Job Details

Overview

Providence is calling a Liability Claims Manager who will investigate, evaluate, and manage professional, general, and other liability claims under the PSJH Insurance Program. The role involves communicating with patients, claimants, caregivers, providers, and leadership; reviewing medical records; interviewing witnesses; assisting with the discovery process; and coordinating with facility risk management for evaluation and investigation.

• Communicate with patients, claimants, caregivers, providers, leadership
• Review and analyze medical records, interview witnesses, assist with the discovery process and communicate with facility risk manager regarding evaluation and investigation
• Write insurance policy coverage letters and analyze policy documents to address coverage
• Set appropriate indemnity and expense reserves
• Select appropriate medical experts for case review
• Develop a plan of action for assigned claims and update the claims file following all material changes in status
• Review and approve statements for services and take proper steps to pay vendors
• Inform Senior Manager Claims of large or complex claims and claims with potential for media exposure
• Report claims with potential excess exposure to excess insurers
• Ensure compliance with relevant claims reporting procedures and required regulations
• Work with defense attorneys specializing in defense of medical negligence claims
• Foster teamwork, operational excellence, and effective communication within the claims team
• Develop and document for each claim or lawsuit a plan of action for resolution by settlement, trial, or other means
• Maintain the electronic file including all material communication, correspondence, analysis, expert opinions, interview summaries and other material documents in accordance with the Claims Policies and Procedures Manual

Responsibilities (continued)

• Investigate, evaluate, and manage professional, general, and other liability claims under the PSJH Insurance Program
• Coordinate with facility leadership, risk managers, defense counsel and others; select defense counsel when appropriate; obtain authority for settlement or trial
• Coordinate disclosures with patients and families; assist in regional conferences and case reviews as requested
• Resolve claims in accordance with policies and regulations; negotiate settlements; monitor trials and advise on disclosure
• Close files in accordance with internal policies and procedures and report to NPDB and state agencies as applicable

Required Qualifications

• Bachelor's Degree in Business Administration, Finance, or related discipline, or equivalent combination of education and experience in the insurance industry; claims management; or legal handling of claims issues
• 5 years of relevant general claims processing or management experience, or equivalent combination of direct legal work, health care or general risk management, and insurance claims handling

Preferred Qualifications

• Certified Professional Healthcare Risk Management (CPHRM)
• 2 years of healthcare professional liability (medical malpractice) claims processing or management experience
• Insurance carrier experience
• Third party professional negligence claims experience
• Experience handling medical negligence professional liability claims and complex general liability claims
• Experience working with defense attorneys in medical negligence claims
• Experience analyzing and addressing coverage in medical professional and general liability policies
• Experience writing policy coverage letters
• STARS / Riskonnect or similar claims management software experience

Salary Range by Location

AK: Anchorage Min: $45.14, Max: $70.07; AK: Kodiak, Seward, Valdez Min: $47.05, Max: $73.04; California: Humboldt Min: $47.05, Max: $73.04; California: All Northern California - Except Humboldt Min: $52.79, Max: $81.94; California: All Southern California - Except Bakersfield Min: $47.05, Max: $73.04; California: Bakersfield Min: $45.14, Max: $70.07; Montana: Non-Great Falls Min: $36.34, Max: $56.41; Montana: Great Falls Min: $34.43, Max: $53.44; Oregon: Non-Portland Service Area Min: $42.08, Max: $65.32; Oregon: Portland Service Area Min: $45.14, Max: $70.07; Texas Min: $34.43, Max: $53.44; Washington: Western - Excluding Tukwila Min: $47.05, Max: $73.04; Washington: Southwest - Olympia, Centralia & Below Min: $45.14, Max: $70.07; Washington: Tukwila Min: $47.05, Max: $73.04; Washington: Eastern Min: $40.16, Max: $62.35; Washington: South Eastern Min: $42.08, Max: $65.32; States outside listed: Min: $36.34, Max: $56.41

About Providence

Our strength lies in Our Promise of Know me, care for me, ease my way. We offer best-in-class benefits and an inclusive workplace where diversity is valued and everyone is essential and respected. Providence serves across multiple states with hospitals, clinics, and health services. The base pay range is listed; additional compensation may be available through shift differentials, on-call pay, overtime, bonuses, or other incentives. Learn more at providence.jobs/benefits.

Why Join Providence?

We provide comprehensive benefits to support you and your family, helping you focus on delivering our mission of caring for the most vulnerable in our communities.

Equality and Inclusion

Providence is an Equal Opportunity Employer. We are committed to a diverse and inclusive workforce free from unlawful discrimination and harassment.

Requisition Details

Requisition ID: 388239 | Company: Providence Jobs | Job Category: Financial Transactions | Job Function: Health Plans Services | Job Schedule: Full time | Job Shift: Day | Career Track: Business Professional | Department: 4008 SS RIS | Address: MT Missoula 500 W Broadway | Work Location: St Patrick Hospital-Broadway Bldg-Missoula MT | Workplace Type: Remote

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