MedStar Medical Group Job - 48955412 | CareerArc
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Company: MedStar Medical Group
Location: MD
Career Level: Entry Level
Industries: Not specified

Description

General Summary of Position
The AVP will manage MedStar's medical professional liability and corporate general liability claims and suits, including those involving any MedStar associate, including employed physicians. They will fully support MedStar's captive insurance program, Greenspring Financial Insurance Limited (GFIL), as well as MedStar's early intervention, patient safety and loss prevention programs. The strategic importance of this position is to successfully manage the significant financial and reputational exposure to MedStar and MedStar Medical Group as a result of medical professional liability claims and the volatile medical professional liability climate in the jurisdictions in which MedStar operates. The AVP reports directly to the Vice President for Risk Management Services with matrix reporting to MedStar's Chief Medical Officer, will develop & maintain a strong working relationship with MedStar corporate leadership and hospital and ambulatory operational and senior leadership and have has matrix responsibility for the hospital and ambulatory risk managers/directors.


Primary Duties and Responsibilities

  • Develops and contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Ensures compliance with hospital/facility policies and procedures and governmental/accreditation regulations.
  • Provides 24/7 professional support and advice to MedStar's ambulatory care programs, hospitals, outpatient surgery centers, urgent care centers, and MedStar's physicians, nurses, and other clinicians in response to any patient care-related issues that have the potential for liability.
  • Responsible in the event of a serious unanticipated outcome to provide support to the clinical staff to ensure that appropriate action and response occurs in a timely fashion. Responsible also to activate MedStar's Early Intervention Program, to include: establishing contact with the patient and/or family as appropriate; advising staff regarding communication with the patient/family, disclosure, apology when appropriate, and documentation. Assist the patient and family to address immediate needs, maintain ongoing relationship with the patient/family until resolution, which could include ongoing financial support or compensation.
  • Manages MedStar's patient bill hold system. Works with hospital and ambulatory leadership regarding decisions to waive bills in connection with a risk event or an adverse event.
  • Works closely with the MedStar VP, Risk Management to manage financial aspects of the MedStar's medical professional liability and corporate general liability claims program including establishing and maintaining a sound claims-reserving program that ensures that liability exposure is timely and adequately recognized and recorded.
  • Oversees outside defense counsel assigned to provide professional legal services in connection with claims and suits. Is responsible for overseeing all aspects of litigation management involving over 200 claims and suits, including the selection of experts, development of litigation strategy, and ultimate disposition of each claim and suit. Reviews and analyzes all defense counsel-prepared case evaluation reports. Reviews with defense counsel the findings of all medical experts and discusses with defense counsel the implication of these findings in connection with the defensibility of the case. Participates in the meetings held by defense counsel with MedStar-employed physicians, nurses and others.
  • Assigns and works with defense counsel retained to represent physicians, nurses and other licensed providers in connection with matters referred to, or complaints filed, with any of the licensing agencies in Maryland and DC.
  • Collaborates with the Office of General Counsel regarding various legal matters including but not limited to, breach of privacy complaints, workplace violence issues, Office of Compliance matters, subpoenas, policies and procedures, amendments to medical records, termination of patient/physician relationships, and other legal/risk claims and events.
  • Works with IT department for evidence to support claims and suits in litigation. Investigates audit trial data, metadata, and other information in the electronic medical record for evidence to utilize to defend claims.
  • Develops and maintains ongoing positive relationships with insurers, attorneys, mediators, legislators, and other constituents; takes a leadership role in broader tort reform efforts both locally and nationally.
  • Responsible for developing and maintaining a strong positive working relationship with all MedStar hospital and ambulatory leadership including hospital presidents, vice presidents of Medical Affairs, and Medstar Medical Group senior leadership regarding all aspects of claims and litigation management, keeping them fully informed regarding the status of claims or suits that involve that hospital or business unit.
  • Maintains a strong positive matrix reporting relationship with the hospital-based risk managers and ambulatory managers responsible for risk and claims management issues to insure that: all incidents that have the potential to result in claims of liability are identified, investigated and reported in a timely manner; and all loss prevention opportunities are identified and that appropriate steps are taken to ensure that similar events do not occur.
  • Provides leadership within the MedStar system for all aspects of identification, management and successful resolution of claims involving medical professional liability and corporate general liability.
  • Demonstrates strong organizational, prioritization and delegation skills while working with minimal supervision.
  • Routinely provides presentations to the Chief Medical Officer, Chief Nursing Officer, Chief Operating Officer and Chief Quality Officer on significant cases.
  • Represents MedStar Health in a most positive manner to all those outside of MedStar, including its patients and their families, physicians, nurses, the business and legal community and the community at large.
  • Conducts training for residents, physicians, nurses and other clinical staff regarding risk management strategies, appropriate documentation in medical records, disclosure conversations with family members and other risk and claims management topics.
  • Participates in meetings and on committees and represents the department and business unit in community outreach efforts. Participates in multidisciplinary quality and service improvement teams and maintains effective working relationships with other departments.

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    Minimum Qualifications
    Education

    • Bachelor's degree Juris Doctor required
    • Advanced degree preferred

    Experience

    • 5-7 years Professional and general liability claims/litigation management experience required and
    • Clinical training preferred

    Licenses and Certifications

    • License to practice law in either the State of Maryland, District of Columbia, or Virginia Upon Hire required and
    • Professional insurance designations Upon Hire preferred

    Knowledge, Skills, and Abilities

    • Excellent oral and written communication skills, including presentation presence.
    • Ability to form strong working relationships with both clinical and administrative leadership.
    • The ability, interpersonal skill and empathetic demeanor to be able to successfully connect with patients and their families and MedStar staff, including nurses and physicians, at times of high stress. Ability to identify, analyze and evaluate complex clinical and legal problems and recommend solution.
    • Able to make independent and timely decisions involving complex situations. Possesses the ability to work as an effective member, at times the leader, of multiple teams.
    • Solid judgement, conceptual and anticipatory skills with a proven ability to think creatively and be flexible in order to meet all challenges. Proven high level of integrity and personal ethics.


    Why MedStar Health?
    At MedStar Health, we understand that our ability to treat others well begins with how we treat each other. We work hard to foster an inclusive and positive environment where our associates feel valued, connected, and empowered. We live up to this promise through:

    • Strong emphasis on teamwork - our associates feel connected to each other and our mission as an organization. In return, our effective team environment generates positive patient outcomes and high associate satisfaction ratings that exceed the national benchmark.
    • Strategic focus on equity, inclusion, & diversity - we are committed to equity for all people and communities. We continue to build a diverse and inclusive workplace where people feel a sense of belonging and the ability to contribute to equitable care delivery and improved community health outcomes at all levels of the organization.
    • Comprehensive total rewards package - including competitive pay, generous paid time off, great health and wellness benefits, retirement savings, education assistance, and so much more.
    • More career opportunities closer to home - as the largest healthcare provider in the Baltimore-Washington, D.C. region, there are countless opportunities to grow your career and fulfill your aspirations.

    About MedStar Health
    MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation, and research. Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team. Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities. It's how we treat people.

    MedStar Health is an Equal Opportunity (EO) Employer and assures equal opportunity for all applicants and employees. We hire people to work in different locations, and we comply with the federal, state and local laws governing each of those locations. MedStar Health makes all decisions regarding employment, including for example, hiring, transfer, promotion, compensation, benefit eligibility, discipline, and discharge without regard to any protected status, including race, color, creed, religion, national origin, citizenship status, sex, age, disability, veteran status, marital status, sexual orientation, gender identity or expression, political affiliations, or any other characteristic protected by federal, state or local EO laws. If you receive an offer of employment, it is MedStar Health's policy to hire its employees on an at-will basis, which means you or MedStar Health may terminate this relationship at any time, for any reason.


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