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RN Consultant Sr. - Professional Liability
CLAIM YOUR FUTURE AS A GREAT PERFORMER!
Providing both satisfying and challenging work along with a highly professional and friendly work atmosphere, Sedgwick has a strong commitment to its colleagues and its clients. If you are seeking a place where you can do great things for those whose lives you touch while maximizing your own career possibilities, Sedgwick is the place for you. As the largest and most innovative Third Party Administrator in the claims industry and the first and only TPA to receive both recognition as the Best TPA in America and the coveted Employer of Choice designation, we invite you to come be a part of our team and, "Claim Your Future."
This fantastic opportunity would be perfect for a RN licensed nurse with their Legal Nurse Consulting certification and/or experience in the Long Island area of NY. This position will be located in house in our Melville, NY office location with possible travel to NYC client facilities. Ideally, someone with Hospital, Risk Management, Clinical and/or Claims experience would thrive in this position.
PRIMARY PURPOSE: To handle complex or high exposure claim issues; to provide medical knowledge of the health care system and health care issues; to independently investigate, analyze and evaluate medical malpractice claims for self-insured and commercially insured clients; to provide information needed to clients as needed to determine liability issues and exposure; and to assist in identification of risk management issues to decrease liability exposure and associated legal costs.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Handles complex or high exposure claim issues; advises and leads Nurse Consultant - PL colleagues.
Receives requests for investigation; reviews and develops action plans and investigates cases accordingly.
Collects data from Company and clients to document and communicate results as appropriate.
Prepares reports summarizing medical records and interviews; outlines issues related to summary reports; and provides analysis and recommendations for further claims handling.
Interviews practitioners involved in medical malpractice claims at hospital facilities weekly as needed.
Participates in follow-up review and investigation as directed and assists in discovery requests as needed.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
Travels as required.
Education & Licensing Bachelor's degree from an accredited college or university preferred. Current RN license required. LNC (Legal Nurse Consultant) Certification or training preferred.
Experience Six (6) years related clinical nursing experience and two (2) years nurse consultant experience or equivalent combination of education and experience required. General or Professional Liability investigation related experience preferred.
Skills & Knowledge
Technical claims knowledge of medical malpractice claims procedures and practices
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Strong organizational skills
Excellent interpersonal skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies
WORK ENVIRONMENT When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick Claims Management Services, Inc., is a leading global provider of technology-enabled risk and benefits solutions. At Sedgwick, caring countsSM; the company takes care of people and organizations by delivering cost-effective claims, productivity, managed care, risk consulting and other services through the dedication and expertise of nearly 15,000 colleagues in some 275 offices located in the U.S., Canada, the U.K and Ireland. Sedgwick facilitates financial and personal health and helps customers and consumers navigate complexity by designing and implementing customized programs based on proven practices and advanced technology that exceed expectations. Sedgwick’s majority shareholder is KKR; Stone Point Capital LLC, La Caisse de dépôt et placement du Québec (CDPQ) and other management investors are minority shareholders.