Stanford Health Care · 1 month ago
Claims Manager
Sacramento, CA
Full-time
Onsite
Senior Level
$66.52/hr - $88.14/hr
5+ years expStanford Health Care is a leading healthcare provider committed to delivering hope and innovation. The Claims Manager role involves investigating, managing, and resolving claims and adverse events, coordinating with internal stakeholders, and overseeing legal counsel.
Health CareHealth DiagnosticsHospitalMedicalPrimary and Urgent Care
Responsibilities
Manages litigated claims, evaluates applicable insurance coverages such as professional and general liability, retains outside counsel, attends mediation, monitors litigation costs, and oversees decisions regarding discovery, strategy, and ultimate resolution
Investigates pre-suit claims, interviews providers, retains consultants when necessary, prepares case reports, communicates with patients and/or families, and directly negotiates settlements when warranted
Prepares claims reports and presents high-exposure cases to leadership and stakeholders, including reinsurance partners
Maintains accurate defense and indemnity reserves on assigned claims as facts and circumstances evolve over the life of the claim
Inputs all work product and case information into the claims database and manages the database for assigned files to ensure that information is accurate and entered in a timely manner
Serves as a resource to other member of the Claims team and Risk Management team members on matters that may have the potential to rise to the level of a claim. Assists in handling general claims or risk management issues as necessary
Qualification
Required
Bachelor's degree required
Five (5) years of progressively responsible and directly-related claim management experience
Ability to analyze and develop solutions to complex problems
Ability to apply judgment and informed decisions
Ability to communicate effectively in written and verbal formats including summarizing data and presenting results
Ability to establish and maintain effective working relationships
Ability to work effectively both as a team player and leader
Knowledge of computer systems and software used in functional area
Knowledge of laws pertaining to professional liability, informed consent, malpractice litigation, and other legal issues
Knowledge of local, state and federal regulatory requirement related to the functional area
Knowledge of medical terms, concepts and practice
Preferred
Juris Doctor (JD) degree preferred
Company
Stanford Health Care
Stanford Health Care is a healthcare center that treats cancer, heart disease, brain disorders, and primary care issues.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Aditya Bhasin
VP Software Design & Development
Jay Shah
Chief of Staff
Recent News
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