Risk Mgmt Investigator

Overview

• Independently investigates professional liability occurrences.
• Evaluates information to identify standard of care issues and quality improvement opportunities.
• Prepares for the legal defense of potentially compensable events, including property loss and liability events.
• Collaborates with Case Managers and Third Party Administrator.
• Maintains confidentiality of all patient and visitor information.

• Bachelor's degree or RN degree.
• Two years of experience in an investigative position or clinical experience.
• Preferred: Knowledge of liability insurance policies, medical terminology, and medical environment.

• Must obtain one of the following within the first year:
  • North Carolina Adjusters License
  • Certified Professional in Health Care Risk Management (CPHRM)
  • Health Care Risk Management (HRM)

1. Ensures compliance with hospital standards and risk prevention.
2. Conducts thorough investigations to avoid civil liability.
3. Requires knowledge of medical care, equipment, NC law, fair claims practices, and healthcare regulatory reporting.
4. Investigates patient injuries related to medical device failures and reports findings.
5. Acts as liaison for Social Services and law enforcement regarding patient status and threats.
6. Consults with staff on risk management to minimize exposures.
7. Coordinates with experts and department personnel to address patient care issues.
8. Reviews incident reports to evaluate injury severity and initiate investigations.
9. Identifies and eliminates hazards to maintain a safe environment.
10. Handles Patient Relations investigations and complaints, including billing adjustments.

• Ability to conduct unbiased interviews and gather facts.
• Accurate documentation and organized work.
• Excellent interpersonal skills and confidence in communication.
• Creative thinking for process improvement.
• Open-mindedness and willingness to learn.
• Manages workload efficiently and prioritizes tasks.
• Proficiency in Microsoft Office.
• Knowledge of medical terminology.
• Professional demeanor and ethical conduct.

• Primarily office-based.
• Occasionally reports to incident scenes.
• Tolerates various indoor and outdoor environments.
• Local travel to affiliates occasionally.
• Limited out-of-town travel (2-3 trips per year).

• Standing: 0-35%
• Walking: 0-35%
• Sitting: 65-100%
• Bending: 0-35%
• Reaching with arms: 0-35%
• Finger and hand dexterity: 65-100%
• Talking: 65-100%
• Hearing: 65-100%
• Seeing: 65-100%
• Lifting, carrying, pushing, pulling:
  • 20 lbs. maximum: 0-35%
  • 50 lbs. maximum: N/A
  • 100 lbs. maximum: N/A