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Risk Management Coordinator at Memorial Health in Springfield, Illinois

Posted in Other 30+ days ago.

Type: Full Time





Job Description:

Overview
Provide support and expertise both interdepartmental and system wide in areas of Risk Management, Professional and General Liability Claims Administration, and Data Management Support.

Qualifications
Education:

* Bachelor's degree with 3 or more years of clinical healthcare experience or Master's degree required

Licensure/Certification/Registry:

* Registered Nurse in the State of Illinois required.

Experience:

* Experience of working in a similar size and complexity of Memorial Health System

Other Knowledge/Skills/Abilities:

* 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

Responsibilities

* 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