Practice made perfect

Join Our Talent Network

Risk Management Specialist in Knoxville, Tennessee, US at TeamHealth

Date Posted: 9/12/2019

Job Snapshot

Job Description

JOB DESCRIPTION OVERVIEW:

This position’s primary responsibility is to assist the Legal Risk Management Office (LRMO) in completing the risk review process required of all contracted providers. The risk management specialist facilitates ongoing requests as it relates to legal risk management and is responsible for tracking all TeamHealth risk related requirements and education until such time all requirements have been completed.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Review all completed questionnaires to ensure completeness and accuracy; follow-up with recruiting if questionnaire is not complete; follow-up with provider if there are discrepancies
  • Review provider responses to the “yes/no” questions within the questionnaire and immediately refer those providers who meet the red-flag criteria as defined by the risk management review process to the Director of Risk Management
  • Complete the required data entry as it relates to the professional screening questions, nonTH malpractice action history, and processing of the NPDB report
  • Verify and ensure completion and accuracy in TeamWorks to include provider’s demographics, education, training, board certification, CME’s, professional liability insurance, etc.; follow-up with appropriate contact within the group if information needs updated
  • Perform initial evaluation of providers requiring a risk review by comparing the provider’s history to the risk rating criteria to formulate the provider’s risk assessment rating
  • Create risk review record in TeamWorks to track the return of questionnaires, additional information required for assessment and any assigned focused education tasks.
  • Collect additional information as needed based on the initial evaluation to include obtaining information from multiple sources
  • Track tasks related to risk reviews using the document tracking fields in TeamWorks and follow-up with the provider and/or medical director to ensure the requested items are received within the allotted time; any provider falling out of compliance will need to be escalated to the appropriate supervisor
  • Process risk review outcomes
  • Compose reports, memorandums, and general correspondence using Microsoft Office Suite, TeamHealth’s STARS system, OnBase, TeamWorks, Cognos and Outlook
  • Maintain extensive databases, records and files
  • Complete other duties as assigned to include providing back up of other employees

 

Job Requirements

QUALIFICATIONS / EXPERIENCE:

  • Associate’s degree in business, healthcare, or related field preferred; or equivalent work experience;
  • Three (3) to five (5) years of related experience;
  • Advanced proficiency in various computer applications, i.e. word processing, spreadsheet, e-mail, database management and presentation software;
  • Ability to work with confidential information and use discretion;
  • Ability to coordinate and meet deadlines and deal with stressful situations;
  • Ability to problem solve and adapt to change;
  • Ability to work productively within a team.
  • Excellent communication skills (verbal and written, with an emphasis in grammar);
  • Excellent organizational skills;
  • Familiarity with modern office equipment, i.e. facsimile, copier, etc.

SUPERVISORY RESPONSIBILITIES:

  • None

PHYSICAL / ENVIRONMENTAL DEMANDS: 

  • Job performed in a well-lighted, modern office setting
  • Occasional lifting/carrying (10 pounds or less)
  • Occasional bending/stooping/reaching/pulling
  • Prolonged sitting
  • Prolonged work on computer/PC 

DISCLAIMER:

Cooperative, positive, courteous and professional behavior and conduct is an essential function of every position. All employees must be able to work with others beyond giving and receiving instructions. This includes getting along with co-workers, peers and management without exhibiting behavior extremes. Job functions may require personal leadership skills such as conflict resolution, negotiating, instructing, persuading, speaking with others as well as responding appropriately to job performance feedback from the supervisor. Additionally, the information contained in this job description has been designated to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this position.