Legal Nurse Consultant in Phoenix, Arizona

March 7, 2011 by nurse
Filed under: Arizona 

Facility Information

Catholic Healthcare West (CHW), headquartered in San Francisco, CA, is a system of 41 hospitals and medical centers in California, Arizona and Nevada. Founded in 1986, CHW is one of the nation’s largest not-for-profit hospital systems and the largest private health care system in California. CHW is committed to delivering compassionate, high-quality, affordable health care services with special attention to the poor and underserved. The CHW network of nearly 10,000 physicians and approximately 53,000 employees provides health care services to more than five million people annually. In 2008, CHW provided $967 million in charity care and unsponsored community benefit.

Job Requirements

The Legal Nurse Consultant (LNC) partners with key players to control and minimize losses and protect the assets of Catholic Healthcare West.

Job Title: Legal Nurse Consultant (LNC)

Department Name: Risk Services Location:
Reports to: Area Claims Manager

Job Summary:

With the objective to control and minimize losses and protect the assets of the corporation, the Legal Nurse Consultant (LNC) partners with the Area Claims Manager (ACM) and Facility Risk Manager to complete comprehensive investigatory reports related to general and professional liability claims. Report completion includes obtaining, organizing, reviewing, and summarizing pertinent records and other documents, interviewing witnesses and research.

The LNC must also evaluate the standard of care, and provide input into the claim resolution strategy based on his/her evaluation. The LNC must also collaborate with the Facility Risk Manager, Area Claims Manager and Loss Prevention Specialists in identifying loss prevention
opportunities.

CHW Mission Statement

CHW embraces the core values of dignity, justice, collaboration, excellence and stewardship. CHW is committed to the mission of providing quality health care to the communities it serves and to advocate for all patients, regardless of their ability to pay.

Tasks/Responsibility:

Evaluate events and quality of care issues relating to Standard of Care specific to a reported HPL/GL event/claim in his/her facilities. Notify Area Claims Manager, Loss Prevention Specialists and/or Facility Risk Manager of these issues.

Complete in a timely manner the initial evaluation of events, claims and lawsuits including, obtaining, organizing, reviewing and summarizing all pertinent documents; i.e., medical records, contracts, policies and procedures; identify standard of care issues in a case; and identify loss prevention issues in a case. Provide specific and detailed information that allows the area claims manager to make critical claims decisions.

Analyze and process claims information into claims management system (iVOS) in a timely manner and with high accuracy and data integrity. Review and update the database as needed.

Prepare a comprehensive investigation:
Identify and interview individuals/employees with particular knowledge relating to the event.
Create initial and subsequent reports in timely manner that include analysis of relevant community standards, facility policies and procedures and whether the standard of care was met.
Analyze whether the damages were caused by a breach in the standard of care.
Conduct additional investigation as requested by area claims manager, risk manager and defense counsel.
Result of the reports are utilized by the Area Claims Manager, Risk Manager and Defense Counsel to develop an effective claim resolution strategy in a prompt and cost efficient manner.

Research claims and loss prevention issues to provide relevant information to the Risk Services Department and Facility Risk Manager which enables development of effective claims management and loss prevention strategies. Educate staff regarding risk reduction strategies as directed by the Area Claims Manager and Risk Manager.

Advocate corporate risk strategies, projects and philosophies so as to bring consistency, cohesion and credibility to the Risk Services Programs. Obtain training and advocate for use of the Event Reporting System. Support the facilitys use of the Event Reporting System and iVOS (claims management system) as well as Loss Prevention initiatives.

Prioritize an ever-changing workload, function in a flexible manner, including identifying changes in the environment of his/her facilities and responding appropriately.

Individual must be able to travel and work at multiple locations.

Qualification: (Skills)

Currently licensed Registered Nurse, preferably a BSN.

Clinical experience required, preferably in high-risk area, i.e., emergency department, OB/GYN, ICU, surgery.

Superior ability to effectively communicate verbally and in writing.

Strong computer skills. Word processing experience and familiarity with Microsoft Office Suite (Word and Outlook)

Strong organizational and research skills.

Liability claims experience/paralegal experience or educational equivalent preferred.

Certification from accredited LNC program and prior work experience as LNC preferred.

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