Sr. Risk Management & Patient Safety Specialist

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.
• 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

• 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
• 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.