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Claims Program Manager

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Mercy Health

10,000+ employees

🏥 Healthcare

🤝 Non-profit

Healthcare • Non-profit

Mercy Health is a mission-driven healthcare organization that provides direct patient care, community health services and a range of support and administrative roles. The organization emphasizes the human side of health care, compassionate, values-based service tied to a ministry mission, workforce development for bedside and support staff, flexible benefits and community outreach. Mercy Health positions itself as both an employer and community health provider focused on dignity, unity and social service.

📋 Description

• Manage complex and large exposure medical malpractice claims, including hospital, employed physician, and deductible-policy claims • Represent BSMH at pre-trial hearings, mediations, arbitrations, and most trials • Manage and direct staff in accordance with organizational objectives and goals • Analyze defense counsel effectiveness annually • Implement and track claims related to the Early Liability Review Program • Set accurate reserves in a timely manner based on formula where possible • Identify potential claims at reporting and conduct appropriate follow-up, including expert evaluation before suit or notice of potential suit • Work extensively with outside defense counsel to manage claims • Verify accurate billing of outside defense counsel • Manage policy reviews to ensure appropriate commercial-policy coverage and congruence between commercial policies and the Captive • Explain risks and alternatives regarding claim options to market and group senior leaders • Work closely with employed physicians named in lawsuits • Collaborate with Risk Management on claim management • Manage coverage issues with insurance staff • Provide direction and oversight of assigned staff duties and projects

🎯 Requirements

• Bachelor's degree required • 7 years of experience handling Professional Liability Claims required • Ability to work Eastern Time Zone hours • Preferred insurance coursework or credentials: CPCU, AIC, ARM, or Insurance Institute courses

🏖️ Benefits

• Competitive pay • Incentives • Referral bonuses • 403(b) with employer contributions (when eligible) • Medical coverage • Dental coverage • Vision coverage • Prescription coverage • HSA/FSA options • Life insurance • Mental health resources and discounts • Paid time off • Parental leave • FMLA leave • Short-term disability • Long-term disability • Backup care for children and elders • Tuition assistance • Professional development support • Continuing education support

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