UNIV - Clinical Risk Manager (Registered Nurse) - Insurance Services

Job Description SummaryThe Insurance Services Clinical Risk Manager supports the Insurance Services Director of Clinical Risk Management by conducting frontline discovery, evaluation, and documentation of clinical events involving healthcare providers across MUSC and the MUSC Health System including the RHN, MUSCP and affiliates, and MUSC Health Affiliates (collectively call the MUSC Enterprise). This role performs medical record reviews, assists in preliminary event assessments, prepares case summaries, supports professional liability processes, and facilitates communication with internal stakeholders. The Clinical Risk Manager collaborates with hospital risk and quality teams, internal counsel, and clinical departments to promote patient safety, reduce clinical risk exposure, and improve system wide learning.The position requires strong analytical skills, excellent communication, and the ability to manage sensitive clinical information with professionalism and discretion.EntityMedical University of South Carolina (MUSC - Univ)Worker TypeEmployeeWorker Sub-Type​ClassifiedCost CenterCC001339 ESS - UNIV - Insurance Services - ClinicalPay Rate TypeSalaryPay GradeUniversity-GEN10Pay Range57,700.00 - 80,800.00 - 103,900.000Scheduled Weekly Hours40Work ShiftJob DescriptionThe Insurance Services Clinical Risk Manager supports the Insurance Services Director of Clinical Risk Management by conducting frontline discovery, evaluation, and documentation of clinical events involving healthcare providers across MUSC and the MUSC Health System including the RHN, MUSCP and affiliates, and MUSC Health Affiliates (collectively call the MUSC Enterprise). This role performs medical record reviews, assists in preliminary event assessments, prepares case summaries, supports professional liability processes, and facilitates communication with internal stakeholders. The Clinical Risk Manager collaborates with hospital risk and quality teams, internal counsel, and clinical departments to promote patient safety, reduce clinical risk exposure, and improve system‑wide learning.The position requires strong analytical skills, excellent communication, and the ability to manage sensitive clinical information with professionalism and discretion.Responsibilities25% Clinical Event Review & Risk AssessmentConducts timely and objective reviews of clinical events with potential for professional liability exposure, focusing on identifying provider involvement, clinical concerns, and factors that may contribute to a future claim or litigation. Performs medical record review and event reporting analysis to determine whether an incident may require escalation for claims consideration.Prepares concise case summaries highlighting potential liability issues, documentation gaps, and patient outcome concerns for Director review. Assists with root cause analysis activities in collaboration with Hospital Risk and Quality partners.Supports early identification of trends or recurring risk factors that could increase exposure to claims or legal action. 30% Professional Liability SupportAssists the Director, insurance representatives, and external counsel in gathering clinical documentation relevant to professional liability events.Coordinates discovery‑related tasks, including obtaining records, clarifying provider involvement, timelines, and clinical facts.Prepares exposure summaries, provider involvement reports, and supports communication of claims‑related updates to internal stakeholders.Maintains accurate case files in alignment with Insurance Services and legal requirements. 15% Communication, Clinical Analysis (Legal/Insurance) & Stakeholder CollaborationSummarizes clinical risk issues, case details, and recommendations for Director review.Communicates routine clinical risk trends, documentation needs, and follow‑up tasks with hospital partners, clinical departments, and operations staff.Facilitates timely escalation of clinical concerns to the Director or senior leadership as appropriate.Supports organizational initiatives related to patient safety, quality improvement, and regulatory readiness. 10% Education, Training & Loss PreventionAssists in developing and delivering clinical risk management education for providers, residents, and clinical teams.Supports implementation of targeted risk mitigation strategies and safety interventions.Promotes a culture of transparency and learning throughout clinical departments. 15% Data Management, RMIS Documentation & Departmental OperationsMaintains accurate, complete, and high‑quality data within the Risk Management Information System (RMIS).Ensures timely entry, tracking, and updating of clinical events and supporting documents.Generates routine reports and dashboards for trend analysis and leadership review.Identifies workflow or data integrity concerns and collaborates with IT or Insurance Programs to troubleshoot.5% Other Duties As AssignedAdditional Job DescriptionMinimum Requirements: A bachelor's degree in Nursing and four years relevant experience. Strong analytical, writing, and critical thinking skills. Ability to maintain confidentiality and manage sensitive clinical information. Excellent interpersonal and communication skills.Education and Training (Preferred)RN clinical licensure.Experience with risk management, quality improvement, patient safety, claims, or legal processes.Familiarity with Root Cause Analysis (RCA), Failure Mode & Effects Analysis (FMEA), Just Culture principles, and national patient safety standards.Experience with RMIS platforms.CompetenciesClinical judgment and ability to interpret medical records.Strong organizational skills and attention to detail.Ability to work independently while supporting team objectives.Customer‑focused and responsive to internal stakeholders.Professionalism when interacting with providers, leaders, and legal partners.Physical Requirements: (Note: The following descriptions are applicable to this section: Continuous - 6-8 hours