SENIOR RMPS SPECIALIST
HybridLos Angeles, California, United States
Job Summary
Provide risk management consultation to physicians and staff by analyzing claims data, identifying trends, and developing risk reduction strategies. Conduct virtual or on-site practice risk assessments to promote patient safety while creating educational guides, templates, and articles for medical professionals. Respond to hotline and email inquiries, participate in rotating after-hours coverage, and counsel members referred to CAPCares regarding adverse patient outcomes. Draft case summaries for peer review meetings and present educational programs to healthcare groups. Evaluate subpoenas and route legal requests to appropriate departments. Requires a healthcare-related bachelor's degree, five years in risk management, and the ability to travel to practice locations within California.
Required Qualifications
- Bachelor's degree in a healthcare related field
- Five years' experience in healthcare risk management or equivalent experience in a healthcare related environment
- Maintain a valid California driver license
- Ability to travel to practice locations within California, with occasional overnight stays, when requested
Desired Qualifications
- master's degree
- RN, RN/JD, or clinical license
- Professional liability experience
- Physician office management or ambulatory care experience
- 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
- Excellent verbal and written communication skills
- Excellent customer service skills
- Ability to work independently and collaboratively
- Strong organizational skills
- Computer skills including Microsoft Office, Word, Excel, PowerPoint
- 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
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