Coordinator - Risk Management - Full Time

Riverside Medical Clinic; Riverside (CA); On-site; USD 65,000 - 85,000; Full time

Benefits offered by this job

Challenging work environment

Growth opportunities within UHS

Competitive compensation

Job summary

Riverside Medical Clinic is seeking a detail-oriented professional to manage policy maintenance, chart review, and support for risk management processes. This onsite role requires coordinating approvals, handling subpoenas, and ensuring HIPAA privacy standards are upheld.

You will work with the Quality and Regional Director, participate in audits, prepare charts for reviews, and maintain documentation. Associates degree or higher and proficiency with Microsoft Office are preferred; LVN is a plus.

Qualifications

• Associates Degree or higher. Computer skills required: Experience with Microsoft Office (Word, Access, Excel). Medical training background desirable.
• Risk Management experience desirable

Responsibilities

• Procure charts for Medical Record Audits and prep for monthly peer review.
• Accept summons/subpoenas/letters of intent on behalf of RMC and Physicians; forward to malpractice carrier and Medical Directors.
• Return medical records to proper chart home base after audits; maintain QRM correspondence and files.
• Mail quarterly reports to health plans in a timely manner.
• Resolve customer complaints or forward to QM Specialist for resolution; collect and enter statistical data.
• Complete data entry in an accurate and timely manner.
• Maintain the privacy of internal and external clients; monitor HIPAA compliance/violations.
• Monitor provider open encounters and prepare memos for fine collection.
• Perform other duties as requested by Manager, Quality and/or Regional Director, Quality

Skills

Data entry

HIPAA compliance

Medical records management

Attention to detail

Communication

Education

Associates Degree or higher

LVN preferred

Tools

Microsoft Office (Word, Access, Excel)

Job description

Responsibilities

Come and join the RMC Family!

We have been in the community since 1935. Our mission is to provide comprehensive multi-specialty medical services in the greater Riverside region. Your passion, inspiration, and talents are invaluable to us and our mission to serve others. Our facility can provide a place for you to thrive and continue your professional development. Quality Healthcare is our passion, improving lives is our reward. We are working to change lives and transform the delivery of healthcare. Riverside Medical Clinic is the best place to work, practice medicine, and receive care.

SUMMARY: Maintain original signed policies and procedures, and maintains Table of Contents to ensure most current, up to date P&Ps. Track progress of revised/new P&Ps through the approval process, obtain required signatures on approved P&Ps, and tracks P&Ps through the approval process. Acts as the liaison between malpractice lawsuits and providers, as well as Corporate Risk. Stays up to date on current litigations and incidents/occurrences within RMC.

QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

HOURS: Monday - Friday 8:30am-5:30pm ONSITE

Qualifications

EDUCATION and/or EXPERIENCE:

Associates Degree or higher. Computer skills required: Experience with Microsoft Office (Word, Access, Excel) Medical training background desirable Risk Management experience desirable

CERTIFICATES, LICENSES, AND REGISTRATIONS: LVN preferred.

ESSENTIAL FUNCTIONS

Essential functions are those tasks, duties and responsibilities that comprise the means of accomplishing the job’s purpose and objectives. Essential functions are critical or fundamental to the performance of the job. They are the major functions for which the person in the job is held accountable. Note: (other duties may be assigned, deleted or changed at any time, at the discretion of management, formally, or informally, either verbally or in writing).

• 1. Procure charts for Medical Record Audits and prep for monthly peer review.
• 2. Accept summons/subpoenas/letters of intent, on behalf of RMC and Physicians. Forward notice to malpractice carrier and Medical Directors. Sequester medical records upon receipt of notice and forward copies to insurance carriers. Prepare duplicate chart for circulation. Maintain original and duplicate chart to assure both are current.
• 3. Send out meeting notifications and assists with meeting packet preparation. Procures charts for special or focused QRM studies. Return medical records to the proper chart home base, upon completion of audits. Maintain QRM correspondence and files in a secure, organized and current state.
• 4. Mail quarterly reports to health plans in a timely manner.
• 5. Resolve customer complaints or forward to QM Specialist for resolution. Collect and enter statistical data in established database.
• 6. Complete data entry in an accurate and timely manner.
• 7. Maintain the privacy of both internal and external clients. Monitors/documents HIPAA compliance/violations.
• 8. Monitors provider open and encounters and prepares memos for fine collection.
• 9. Any other duties requested by Manager, Quality and/or Regional Director, Quality

Opportunity Details

• Challenging and rewarding work environment
• Growth and Development Opportunities within UHS and its Subsidiaries
• Competitive Compensation

About Universal Health Services

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.