Healthcare Risk Management SME

  • Apexon,
  • Remote or Southfield, MI
  • 42 minutes ago
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Apexon
Full Time

Job Description

Role Title: Healthcare Risk Management SME
Location: Remote
Full Time
US citizens only

Minimum years of work exp: 5 Years

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

Required Skills:

  • Certification in HRM (ASHRM) strongly preferred
  • 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

Desired Skills:

Day-to-day 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.

Additional Update: Please refer to the CPHRM Certificate Holder List in the Information File section. You can first reach out to them and submit their profile. In case if you are approaching candidates who doesnt hold certification, then should be able to clear an exam which includes:

  1. At least 5 years of experience in a health care setting or with a provider of services to the health care industry and
  2. 3,000 hours or 50 percent of full-time job duties within the last three years dedicated to health care risk management in a health care setting or with a provider of services (e.g. consultant, broker, or attorney) to the health care industry.

Note:

Public Trust or ability to acquire
W2 candidates only
US citizens only
Right to Hire - Yes


Company Information

Apexon is a digital technology services and platform solutions company that partners with clients to improve their digital experience and insight. With more than 25 years of experience, our 5000+ Apexers in more than 10 offices worldwide are helping companies enhance their digital experience with their customers.

We work in the areas of digital experience, analytics, AI and cloud to unlock the power of technology for our clients to empower humans with intelligent and experiential solutions. We enable #HumanFirstDigital.

Dice Id : tecnosb
Position Id : 2021-15638
Originally Posted : 3 months ago

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