RWD Consulting has an excellent opportunity for a full-time Registered Nurse (RN) -Risk Management to provide services at the Walter Reed National Military Medical Center in Bethesda, MD.  This position offers compensation with excellent M-F day-shift hours.  Come use your experience providing care to help our nation's military! 

Scheduling Details:

• Core hours are between 6a - 4p (Monday - Friday)

Scope of Work/Service (tasks include, but are not limited to):

• Leads the coordination between care providers and plan members with the goal of maximizing member benefits while managing costs.
• Oversees the assessment of medical necessity of procedures and/or admissions, conducts pre-certification or authorization, and ensures compliance with established guidelines.
• Assists members in appeals for denied services. Interprets benefits and guides members to choose to the appropriate providers, projects and resources.
• Applies the medical and reimbursement policies within the claim adjudication process.  
• Provide on-call support as required for rapid response to high priority issues and tasking.
• Collects, analyzes and trends data on patient incidents utilizing the event reporting system. Monitors event reporting system and investigates adverse events as appropriate.
• Facilitates root cause analyses of adverse events, participates in development of action plans, and monitors implementation of action plans.
• Utilizes acquired knowledge from analyses, investigations and root cause analyses to recommend process improvements in patient safety and quality initiatives.
• Ensures compliance with organizational wide risk management program regarding statutory mandates, regulatory requirements and accreditation standards of professional organizations, i.e., JCAHO, OSHA, etc.
• Collaborates, shares pertinent information with members of the healthcare team regarding the risk management program. Ensures staff is educated on established guidelines for reporting a significant medical error or unanticipated outcome in the patient's care which results in patient harm.
• Assist in the development and participates in contingency plans of organizational disaster preparedness and patient safety initiatives.

Required Qualifications:

• Must be able to obtain and maintain a National Agency Check with Local Check and Credit Check (NACLC) government security clearance.
• Requires a bachelor’s degree in Nursing.
• Possess current unrestricted license to practice as a registered nurse in one of the 50 states, the District of Columbia, the Commonwealth of Puerto Rico, Guam, or the U.S. Virgin Islands.
• Possess and maintain at all times, current certification in Basic Life Support (BLS).
• Possess a minimum of 5 years related experience; have obtained the minimum experience working in an outpatient acute care (hospital based) or ambulatory care setting.
• Previous experience in a supervisory and/or management role required.
• Knowledge of State, Federal, and JCAHO regulations.
• Minimum of two years experience with healthcare risk management preferred.
• Previous experience with hospital management, risk and claims management also preferred.

If this sounds like an opportunity you'd be interested in, do not hesitate and apply online today!  

If you do not find interest in this opportunity but know of someone who may, we kindly ask that you refer the individual to RWD Consulting, LLC by forwarding this job posting.
  Established in 2004, RWD Consulting, LLC (RWD) provides tomorrow’s solutions today. We achieve mission-critical results for federal, public and private sectors through our core competencies: Data Management & Analytics, Information Technology, Logistics & Supply Chain Management, Facility Operations & Management, and Project Management, Administrative & Technical Support. Our services enhance our clients’ capabilities and allow them to focus on their mission and goals.

RWD Consulting, LLC is an Equal Opportunity Employer.