Area Claims Manager

🕒 il y a 12 jours

🌽 Illinois – Distant

infoinfo

💵 $51 - $85 / heure

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

👔 Manager

🗣️🇺🇸🇬🇧 Anglais requis

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Logo of Trinity Health

Trinity Health

10 000+ employés

🏥 Santé

📚 Éducation

🤝 À but non lucratif

Healthcare • Education • Non-profit

Trinity Health est l'un des plus grands systèmes de santé catholiques à but non lucratif du pays. Il rassemble 123 000 collègues et près de 27 000 médecins et cliniciens qui prennent soin de diverses communautés à travers 26 États. Reconnue à l'échelle nationale pour ses soins et son expérience, le système Trinity Health comprend 88 hôpitaux, 135 lieux de soins continus, le deuxième plus grand programme PACE du pays, 136 lieux de soins d'urgence ainsi que de nombreux autres services de santé et de bien-être. Basée à Livonia, Michigan, son chiffre d'affaires annuel s'élève à 21,5 milliards de dollars avec 1,4 milliard de dollars réinvestis dans ses communautés sous forme de soins de charité et d'autres programmes d'aide communautaire.

Description

• 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 and damages • Develop resolution strategies and resolve claims and lawsuits fairly and equitably • Review incidents and open claims as needed • Assess coverage and obtain formal coverage analysis when indicated • Formulate and implement investigation plans • Establish and complete timely indemnity and expense reserve reviews • Determine claim resolution strategies and negotiate or direct negotiations through resolution • Notify excess insurers and provide file updates • Maintain claim diaries and update claim files • Participate in Regional Claims Review and Large Loss meetings • Represent Health Ministry/Trinity Health in case evaluations, settlement conferences, mediations and trials • Retain, direct and supervise outside defense counsel; review attorney reports, fees and litigation expenses • Ensure Medicare, NPDB and state reporting compliance • Collaborate with Loss Control Directors and Health Ministry Risk Management/Patient Safety colleagues • Maintain and update the Clearsight database and review monthly reports for accuracy, data integrity and reserves • Serve as liaison to senior leadership regarding pending matters and potential exposure • Participate in committees and provide claims subject matter expertise • Monitor legislation, court decisions and emerging claims-litigation trends • Develop individual goals and attend team and department meetings

🎯 Exigences

• Bachelor’s degree in a related field, or an equivalent combination of education and experience • Three (3) to five (5) years of experience as a liability claims professional adjuster, defense malpractice attorney or hospital risk manager • Proficiency in the use of IRMS claim database (Clearsight) • Working knowledge of medical terminology • Strong analytical skills • Ability to organize and communicate information 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 • Ability to work in a collaborative, shared leadership environment • Ability to travel to various Trinity Health sites up to 50% of the time • Ability to work independently at a remote location • Ability to adapt to frequently changing work priorities and work under pressure • Ability to perform moderate physical activity, lifting and bending

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🗣️🇺🇸🇬🇧 Anglais requis