Healthcare Risk Management SME

Full Time
San Antonio, TX
Posted
Job description

Urgently Hiring ( Remote)

Job Responsibilities

Receive and record malpractice claim payments monthly, active-duty death/disability cases and initiate the required clinical quality review process; correctly identify and process medical malpractice claims by legal outcome (payment) type and standard of care.


Process clinical, government administrative and criminal adverse action cases. In Accordance With (IAW) Department of Defense Instruction 6025.13, Medical Quality Assurance (MQA) in the Military Health System (MHS), Defense Health Agency Procedural Manual 6025.13, Clinical Quality Management in the Military Health System (DHA-PM 6025.13), and Air Force Instruction (AFI) 44-119, Medical Quality Operations.

Required Skills

Current, unencumbered RN licensure preferred

  • MHS/DHA experience preferred
  • Ability to effectively communicate at various levels within the organization (i.e., HQ, market, facility
  • Proficient in Microsoft Office tools
  • At least five years of experience in healthcare setting or with a provider of services to the healthcare industry
  • At least two years of job duties dedicated to healthcare risk management

Minimum of 5 years' Experience
Certification in HRM (ASHRM) strongly preferred

Education Background:

Bachelor's Degree in Nursing, Business/Management or a Healthcare related field.

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