Clinical Risk Specialist (RN / PA)

The Execu|Search Group
Aug 13, 2017
Aug 14, 2017
Employer Type
Direct Employer
Employment Type
Full Time
Job Description:

About the Opportunity A recognized insurance company headquartered in New York City is actively seeking a self-motivated and compassionate Registered Nurse (RN) or Physician Assistant (PA) for a promising opportunity on their staff as a Clinical Risk Specialist. In this role, the Clinical Risk Specialist performs medical malpractice case reviews from a patient safety and loss prevention perspective utilizing the company's case review methodology. Apply today! Company Description Insurance Company Job Description The Clinical Risk Specialist (RN / PA) will: * Review and analyze claims data to support PSLP patient safety initiatives; enter relevant information into patient safety data collection system following case review manual guidance and business rules * Collaborate with PSLP team to develop and refine data collection activities, including the identification of additional data elements for review * Conduct focused reviews to provide institutions and initiatives with information pertaining to actionable themes, common trends, etc. * Report potential risk trends and patient safety opportunities identified from new claims analysis * Provide ongoing monitoring and updating of open professional liability cases to accurately reflect all available information at the time of review * Meet with assigned institutional Director on an ongoing basis to inform them of potential institutional risks * Share information identified through new and ongoing case reviews * Work with Associate Director and Data Manager to identify risk and improvement opportunities and assemble relevant information in support of clinical initiative * Review new cases on a monthly basis * Re-review cases based on established triggers * Support business operations improvement efforts through defined data quality control mechanisms Required Skills * Bachelor's degree in nursing or other advanced clinical education * Registered Nurse or Physician Assistant license * 3 years of nursing/clinical experience * Strong analytical and organizational skills * Strong oral and written communication skills * Excellent computer skills with experience in Excel, Word and PowerPoint * Ability to work independently as well as collaboratively * Ability to embrace the importance of subscriber service and demonstrate a continuous focus in support of this mission * Able to understand how data collection and data elements impact and support the overall goals of the PSLP Department functions and subscriber relationships Desired Skills * 5+ years of nursing/clinical experience * 3+ years of performance improvement, quality or risk management experience * Clinical chart review and chart abstraction experience * Familiarity with Electronic Medical Records