physicians and their staff focusing on patient safety and risk management.
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Research and write professional RMPS articles.
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Create and present educational programs on risk management topics and strategies to physicians and other healthcare related groups.
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Participate in RMPS Departmental and organizational meetings, goals, projects, committees
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Participate in Risk Assessment Peer Review meetings, including review of materials, drafting case summaries and minutes
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Staff CAPCares Unit as assigned, including:
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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.
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Identify and manage Adverse Patient Outcome cases subject to intervention with Patient Assistant Services (PAS).
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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:
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Bachelor’s degree in a healthcare related field required; master’s degree preferred
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RN, RN/JD, or clinical license preferred
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Five years’ experience in healthcare risk management or equivalent experience in a healthcare related environment
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Professional liability experience highly desirable
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Physician office management or ambulatory care experience preferred
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Experience and participation in patient safety/risk management and quality improvement (QI/QA) activities or committees
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Knowledge of root cause analysis (RCA), adverse event management, responding to grievances and complaints, advance directives and release of protected health information
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Experience identifying educational and learning needs/gaps of healthcare professionals or physician office practices and developing education and providing training to address the needs
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Experience writing articles, healthcare educational material, and professional business correspondence
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Experience in public speaking, e.g., creating and providing presentations to medical personnel or teaching classes
Other Skills and Abilities:
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Excellent verbal and written communication skills
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Excellent customer service skills
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Ability to work independently and collaboratively
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Strong organizational skills
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Maintain a valid California driver license to travel to physician offices or other venues
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Ability to travel to practice locations within California, with occasional overnight stays, when requested
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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.
