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Job Description

Business Unit: Rush Medical Center

Hospital: Rush University Medical Center

Department: RUSH Risk & Claims Management

**Work Type:** Full Time (Total FTE between 0.9 and 1.0)

**Shift:** Shift 1

**Work Schedule:** 8 Hr (8:00:00 AM - 5:00:00 PM)

Rush offers exceptional rewards and benefits learn more at our Rush benefits page (https://www.rush.edu/rush-careers/employee-benefits).

**Pay Range:** $100,776 - $174,595

Rush salaries are determined by many factors including, but not limited to, education, job-related experience and skills, as well as internal equity and industry specific market data. The pay range for each role reflects Rush’s anticipated wage or salary reasonably expected to be offered for the position. Offers may vary depending on the circumstances of each case.

Summary:

The Office of Risk Management is responsible for claims investigation and management and overseeing loss control activities for Rush University Medical Center, Johnston R. Bowman Health Center for the Elderly, Rush Oak Park Hospital, and all personnel named as insureds under the Medical Center’s Self Insurance Trust Fund Agreement. The Office of Risk Management also works directly with the Office of Legal Affairs and outside defense counsel. The Risk Manager will identify potential liability situations, investigate and manage those potential claims, as well as lawsuits and attorney’s liens. The Risk Manager RN will participate with the loss control activities in his/her assigned areas and as needed throughout the Medical Center. Additionally, the Risk Manager RN is responsible for initial screening and evaluation of patient/family/visitor complaints and coordinating with appropriate departments, physicians and personnel for resolution. This position’s objective is to reduce unplanned or unexpected financial loss to the Medical Center through identification, evaluation and reduction of the risk of patient injury associated with medical care, as well as visitor injuries as well as to minimize loss through effective claims handling pursuant to the terms of the Medical Center’s Self Insurance Program. Exemplifies the Rush mission, vision and values and acts in accordance with Rush policies and procedures.

Required Job Qualifications:

+ Bachelor’s degree in nursing (BSN) with three years of clinical nursing experience and a knowledge of the clinical care of patients.

+ Experience within the health care industry and risk management.

+ RN license in the state of Illinois.

+ PR certification.

+ Excellent verbal and written communication skills.

Preferred Job Qualifications:

+ Previous experience with summarizing and analyzing medical records.

Responsibilities:

+ Analyze coded Unusual Occurrence Reports.

+ Scrutinize attorney requests for records received by the Medical Records Department.

+ Evaluate telephone reports/correspondence from physicians, nurses, hospital personnel, patients and visitors regarding incidents to determine liability on behalf of the Medical Center.

+ Execute a detailed review of potential liability claimants’ medical records

+ Interview medical center employees having relevant knowledge of the incident (residents, nurses, other hospital personnel, attending physicians on the Medical Service Plans within the limitation identified by Illinois case law).

+ Secure evidence (broken equipment, foreign bodies, faulty catheters, etc.).

+ Indicate possibility of product liability. Report potential problems to manufacturers and FDA in accordance with the Safe Medical Device Act.

+ Formulate written investigative reports for the Office of Risk Management and the Office of Legal Affairs, detailing analysis of medical facts, including determination of whether standards of care were breached, assessment of damages, and an opinion of the potential risk/liability for the Medical Center.

+ Direct findings to the Director and General Counsel at weekly meetings with recommendations for management of potential claims.

+ Notify potential claims to the excess insurance carriers, summarizing potential liability exposures

+ Execute a detailed review and analysis of the plaintiff’s medical record.

+ Interview named defendants who are Medical Center employees and other employees having relevant knowledge of the incidents in the Summons and Complaint within the limitations identified by Illinois case law.

+ Examine medical records from other institutions.

+ Formulate a detailed report of findings for use by outside defense counsel.

+ Draft answers to interrogatories and submit materials requested in Notices to Produce and to establish a basis for actions taken by employees.

+ Search for historical documents within the Medical Center to comply with Notices to Produce and to establish a basis for actions taken by employees.

+ Verify employment status and current whereabouts of all defendants or potential defendants.

+ Set reserves on assigned cases at semiannual Bordereau meetings in conjunction with General Counsel and outside defense counsel.

+ Assist defense counsel at trial. Report trial events to the AVP of Risk Management and General Counsel daily.

+ Contribute to settlement discussions and mediation sessions by providing opinions and analysis of key factors.

+ Direct potential mediation candidates to Mediation Consultant and General Counsel. Attend mediation meetings and draft summary reports to President and Senior Vice Presidents.

+ Direct formal written status reports to various excess insurance carriers on assigned claims, including an evaluation of liability, damages, settlement value, etc.

+ Educate nursing, ancillary departments, house staff and medical staff on pertinent risk management issues.

+ Contribute articles to the Health Law Reporter regarding risk management concerns.

+ Recognize incident trends and loss control activities with concentration to specific assigned areas.

+ Participate in the Performance Improvement process.

Rush is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.

**Position** Clinical Risk Manager RN

**Location** US:IL:Chicago

**Req ID** 18586