College degree required.
Clinical background strongly preferred -- RN, advanced practice nurse, physician assistant, or other clinical background.
Experience in hospital risk management or related areas preferred.
Strong computer skills preferred.
Certification as, or willingness to pursue certification, as a Certified Professional in Healthcare Risk Management (CPHRM).
Evaluate clinical complaints and incidents which may prove compensable.
Investigate incidents retrospectively, participate in root cause analyses, and investigate risk areas and issues prospectively, under the direction of the CMO and CQPSO.
Ensure appropriateness of clinical documentation and informed consent in regard to identified incidents and proactively.
Ensure 24/7 availability of staff to respond to questions and incidents.
Under the direction of the CMO and CQPSO, ensure clinical regulatory compliance.
Participate in Joint Commission, Department of Health and Mental Hygiene, and other regulatory surveys.
Respond to subpoenas.
Track data related to complaints and incidents, and maintain database.
Track regulatory agency complaints.
Assist Claims Manager in provision of information and data regarding claims and related matters.
Assist Claims Manager in annual and other updates regarding Mercy's self insurance trust.