Role Title: Healthcare Risk Management SME Location: Remote Full Time US citizens only Minimum years of work exp: 5 Years Education: Bachelor's Degree in Nursing, Business/Management or a Healthcare related field. Required Skills:
- Certification in HRM (ASHRM) strongly preferred
- Current, unencumbered RN licensure preferred
- MHS/DHA experience preferred
- Ability to effectively communicate at various levels within the organization (i.e., HQ, market, facility
- Proficient in Microsoft Office tools
- At least five years of experience in healthcare setting or with a provider of services to the healthcare industry
- At least two years of job duties dedicated to healthcare risk management
- Receive and record malpractice claim payments monthly, active duty death/disability cases and initiate the required clinical quality review process; correctly identify and process medical malpractice claims by legal outcome (payment) type and standard of care.
- Process clinical, government administrative and criminal adverse action cases. In Accordance With (IAW) Department of Defense Instruction 6025.13, Medical Quality Assurance (MQA) in the Military Health System (MHS), Defense Health Agency Procedural Manual 6025.13, Clinical Quality Management in the Military Health System (DHA-PM 6025.13), and Air Force Instruction (AFI) 44-119, Medical Quality Operations.