Medical Investigator

S R International•Phoenix, AZ

2d•$22•Hybrid

About The Position

Duties and responsibilities: Conducting investigations for allopathic physicians and physician assistants licensed in Arizona 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. Tentative start date will be dependent upon interviews conducted, onboarding completed, and the state agency issuing a PO. HireRight must be used for Global ID. Local Only Candidates - Resumes must specify the current location of the candidate, all those who do not state current location will not be considered. - AS A REMINDER - Candidates must be local at time of submission, and available for in person interviews within 1 week of the posting close date. Candidates must also be able to start within 2 weeks of an offer being made. Duties are equivalent of a paralegal or high-volume case manager. 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 Arizona Medical Board; on occasion, testify before the Office of Administrative Hearings; prioritize, plan, organize, and conduct investigations, including site inspections.

Requirements

Effective written and oral communication (including email)
Organization and Follow Through
Knowledge of Microsoft Office Suites (Word, Adobe PDF)
Experience in reading and interpreting medical records.
Skill in production of timely and accurate reports and documentation.
Skills in applying and interpreting Federal and State 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.
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.
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.

Nice To Haves

Medical Assistant / healthcare background, paralegal training, medical billing, and coding experience is a plus.
Self-Starter: Enthusiasm, Flexibility and Motivation; Work effectively without regularly needing to be told what to do
Critical Thinking and Problem-Solving: Identify similar situations following established routines/instructions
Team Player: Ability to work with various investigators, internal and external medical physicians, support staff services, and different departments
Knowledge of healthcare terminology
Medical Assistant / Background in Healthcare

Responsibilities

Review complaints, determine allegations, draft notice letters to respondent and contact the complainant
Request 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
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