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UNC Health · 1 month ago

Claims and Litigations Manager

Chapel Hill, NC

Full-time

Hybrid

Senior Level

5+ years exp

UNC Health is an inclusive organization with a mission to improve the health and well-being of the communities they serve. The Claims and Litigation Manager is responsible for investigating claims against healthcare providers and managing the lawsuit process through resolution, including negotiating settlements and managing external legal counsel.

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Responsibilities

Manages and conducts claims investigations, gathering data from healthcare providers and employees in a timely manner, researching medical records, protocols, laws, policies and procedures governing the alleged claim. Interviews provide employees, patient, patient family members, and others who are involved with the incident and claim. Obtains internal and expert opinion reviews, prepares case files in orderly, thorough manner; maintains accurate documentation

Defines issues involved in the case and makes recommendations for settlement strategies. Negotiates and settles medical malpractice claims or otherwise assists in defense of those claims. Gathers information and reviews settlement agreements. Authorizes funding for settlement payments. Manages external legal counsel hired to represent insureds and manages litigation through resolution

Attends conferences with attorneys and staff, mediations, and depositions, and arranges meetings, and communicates policies and procedures to all involved in the claims

Inputs all claims and incident information into claims database. Follows through on patient complaints and legal/risk management matters that have potential to result in claims. Interacts as requested with internal and external stakeholders on scheduling of depositions, conducting depositions, coordination of discovery (documents for production and responses to interrogatories), and completion of documentation for claims files

Plans, develops, and presents educational sessions with insured faculty and staff regarding loss prevention and reduction techniques, insurance coverages and exclusions, medical record documentation, legal issues and communication techniques. Provides risk management advice to staff regarding incidents that have occurred or issues that are anticipated

Assists the Director in evaluating claim exposure, preparation of summaries and other risk management reports, and the development of claims and risk management policies and procedures

Qualification

Claims investigationRisk managementMedical malpractice knowledgeLegal knowledgeNegotiation skillsComputer systems knowledgeMedical terminologyEffective communicationTeam leadershipProblem-solving