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Providence · 10 hours ago

Senior Manager Claims

United States

Full-time

Remote

Senior Level

$56.40/hr - $89.04/hr

7+ years exp

Providence is a comprehensive health care organization serving various communities across the United States. The Senior Manager, Claims role is responsible for managing and supervising a team handling multi-line health provider and institutional claims, ensuring compliance and effective outcomes while collaborating with key stakeholders.

Hospital & Health Care

Responsibilities

Management and supervision of a team handling multi-line health provider and institutional claims

Responsible for file management, stewardship and file outcomes of the team in collaboration with key system leadership

Ensuring accurate regulatory compliance, adherence to department policy and procedures, stakeholder presentations, and team development

Coaching to best outcomes for high exposure, complex matters including medical negligence, organizational negligence, directors and officers, fiduciary, general liability and similar matter types

Participating in procuring and sharing conclusions to provide actionable insights to key stakeholders across the organization

Collaborating with various teams to provide consultation, oversight, risk avoidance and mitigation recommendations, data analytics, and efficiency execution

Coordinating with operational staff as needed to ensure efficient outcomes

Qualification

Claims managementMedical negligence expertiseSupervisory experienceProgram planningInsurance experienceProject managementLeadership trainingData analyticsStakeholder presentationsTeam developmentChange managementLean methodologyHEDIS experienceCAHPS experienceMedicare 5-Star RatingNCQA accreditationURAC accreditation