HCA, Hospital Corporation of America Manager of Claims Liability in Nashville, Tennessee

Serving our community for more than 30 years, TriStar Southern Hills has been a leader for a wide range of healthcare services, including emergency services, cardiology, orthopaedics and rehabilitation. TriStar Southern Hills is an Accredited Chest Pain Center with PCI and a Primary Stroke Center. There are more than 300 board certified physicians representing more than 20 specialties, many of whom have offices located on our campus.

POSITION SUMMARY: The Quality/Risk Management Specialist is responsible for coordination of risk management, quality and survey compliance activities under the direction of the Director of Quality/Risk Management, including developing and implementing an annual plan and participation in the Premium Credit program. The Quality/Risk Management Specialist also ensures collaboration with the Medical Staff Quality Coordinator, other Quality Department staff, and the Infection Control Nurse on any identified issues. The Quality/Risk Management Specialist also assists with coordination of the QI program throughout the hospital through interdisciplinary measurement, analysis and actions to improve services. Maintains systematic data collection and flow of information between departments and into applicable committees. Identifies adverse trends and collaborates with others to improve processes and outcomes.

The Quality/Risk Management Specialist maintains the risk reduction program by reviewing reports as appropriate, handling claims, coordinating information involving quality and risk issues and trends, and assisting with education of hospital staff in Quality and Risk Management programs. Manages Root Cause Analysis, UIRS and other analysis functions geared toward improving patient care and decreasing risk.

*POSITION QUALIFICATIONS: * 1. Current state licensure (RN), baccalaureate degree (preferably in health care) 2. CPHQ preferred 3. 5 years experience in health care and 2 years experience in clinical risk management preferred. 4. The capacity and interpersonal skills to successfully interact with hospital personnel and physicians.
5. Analytical and statistical skills and broad range of knowledge in healthcare regulatory and accreditation requirements.

Title: Manager of Claims Liability

Location: Tennessee-Nashville-Southern Hills Medical Center

Requisition ID: 00145-55580