Risk Management Kaiser Permanente

Mary Ann Brown, R.N., J.D *******@*******.***

Cell 703-***-****

Summary

A highly talented, detail-oriented, efficient, and organized professional known for excellent communication skills, both written and oral. Extensive experience working with Federal and State laws, and regulations. Capable of implementing and enhancing operational procedures to ensure maximum efficiency, productivity, and profitability. Highly trustworthy, discreet and ethical. Possess strong analytical and problem-solving skills. Adheres to the highest standards of integrity and builds exceptional relationships by working and finding win-win solutions.

Areas of expertise include:

Legal Affairs

Risk Management

Regulatory Compliance and Research

Registered Nursing 15 years

Legal / Management Experience

Retirement 2019 – Present

Kaiser Permanente Rockville, MD

Sr. Risk Manager, NOVA July 2011 – July 2019

Assessed incident reports and member complaints for conversion to potentially compensable events (PCE).

Strategized how to approach providers and staff regarding early intervention and resolution of UORs.

Coordinated Sentinel Event reporting. Collaborated with physicians and departments to develop strategies when communicating with members after adverse events. Provided support during physician and family meetings.

Collaborated with Regional Claims Manager for successful management and disposition of pre-suit claims. Assisted attorneys with medical malpractice cases. Analyzed and summarized medical records.

Reviewed administrative cases with staff to ensure that administrative appeal decisions were based on the correct application of the members’ benefits and that all issues were fully addressed.

Served as a consultant to medical center staff and providers. Assisted with questions involving a myriad of issues concerning informed consent, advanced directives, Power of Attorney, responses to the Board of Medicine, subpoena handling, contacting attorneys and HIPAA concerns.

Developed effective Risk Management educational programs for providers and staff.

Maintained a risk management database to identify opportunities for improvement, corrective actions taken, and follow-up to evaluate compliance and efficacy.

Continued to review and assist in the revision of the Risk Management policies and procedures regarding required reporting, treatment of minors, and incident reporting.

Conducted training seminars for physicians and billing personnel on the Medicare teaching physician coding and documentation requirements.

Kaiser Permanente Falls Church, VA

Advice Call Center July 2009 –July 2011

Provided telephone triage service to Kaiser members, using established guidelines, to ensure members received the appropriate level of clinical care in a timely, efficient manner.

Bar Membership / Professional Affiliations

District of Columbia

United States of Court of Federal Claims

Virginia State Bar Association

Nursing License - Virginia

Achievements

Recipient - Marymount University Alumna Achievement Award

Recipient - Public Health Service Award

Published Chapter Author- Concepts of the Nursing Profession

Legal Accountabilities in the Health Care Environment

Other Employment

U.S. Department of Health and Human Services, Public Health Service - Office of the General Counsel – Rockville, MD

US Court of Federal Claims, Office of Special Masters - Washington, D.C

The George Washington University Hospital - Washington, D.C

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