Sr. Risk Management Specialist

About the Role

Provide risk management consultation and support to physician members and insureds.

Responsibilities

• Act as a resource to physicians and their staff regarding risk management and current issues related to physician/medical practice liability.
• Manage complex and sensitive issues related to risk reduction strategies for physician practices.
• Provide risk management advice to Hotline and email requests from physicians and their staff.
• Participate in rotating after-hours (evenings, weekends, and holidays) Hotline coverage.
• Organize, plan, and conduct virtual or on-site physician practice risk assessments to promote patient safety practices and minimize malpractice risk.
• Function as an RMPS resource to other CAP department staff.
• Analyze claims data and other data sources to identify trends and develop risk reduction strategies using 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, and 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 the 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 Assistance 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 those 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.

Skills

• 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, and PowerPoint.

Preferred Knowledge

• 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.
• Medical, legal, and insurance databases.

Location

Open to all branches (Los Angeles, Orange County, San Diego, Walnut Creek).