Hybrid schedule after training will be 3 days at home 2 days in office
Description:
DUTIES AND RESPONSIBILITIES:
Conducting investigations of allopathic physicians and physician assistants licensed in AZ related to quality of care allegations and unprofessional conduct. Matters investigated include quality of care allegations, criminal convictions, and sensitive issues such as substance abuse and sexual misconduct.
Duties are equivalent of a paralegal and medico-legal administrator managing a substantial case volume. Duties include reviewing the complaint and preparing notice letters to respondent with allegations and reaching out to the complainant; determine appropriate medical records or supporting documents to request by subpoenas; conduct interviews of the respondent, complainant, patient and/or any witnesses; interpret statutes and rules; manage multiple cases at varying stages in the investigative process; prepare case reports and present cases before the client; on occasion, testify before the client; prioritize, plan, organize, and conduct investigations, including site inspections.
SKILLS:
Experience in reading and interpreting medical records. Skill in production of timely and accurate reports and documentation. Skills in applying and interpreting client statutes and rules governing investigations and the practice of medicine. Skill in presenting cases in a hearing or trial setting. Must be able to handle and prioritize a large case load. Medical Assistant / healthcare background, paralegal training, medical billing, and coding experience is a plus.
Day to Day Tasks Include:
Review complaints, determine allegations, draft notice letters to respondent and contact the complainant
Request/subpoena medical records or supporting documents/information relevant to the investigation
Follow-up on outstanding requests/responses
Organize (bookmark) medical records/supporting documents to add to the case file within Adobe
Determine next steps within the investigation to keep the case moving forward
Provide status updates when requested to complainant and respondent
Prepare memos/investigative reports for matters related to unprofessional conduct
Conduct interviews with complainants, respondents or witnesses
Prioritize daily tasks
Update case notes and case status
Respond to inquiries from the Medical Consultants reviewing cases
Top 3 Required Skills: (Non-Negotiable)
1. Effective written and oral communication; Skill in production of timely and accurate Reports/Memos
2. Organization and Follow Through
3. Knowledge of Microsoft Office Suites (Word, Adobe PDF)
Top 5 Preferred Skills: (Preferences)
1. Experienced medico-legal administrator, paralegal, or healthcare compliance analyst/auditor
2. Self-Starter: Enthusiasm, Flexibility and Motivation; Work effectively without regularly needing to be told what to do
3. Critical Thinking and Problem-Solving: Identify similar situations following established routines/instructions
4. Team Player: Ability to work with various investigators, internal and external medical physicians, support staff services, and different departments
5. Knowledge of medical terminology / Background in Healthcare
ABILITIES:
Ability to conduct investigations, including review of medical records to determine relevance to the investigation.
Ability to multi-task, prioritize, plan, analyze, and coordinate investigations. A
Ability to extract and utilize facts from a variety of sources and apply the relevant statutes, rules and policies to prepare clear, accurate and quality documents within specified time frames.
Required Skills
Effective written and oral communication (including email)
Organization and Follow Through
Knowledge of Microsoft Office Suites (Word, Adobe PDF)
Preferred Skills
Knowledge of healthcare terminology
Medical Assistant / Background in Healthcare
Monthly Requirement:
Attend monthly Board meetings to present your cases and support medical consultants.
Notes:
Position will be in office until they are finished with training and are able to work independently
Hybrid schedule after training will be 3 days at home 2 days in office
VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status