Providence Health & Services ยท 1 day ago
General Liability Claims Manager, Healthcare *Remote*
Washington, United States
Full-time
Remote
Mid, Senior Level
$46.11/hr - $73/hr
5+ years exp
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Responsibilities
Be responsible for day-to-day oversight of general and professional liability claims in accordance with the System's claims program policies and procedures and within an assigned Region or scope of responsibility
Be responsible for investigating, evaluating and managing professional and other liability claims against the organization as assigned
Maintain up-to-date and accurate claims files, including summaries, action plans, and claims status in the claims data management software
Coordinate with facility leadership, risk managers, defense counsel, and others; ensuring compliance with relevant claims reporting procedures and required regulations
Provide feedback and recommendations to the Management on evaluations, litigation trends, department policies and procedures, system-wide claims and litigation processes, and appropriate System risk management issues
Be directly responsible for fostering teamwork, operational excellence and effective communication within the claims team, including other Claims Managers, Claims Technicians and Claims Specialists
Review and analyze medical records, interview witnesses, assist with the discovery process and communicate with facility risk manager regarding evaluation and investigation
In collaboration with facility risk management, set appropriate indemnity and expense reserves including documentation of jury verdict research or similar analysis of exposure
Select appropriate medical experts for case review
Develop a plan of action for assigned claims and update the claims file following all material changes in status
Review and approve statements for services and take proper steps to pay vendors
Inform Management of large or complex claims and claims with potential for media exposure
Report claims with potential excess exposure to excess insurers
Develop and document for each claim or lawsuit a plan of action for resolution by settlement, trial or other means
Maintain the electronic file including all material communication, correspondence, analysis, expert opinions, interview summaries and all other material documents in accordance with the Claims Policies and Procedures Manual
Maintain up-to-date claims status and actions plans on all Potential Claims, Claims and litigated matters in the claims data management software
Negotiate settlements
Monitor trials
Close files in accordance with internal policies and procedures and facilitate appropriate reporting to NPDB and state agencies
Participate in department and claims team projects as assigned to develop and improve procedures, policies; to improve efficiency of department work; and to assist the Group Vice President and Director of Risk & Claims as needed
Provide feedback and recommendations to Management regarding claims trends and appropriate risk management responses
Provide input for quality and patient safety projects, through the Risk & Integrity Services division and Risk, Claims, & Insurance department
Qualification
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Required
Bachelor's Degree in Business Administration, Finance, or a related discipline -OR- a combination of equivalent education and experience
5+ Years of experience in any of the following areas of focus / specialty: General Liability Claims Processing, General Liability Claims Management, General Liability Legal Experience (E.G. Paralegal, Etc.), Healthcare Risk Management, General Risk Management, Insurance General Liability Claims Handling
Preferred
Experience with a mix of general liability claims, including at least 10 claims with significant bodily injury and experience with STARS software
Healthcare experience
Certified Professional Healthcare Risk Management (CPHRM)
Benefits
401(k) Savings Plan with employer matching
Health care benefits (medical, dental, vision)
Life insurance
Disability insurance
Time off benefits (paid parental leave, vacations, holidays, health issues)
Voluntary benefits
Well-being resources
Company
Providence Health & Services
At Providence, our strength begins with understanding.
10001+ employees
H1B Sponsorship
Providence Health & Services has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2023 (23)
2022 (33)
2021 (32)
2020 (24)
Funding
Current Stage
Late StageLeadership Team
Jennifer Burrows
Chief Executive Officer
Rod Hochman
President and CEO
Recent News
2024-11-29
oregonlive.com
2024-10-26
Providence Business News
2024-10-26
Company data provided by crunchbase
