Area Claims Manager

🕒 Outubro 13

🌽 Illinois – Remoto

🌽 Illinois – Remote

💵 $51 - $85 / hora

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

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• Aberta há 29 dias.
• As vagas desta empresa costumam ser preenchidas em 21 dias.
• Repostada uma vez.

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Trinity Health

SiteLinkedInTodas as Vagas

10.000+ funcionários

🏥 Saúde

📚 Educação

🤝 Sem Fins Lucrativos

Healthcare • Education • Non-profit

A Trinity Health é um dos maiores sistemas de saúde sem fins lucrativos e católicos do país. É uma família de 123.000 colegas e quase 27.000 médicos e clínicos cuidando de comunidades diversas em 26 estados. Reconhecida nacionalmente pelo cuidado e experiência, o sistema Trinity Health inclui 88 hospitais, 135 locais de atendimento contínuo, o segundo maior programa PACE do país, 136 locais de atendimento de urgência e muitos outros serviços de saúde e bem-estar. Com sede em Livonia, Michigan, sua receita operacional anual é de US$ 21,5 bilhões, com US$ 1,4 bilhões retornados para suas comunidades na forma de assistência filantrópica e outros programas de benefícios comunitários.

Descrição

• Strategize and implement a cost-effective process to manage Hospital Professional Liability, General Liability, and Employment Practices Liability claims and litigation • Co-manage uninsured litigation across the system • Design and direct claim investigation processes • Evaluate claims regarding liability, causation, damages, standard of care, witness credibility, and expert opinions • Develop resolution strategies and resolve claims and lawsuits fairly and equitably • Review new incidents, open claims, and assess coverage • Establish and complete timely indemnity and expense reserve reviews • Determine claim resolution strategies, negotiate settlements, and direct negotiations within delegated authority • Notify excess insurers and provide file updates • Maintain claim diaries and update claim files according to Best Practice Protocol • Participate in Regional Claims Review and Large Loss meetings • Represent Trinity Health in evaluations, settlement conferences, mediation, facilitations, and trials • Retain, direct, and supervise outside defense counsel; review attorney reports, recommendations, fees, and litigation expenses • Ensure compliance with Medicare, NPDB, and State reporting requirements • Collaborate with Loss Control Directors to identify risk management trends and opportunities • Keep IRMS management apprised of significant case developments • Direct and supervise Claims staff maintaining and updating the ClearSight database • Communicate with Health Ministry Risk Management and Patient Safety colleagues regarding claims, exposure, evidence preservation, authority requests, and litigation protocols • Serve as liaison to senior leadership regarding pending matters, high-exposure claims, and media-sensitive matters • Develop individual goals, attend team and department meetings, and participate in committees • Review monthly ClearSight reports for accuracy, data integrity, and reserve assessment • Monitor legislation, court decisions, and emerging claims litigation trends • Maintain knowledge of applicable laws, regulations, compliance programs, and policies

🎯 Requisitos

• Bachelor’s degree in a related field, or an equivalent combination of education and experience is required • Three (3) to five (5) years of experience as a liability claims professional adjuster, defense malpractice attorney or hospital risk manager is necessary • Advanced knowledge and working relationships in risk management, quality management and improvement is helpful • Proficiency in the use of IRMS claim database (Clearsight) • Working knowledge of medical terminology is required • Strong analytical skills • Ability to organize and communicate information both orally and in writing with all levels of the organization • Initiative and ability to handle responsibility independently • Ability to meet deadlines and respond to shifting priorities • Must be comfortable operating in a collaborative, shared leadership environment • Must be able to travel to the various Trinity Health sites up to 50% of the time • Must be able to work independently at a remote location • Must be able to adapt to frequently changing work priorities and work under pressure • Must be able to perform moderate physical activity, lifting and bending

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