LNCs in Risk Management

[Katillac, RN]

I just wanted to post about an opportunity available for LNCs that I haven't seen mentioned a lot.

I work in risk management as a claims investigator for the organization that administers the professional Liability Insurance for a group of hospitals and practitioners. When a suit is filed, or when an incident occurs in which the risk management office thinks there is a possibility of malpractive being alleged, I pull the chart, review it, and do whatever research I need to do on the specifics of the case to become conversant in it. Then I interview the involved insured parties (attending MDs, residents, other hospital employees including nurses) to find out what happened. I then write up a report including the interview and my assessment of any breaches in appropriate standards of care as well as what I think the problems are with documentation, with the witnesses, etc.

The nice part about it is that I am a part of the defense, so the people I interview are usually appreciative of my efforts to understand the case. They know that the plaintiff is likely to bring up the same issues I am bringing up because their experts have reviewed the record, too, and the insured know they need to help the lawyers prepare a defense.

I am a nine to five employee, so I don't have the flexibility that some LNCs enjoy, however once I get more experience I will be able to work from home at least one day a week, and I do get all of the weekends and holidays off. I do need to say that the rate of pay is not as high as it was when I was in the clinical setting, but for me the tradeoff is worth it, especially because I don't need to do all of the billing and record keeping.

I would imagine that any insurance company that writes medical malpractice has claims examiners. They would be the people, I would think, who would be in a position to steer you towards a potential employer. Additionally, most facilities have some form of risk management, and a big facility will probably have it's own occurrence investigators, possibly as part of the quality improvement department.

Something to think about, perhaps, for you LNCs that have had a tough time getting a practice going. You could do this for a while to get your experience and then go independent if you wanted to, although in my company there is a reasonable career path; many of the people at the top started as investigators.

[sirI, MSN, APRN, NP]

Thank you, Katillac, for your input. Excellent advice!!

[lecavalier4]

Did you have any risk management experience before you started working in that position? Any positions I find like yours, they all want experience.

[Katillac, RN]

Did you have any risk management experience before you started working in that position? Any positions I find like yours, they all want experience.

No, perhaps I just lucked out, but I had no experience. I was given a straightforward case to review during the interview, after which I was asked to write a summary, identifying pertinent issues I noticed in the chart, people I would want to interview and what questions I would ask. So I think they got a sense of my ability at that point.

During one of the interviews it was said that they feel they can teach an investigator how to write reports and one can learn about specialty areas one has no knowledge of. They focus more on whether the candidate can generally analyze and communicate well.

Good luck with your search, if this is something you would be interested in. :)

[Bluehair]

Thanks for your encouraging post! I just submited an application for a RM position yesterday. Found out today that I got it in just under the wire, they will be scheduling interviews next week. Here' to hoping my LNC training gives me the edge I need to get the position. It sounds very interesting. and I am realizing I am getting to a point in life where the security of a 'job' is appealing.

[Katillac, RN]

Best of luck, Bluehair!

I was surprised that just yesterday I got a call from a recruiter for yet another nurse investigator position. For those of you that are interested in this sort of position, I suggest that you go to your monster.com and careerbuilder resumes and make sure that your LNC is mentioned under your education. If somebody is looking for someone with LNC background, they may put that in their search and you would pop up.

Also, even if the job listing specifies that they are looking for someone with experience, if you shine as a candidate in other areas you may get an interview. Then you have your chance to talk about what you have that compensates for a lack of experience in the specific area.

For example, "Mr. Jones, my lack of experience with OB investigations per se may be of concern to you. However, my background as a midwife and my work with quality improvement with MIDWIVES-R-US have helped to prepare me for a role as a nurse investigator. I've taken the liberty of preparing a report on a fictitious case for you to review." Minus the report, you could use that language in a cover letter.

Whoops! I went a little off topic here. Back to you, Bluehair.

[sirI, MSN, APRN, NP]

Once again, Katillac, you've provided excellent advice!!

[Bluehair]

Update: Did not get the Risk Mgmt. job. I'm currently pursuing a job with an insurance company. The LNC kicked me up a notch above other candidates (so they said!), though the position is not specifically claims review. Will see how it goes...

Thanks for the encouragement!!

[sirI, MSN, APRN, NP]

Good luck, Bluehair!!

[lilyzhou]

Hi, I am lily,I am thinking to get LNC recently, but, my concern is I currently working in a big hospital, and they has risk management, is that possible to work there after i get LNC in order to practice my skills before I start my own business?

[emo77]

Any idea how I could squeeze this type of work in with my full time night postion as a staff RN? I've been checking this type of employment out for awhile, I just don't see anything but full time wanted by those hiring...What are the general prerequisites/education needed?