This position is in the Professional Liability Program at Washington University School of Medicine in St. Louis, Missouri.
Manages the investigation of claims alleging medical professional liability. Analyzes and evaluates incident reports and lawsuits. Reviews medical records and performs interviews of members of the health care team. Prepares investigative reports for Director and Legal Counsel regarding potentially compensable events covered by the Self-Insured Professional Liability Program, and other reports as requested by Senior Management. Coordinates case development and case management. Participates in risk financing efforts. Promotes patient safety; develops working relationships with Director of Patient Safety regarding ongoing patient safety improvement efforts; develops and provides education programs to departments; coordinates communications with affiliated hospitals.
PRIMARY DUTIES AND RESPONSIBILITIES:
Communicates in an effective and timely manner to appropriate individuals (i.e. Director of Risk Management, Office of General Counsel, Director of Patient Safety, physician and risk managers of affiliated institutions) the occurrence of adverse events. Represents the University in attendance at debriefings and root cause analyses (RCA) as requested. Advises physicians and others regarding documentation and communication practices, and disclosure of adverse events to patients and families. Recognizes, reviews and triages adverse events which need to be reported to the Director and others as listed above.
Conducts internal claims and events investigations, plans and helps implement defense strategies and negotiates disposition of assigned files. Specific activities associated with those responsibilities includes: conducts meetings with physicians, analyzes medical record information and event reports; coordinates with Office of General Counsel and the Director of Professional Liability in the direction of approved legal counsel and other legal personnel involved in the defense of claims and lawsuits; coordinates expert witness reviews; coordinates University response to discovery and provides affidavit in response to discovery requests and answering interrogatories; coordinates witness preparations; makes recommendations for resolution of claims; and coordinates meetings with Director, defense counsel and Office of General Counsel to perform decision tree analysis to determine case value. Attends mediation, arbitration and/or trial.
Prepares and submits required reports to Department Heads, Office of General Counsel, Director of Professional Liability, excess insurance carrier, and when applicable, assists with preparing the University’s response to external agency investigations, i.e. professional Board of Healing Arts inquiries.
Assists with the Self-Insured Professional Liability Insurance Program operations, including with the submission of the insurance application. Reviews risk financing information with the actuary, broker, insurance representative, auditors, and University personnel.
Establishes indemnity and expense reserves based on the reserving policy. Participates in negotiating settlements within authority. Reviews and approves defense counsel related bills. Provides direction to adjust patient bills.
Designs and incorporates patient safety measures into educational programs for University personnel including new employee orientation, and periodic updates focused on specialty-specific topics. Identifies and selects different instructional resources and methods to provide information to physicians on Risk Management techniques for use in their professional practice.
Represents the University on Risk Management matters at Barnes-Jewish Hospital, St. Louis Children’s Hospital, and their associated locations.
Washington University is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity or expression, national origin, genetic information, disability, or protected veteran status.
Seven years of experience analyzing, interpreting and communicating medical information with five years of managing professional liability matters and/or patient safety measures for physician programs.
Internal Number: 46115
About Washington University School of Medicine
Washington University School of Medicine is committed to advancing human health throughout the world. As noted leaders in patient care, research and education, our outstanding faculty has contributed many discoveries and innovations to science and medicine since the school’s founding in 1891.