- Conduct comprehensive on-site risk evaluations for policyholders that includes facility review, evaluation of policies and procedures; medical record review and analysis: and interviews with staff and providers. Follow-up on risk issues.
- Review and analyze claims experience of assigned group accounts to identify risk trends.
- Prepare Evaluation Reports and assist assigned group accounts with strategies, resources, and activities to help improve risk status.
- Present general and topic-specific education programs to policyholders and policyholder's office staff.
- Prepare and present Executive Summary Reports to administration/leadership of large medical groups.
- Assist other departments and committees with risk management issues including providing risk evaluation services as requested by the Underwriting Committee.
- Attend and/or represent SVMIC at industry or related conferences, meetings, or seminars as required.
- Participate in cross-functional teams.
- Meet or exceed supervisor's expectations for productivity, quality, continuous improvement, and goal accomplishment.
- Contribute to SVMIC's success by identifying opportunities and making recommendations that may lead to improved processes.
- Regular and predictable on-site attendance required.
- Ability to work remotely.
- Available to travel by various means (this includes air travel) as business needs dictate.
- Complete special projects and other duties assigned.
- Associate degree or above, Bachelor's Degree in healthcare preferred.
- Minimum 5 years of clinical RN experience.
- Valid Registered Nurse licenses maintained in good standing in the state of Tennessee.
- A valid Driver's License is required.
- This position required to travel throughout the state of TN and the contiguous states by automobile for approximately 6 overnight stays/ month on average.
- LNCC, CLNC, CPHRM, or similar designation preferred.
- Experience in medical record analysis/legal nurse consulting is a plus.
- Highly focused with excellent analytical, and critical thinking skills.
- Ability to efficiently manage multiple, complex projects.
- Proficient with Outlook, Word, Excel, PowerPoint, and a variety of software programs.
- Ability to research, read, comprehend, analyze, apply, and distill large amounts of complex information into useful tools, presentations, and /or conversations.
- Must reside in East, TN. (Bristol, Johnson City, Kingsport.)
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Risk Evaluation Consultant - Kingsport, United States - State Volunteer Mutual Insurance
Description
General FunctionAssist with policyholder retention and satisfaction by providing various risk evaluation and education services.
Major Duties and Responsibilities
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
SVMIC's mission is to protect, support, and advocate for physicians and other healthcare providers. As a mutual company, our vision is to be the premier provider of medical professional liability insurance, education, and support in the markets we serve. SVMIC is owned by its policyholders, and all its activities and strategic priorities focus on achieving its mission and vision. For more information, visit .
SVMIC is an equal-opportunity employer, and we value diversity of all kinds.
