Clinical Care Investigator

The Board of Registration and Medicine within the Department of Public Health (DPH) is seeking an experienced Registered Nurse to evaluate complaints against physicians and identify those allegations that raise issues of substandard care.

The Clinical Care Investigator will identify and obtain appropriate medical records to review, analyze, and summarize. The Investigator will work with complaint counsel to identify relevant witnesses and conduct interviews as determined by the team, and also identify and interview physicians who will act as experts. The incumbent organizes and prepares materials for expert review; writes clear, concise and logically sequenced memoranda; and assists complaint counsel in the preparation and presentation of adjudicatory matters before the Board and the Division of Administrative Law Appeals (DALA).

Please note: The selected candidate will need access to reliable transportation for work-related travel as required.

Duties and Responsibilities (these are a general summary and not all inclusive):

• Reviews and investigates complaints and reports from patients, individuals, mandated reporters and other sources to determine potential violations of laws, regulations or standards of medical care affecting the public health, safety and welfare. Identifies those allegations that raise issues of substandard care requiring further investigation; proceeds accordingly by requesting medical records and/or interviewing witnesses; maintains a record of interviews and prepares investigative reports in a timely manner; maintains activity logs documenting case work.
• Oversees a caseload by prioritizing work appropriately, setting and achieving goals and responding to deadlines in a timely manner. Prepares accurate, objective summaries of medical records for use by complaint counsel and Board committees; provides clinical analysis of consumer complaints and statutory reports, drawing on medical knowledge  and experience to determine whether care was substandard.
• Analyzes consumer complaints and statutory reports, evaluates physician responses and reviews related medical records; prepares memoranda containing an analysis of the medical issues and recommends disposition.
• Works collaboratively with complaint counsel and investigators in the disciplinary processing of a case; summarizes medical records and provides education on the medical issues; identifies additional medical records and materials to be subpoenaed and persons to be interviewed; gathers and analyzes relevant medical literature.
• Identifies and interviews qualified physicians who are willing to provide an expert opinion on the quality of care provided in a particular case; organizes materials for expert review and assists complaint counsel in interviewing expert witnesses and preparing experts for hearing, as needed.
• Assists complaint counsel in the preparation of legal documents such as a subpoenas, affidavits, Statement of Allegations, Consent Orders and memoranda on disposition.
• Assists complaint counsel in the preparation and presentation of cases at DALA, as well as at depositions and pre-trial conferences; attends hearings and/or gives sworn testimony at hearings as necessary; assists complaint counsel in the preparation of questions and exhibits to be used at hearings.
• Adheres to strict legal and regulatory requirements of confidentiality and prohibitions against unauthorized disclosure of sensitive, confidential and privileged information regarding patients, physicians and law enforcement investigations.
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