Posted in Other 30+ days ago.
Type: Full Time
Provide support and expertise both interdepartmental and system wide in areas of Risk Management, Professional and General Liability Claims Administration, and Data Management Support.
* Bachelor's degree with 3 or more years of clinical healthcare experience or Master's degree required
* Registered Nurse in the State of Illinois required.
* Experience of working in a similar size and complexity of Memorial Health System
* Highly developed negotiation and interpersonal skills.
* Ability to work under limited supervision making decisions on non-routine issues and ability to provide solutions
* Moderate physical effort required
* Seldom travel
* Assess episodes of care to evaluate compliance with the Medical Practice Standard of Care
* Engages in communication with healthcare providers and their patients to evaluate compliance with established processes, policies, and procedures.
* Recommend levels of appropriate compensation to claimants.
* Establish appropriate financial reserves to pay claimants for medical care, legal fees, and related costs.
* Works directly with MHS inside and outside legal counsel and insurance carriers to resolve all levels of claims.
* Acts as liaison between MHS and vendors when events occur. Provides details of events to be reported to the vendors and the Food and Drug Administration.
* Consults directly with the Quality Assurance and Medical Staff Office personnel to bring matters to their attention to improve processes and assist physicians in providing higher levels of care.
* Acts as daily consultant to all MHS staff and physicians in reference to risk control actions.
* Performs other duties as required