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Under general direction, provides health care risk management services within the Medical Legal Services Department and performs and/or assists with all aspects of the Health Sciences Center’s clinical risk management and professional liability programs.
Knowledge of medical and legal terminology
Knowledge of medical procedures
Knowledge of professional liability claim management
Interpersonal/human relation skills
Verbal and written communication skills
Ability to organize/prioritize duties
Ability to maintain confidentiality
Ability to operate personal computer and office equipment
Graduate of an approved RN program, with bachelors degree in nursing and an associate’s degree in paralegal studies preferred; supplemented with two (2) years of nursing experience and two (2) years of health care risk management or healthcare liability defense experience.
Reviews, screens, and initiates investigation of patient incidents/occurrences, lien letters, new suits, and claims; interviews staff, collects necessary documents and evidence, summarizes medical records, and recommends appropriate actions.
Performs and/or assists with all aspects of the department’s risk management and legal functions; receives, reviews, and classifies all patient incident reports; interacts with quality improvement functions; conducts clinical risk management orientation; designs and implements education programs; performs ongoing clinical risk analysis of incident data.
Reviews, investigates, and initiates resolution of patient complaints, billing issues, and medical negligence claims.
Assists with preparation for external audits and reviews including but not limited to file preparation and claims presentations.
Assists with professional liability claim management.
Prepares reports to appropriate outside agencies and patients as required under the supervision of the Director of Medical Legal Services.
Performs other duties as assigned.
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