Patient Safety Specialist

The Doctors Company is a physician-owned medical malpractice insurer committed to advancing, protecting, and rewarding the practice of good medicine. The Patient Safety Specialist reviews and codes claims data and medical records, supports data quality and reporting, and assists with patient safety research, publications, training, and analytical studies.

Responsibilities

• Provides requested clinical data sets
• Assists in the development of articles and other resources for internal and external publication
• Collaborates with Director to produce reports of claims data and analytical studies
• Presents information to internal customers on patient safety topics related to current data as requested
• Using multiple taxonomies, analyzes and codes claims data into TDC AIDE and outside vendor systems
• Reviews and validates case summaries, coding outputs, claim information, and other system-generated content to support accuracy, consistency, and appropriate use in case analysis
• Identifies trends and areas of interest during work with clinical data
• Maintains quality in coding of clinical data using evidence-based taxonomy
• Completes coding within a productive period
• Attends coding and taxonomy meetings as required
• Maintains knowledge of data retrieval tools, reporting platforms, and department data resources used to support coding analysis, benchmarking, and patient safety priorities
• Stores, organizes, and maintains data files, coding resources, reports, and related documentation in accordance with department policy and data management/governance practices
• Supports data quality by identifying missing, inconsistent, or potentially inaccurate information and communicating issues that may affect data use, analysis, or reporting
• Tracks taxonomy updates, coding guidance changes, data definitions, and related change-management activities that affect how claims data are captured, interpreted, or reported
• Provides training and subject matter expertise on data utilization, benchmarking, coding structure, taxonomy updates, and reporting practices
• Supports validation of data extracts, reports, and taxonomy-related outputs to identify inconsistencies and promote reliable data use
• Maintain full compliance with all organizational policies, procedures, and established standards (e.g. accurately recording time worked, Submitting PTO, mandatory corporate training)
• Keep technical knowledge and skills current to effectively support department priorities
• Complete all performance and development activities including the performance review process in a timely manner
• Fulfill all required training and development obligations to maintain essential skills and credentials
• Complete all mandatory compliance courses on time, meeting corporate training standards
• Pursue additional learning opportunities that strengthen professional capabilities and contribute to team and organizational performance, with prior manager approval
• Support enterprise and departmental objectives by taking on assigned projects and delegated tasks with accountability, attention to detail, and timely execution
• Identify and implement process improvements that enhance business efficiency and strengthen organizational effectiveness
• Proactively provide regular updates to leadership on project status, deliverables, and outcomes
• Maintain flexibility and agility to take on additional responsibilities as organizational needs evolve

Preferred

• Experience working in healthcare risk management, patient safety, quality improvement, infection control, utilization review, case management or legal nurse consulting
• Registered Nurse or other clinical licensure
• Experience with coding taxonomies, claims databases, clinical data classification, data visualization, benchmarking, healthcare analytics, or data quality review
• Experience developing reports, analytic summaries, presentations, articles, educational materials, abstracts, or other patient safety resources
• Experience with advanced Excel, Power BI, dashboard tools, or other analytic/reporting platforms
• Infection Control
• Utilization Review
• Case Management
• Legal Nurse Consulting
• Registered Nurse License
• Clinical Licensure
• Coding Taxonomies
• Claims Databases
• Clinical Data Classification
• Data Visualization
• Benchmarking
• Healthcare Analytics
• Data Quality Review
• Report Development
• Analytic Summaries
• Presentation Development
• Article Writing
• Educational Materials
• Abstract Development
• Patient Safety Resources
• Advanced Excel
• Power BI
• Analytic Platforms
• Reporting Platforms

Benefits

• This position is eligible for participation in the Company's Short-Term Incentive Plan (STIP), offering additional compensation driven by individual and company performance.
• Medical, family and bereavement leave
• Same-sex domestic partner benefits
• Short- and long-term disability programs
• An employee assistance program
• Health, dental, and vision insurance
• Health care tax-free spending accounts with a company match
• 401(k) and Roth IRA with company match, as well as catch-up plans for both
• Vacation days, sick days, and paid personal days each calendar year (with vacation increases based on length of service)
• Paid holidays each calendar year
• Life and travel insurance
• Tax-free commuter benefits
• In-person and online learning opportunities
• Cross-function career opportunities
• Business casual work environment
• Time off to volunteer
• Matching donations to qualifying nonprofit organizations
• Company-sponsored participation at non-profit events
• Full-time hybrid work arrangement (2x per week in-office)

Company

• Physician-owned medical malpractice insurer for healthcare professionals.
• Napa, California, USA
• http://www.thedoctors.com/
• Founded in 1976
• 501-1000 employees

Qualifications

• Baccalaureate or advanced degree in nursing, healthcare, health sciences, patient safety, risk management, health information management, data science, or a related field
• Three (3) or more years of experience in one or more of the following areas: healthcare, medical malpractice claims, patient safety, healthcare risk management, quality improvement, clinical review, clinical data analysis, claims analytics, healthcare data analysis, or healthcare data science
• The ability to work independently and unsupervised
• The ability to work well with others
• Strong organizational skills
• Strong analytical skills, including the ability to identify patterns, synthesize information, recognize potential data issues, and explain findings clearly
• Proficient computer skills using Word and Excel in a windows environment
• Strong written and verbal communication skills
• Ability to review medical record information, malpractice claim facts, patient safety issues, risk factors, and other data to support accurate analysis and reporting
• Understanding of medical terminology and clinical systems
• Understanding of clinical medicine
• Knowledge of liability concepts and standards of care
• Ability to calculate and interpret basic data measures, including counts, percentages, proportions, and trends, to support claims analysis and reporting
• Experience working in healthcare risk management, patient safety, quality improvement, infection control, utilization review, case management or legal nurse consulting
• Registered Nurse or other clinical licensure
• Experience with coding taxonomies, claims databases, clinical data classification, data visualization, benchmarking, healthcare analytics, or data quality review
• Experience developing reports, analytic summaries, presentations, articles, educational materials, abstracts, or other patient safety resources
• Experience with advanced Excel, Power BI, dashboard tools, or other analytic/reporting platforms
• Three (3) or more years of experience in one or more of the following areas: healthcare, medical malpractice claims, patient safety, healthcare risk management, quality improvement, clinical review, clinical data analysis, claims analytics, healthcare data analysis, or healthcare data science.

Required skills

• Claims Analysis, Clinical Data Analysis, Clinical Data Classification and Coding Taxonomies, Clinical Medicine, Healthcare Risk Management, Liability Concepts and Standards of Care, Medical Malpractice Claims, Medical Record Review, Medical Terminology, Microsoft Excel, Patient Safety, Power BI

Preferred skills

• Registered Nurse or other clinical licensure

Experience

• 3+ years