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Clinical Risk Manager & Legal Nurse Specialist

Apply now Job no: 496606
Work type: Staff - Full-Time
Location: Health Science Campus Support
Categories: Nursing, Full-Time, None, Legal

Title: Clinical Risk Manager & Legal Nurse Specialist

Department Org: Office Of Legal Affairs - 104890

Employee Classification: U1 - Unclassified PSA FT

Bargaining Unit: Professional Staff Association

Primary Location: Health Science Campus Support

Shift:  1

Start Time:  8:30am   End Time:  5pm

Posted Salary: Commensurate with experience

Float: No

Rotate: No

On Call: No

Travel: No

Weekend/Holiday: No

Job Description:

This role oversees and coordinates the processes involved in managing the professional liability and risk exposures for the University’s healthcare facility. The position is responsible for the investigation, coordination, and oversight of potential and actual medical malpractice claims and lawsuits through the University’s Litigation Management Process.

Principal Duties and Responsibilities

Rank

List of Job Duties

Percent of Time

1

Monitors all incident reporting, investigates, and coordinates the management of potential and actual professional liability claims and adverse events or issues through the University’s Litigation Management Process:

20%

(broken down below)

1(a)

Reviews patient medical records and collects data for legal risk analyses to determine appropriateness, timeliness, and efficiency of patient care components in conjunction with healthcare providers and staff.

10%

1(b)

Interviews healthcare providers and staff as part of the claim investigation process.

2.5%

1(c)

Prepares summaries of medical chart reviews and provides standard of care opinion, collects data for insurance reports, and assists in setting claim reserves and recommending settlements to the University for approval.

2.5%

1(d)

Attempt to proactively mitigate or resolve potential claims and advise clinical staff on patient risk-related issues. Collaborates with Office of Legal Affairs – HSC when incidents become formal claims regarding settlement negotiations.

5%

2.

Assists the Attorney General’s office in the claims litigation process which includes participation in discovery, depositions, trial preparation and trial attendance with the interest of protecting the assets of the University.

10%

3..

Directly responsible for the detailed maintenance of the litigation database for internal tracking and loss run reporting for insurance purposes.

7.5%

4.

Administers the UT professional insurance program that covers the University of Toledo and University of Toledo Physicians, LLC: Coordinates the underwriting process for the UT professional insurance program, which includes management of the Underwriting Committee and participation on the Credentials Committee; coordinates the practice location approval process with the Dean of the College of Medicine and Life Sciences.

40%

4(a)

Maintain the Risk Database, participating in the credentialing process, and coordinating the practice location approval process for all practitioners.

10%

4(b)

Responsible for responding to all malpractice insurance/claims history requests for the University of Toledo students, residents, CNPs, PAs, PhDs, social workers, surgical staff, and physicians (past and present).

5%

 

4(c)

Performs Risk triage for hospital and all practice locations. Participates in 24/7 on-call legal-risk coverage. Consults with Office of Legal Affairs – HSC as necessary.

5%

4(d)

Assists Associate Vice President and Chief Assurance Officer in annual reporting, auditing, conference discussions and presentations in relation to the University’s professional liability insurance program.

25%

4(e)

Reviews and research issues of risk exposure as presented from all areas of the university and medical center, providing direction to staff and collaborating with other staff in the Office of Legal Affairs as appropriate.

5%

4(f)

Assists the Department of Service Excellence in the investigation of patient complaints and assesses such complaints for potential risk issues. Participates in the Grievance Committee meetings for complaint analysis.

5%

4(g)

Supports the hospital quality assurance and peer review committees when applicable.

5%

4(h)

Coordinates with Finance Department to allocate insurance costs, claims costs and collaborates on various actuarial and financial studies.

2.5%

5

Creates and presents clinical risk education to clinical staff.

2.5%

6

Provides consultation on the development and/or review of institutional policies and procedures and participates in various committees in an effort to reduce the impact of risk on the organization.

2.5%

7

Collaborates with the Workers’ Compensation Department on University’s workers’ compensation issues on all campuses.

2.5%

8

Completes internal reporting for medical device recall management. Completes reporting to external entities/agencies as appropriate (e.g., NPDB, FDA, OSMB).

02.5%

9

Administrates all dental claims and coordinates patient care with the University’s Dental program.

2.5%

10

Other duties as assigned.

10%

 

TOTAL

100%

 

Minimum Qualifications:

Education/experience/licensing:
• Current RN licensure required.
• Bachelor’s degree required.
• Master’s degree or JD preferred.
• Must have five (5) years of nursing experience, including inpatient units.
• Must have two (2) or more years’ experience in a hospital or clinical setting with the ability to analyze and evaluate complex medical reviews and data.
• Requires knowledge of risk and insurance principles and of the Ohio Revised Code, as it applies to state institutions.
• At least one (1) year of experience in reviewing and handling professional liability claims.


Communication and other skills:
• Strong analytical and writing skills.
• Academic background preferred.
• Accuracy and attention to detail.
• Strong interpersonal skills & ability to communicate effectively throughout all levels of the organization.
• Proficiency in Microsoft Office Suite and related software applications.

Conditions of Employment:

To promote the highest levels of health and well-being, the University of Toledo campuses are tobacco-free.  To further this effort, the University of Toledo Health Science Campus Medical Center is requiring candidates for employment to be nicotine-free.  Pre-employment health screening requirements will include cotinine (nicotine) testing, as well as drug and other required health screenings for the position. With the exception of positions within University of Toledo Main Campus and the University of Toledo College of Medicine and Life Sciences, the employment offer is conditional upon successful completion of a cotinine test and Occupational Health clearance.

 

Equal Employment Opportunity Statement:

The University of Toledo is an equal opportunity, affirmative action employer. The University of Toledo does not discriminate in employment, educational programs, or activities on the basis of race, color, religion, sex, age, ancestry, national origin, sexual orientation, gender identity and expression, military or veteran status, disability, familial status, or political affiliation. 

The University is dedicated to the goal of building a culturally diverse and pluralistic faculty and staff committed to teaching and working in a multicultural environment and strongly encourages applications from women, minorities, individuals with disabilities, dual-career professionals and covered veterans.

The University of Toledo provides reasonable accommodation to individuals with disabilities. If you require accommodation to complete this application, or for testing or interviewing, please contact the Human Resources Department at 419-530-4747 between the hours of 8:30AM and 5:00PM or apply online for an accommodation request. 

Computer access is available at most public libraries and at the Office of Human Resources located in the Center for Administrative Support on the Main Campus of the University of Toledo.

Advertised: Eastern Standard Time
Applications close:

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Last Updated: 12/11/23