RN Risk Evaluation Consultant

November 4

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Description

• Assist with policyholder retention and satisfaction by providing various risk evaluation and education services. • Conduct comprehensive on-site risk evaluations for policyholders that includes facility review, evaluation of policies and procedures; medical record review and analysis: and interviews with staff and providers. • Follow-up on risk issues. • Review and analyze claims experience of assigned group accounts to identify risk trends. • Prepare Evaluation Reports and assist assigned group accounts with strategies, resources, and activities to help improve risk status. • Present general and topic-specific education programs to policyholders and policyholder’s office staff. • Prepare and present Executive Summary Reports to administration/leadership of large medical groups. • Assist other departments and committees with risk management issues including providing risk evaluation services as requested by the Underwriting Committee. • Attend and/or represent SVMIC at industry or related conferences, meetings, or seminars as required. • Participate in cross-functional teams. • Meet or exceed supervisor’s expectations for productivity, quality, continuous improvement, and goal accomplishment. • Contribute to SVMIC’s success by identifying opportunities and making recommendations that may lead to improved processes. • Regular and predictable on-site attendance required. • Ability to work remotely. • Available to travel by various means (this includes air travel) as business needs dictate. • Complete special projects and other duties assigned.

Requirements

• Associate degree or above, Bachelor's Degree in healthcare preferred. • Minimum 5 years of clinical RN experience. • Valid Registered Nurse licenses maintained in good standing in the state of Tennessee. • A valid Driver's License is required. • This position required to travel throughout the state of TN and the contiguous states by automobile for approximately 6 overnight stays/ month on average. • LNCC, CLNC, CPHRM, or similar designation preferred. • Experience in medical record analysis/legal nurse consulting is a plus. • Highly focused with excellent analytical, and critical thinking skills. • Ability to efficiently manage multiple, complex projects. • Proficient with Outlook, Word, Excel, PowerPoint, and a variety of software programs. • Ability to research, read, comprehend, analyze, apply, and distill large amounts of complex information into useful tools, presentations, and /or conversations. • Must reside in East, TN. (Bristol, Johnson City, Kingsport.) or Knoxville, TN.

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