Claims Program Manager
easyservice · Work at Home - Any State ·
- Work mode
- Remote
- Category
- Project management
Manages medical malpractice claims, sets reserves, and coordinates with defense counsel and physicians; ensures policy compliance and risk mitigation for a healthcare system.
Thank you for considering a career at Bon Secours Mercy Health!
Scheduled Weekly Hours:
40Work Shift:
Days (United States of America)Summary of Primary Function/General Purpose of Position
Effectively and efficiently manages complex and large exposure medical malpractice claims, including hospital and employed physician claims and claims covered by the deductible polices. Acts as the BSMH representative at pre-trial hearing, mediations, arbitrations and attends most trials. Manages and directs staff in accordance with organizational objectives and goals.
This is a remote/work from home position. Hire must be able to work eastern time zone hours.
Essential Job Functions
Manages the analysis of defense counsel effectiveness on an annual basis
Implements and tracks claims related to the Early Liability Review Program
Timely setting of accurate reserves based on formula (where possible)
Identification of potential claims at the time of reporting and appropriate follow up such as expert evaluation prior to suit or notice of potential suit
Works extensively with outside defense counsel to manage the claims
Verifies accurate billing of outside defense counsel
Manages policy reviews to assure appropriate scope of coverage within commercial policies and assure congruence of coverage between commercial policies and the Captive.
While working with market and group senior leaders explain the risks and alternatives regarding various claim options.
Works closely with employed physicians when the physicians are named in a lawsuit
Works closely with the Risk management related to claim management
Manages closely with the insurance staff regarding coverage issues
Manages staff to meet organizational objectives. Provides direction and oversight of assigned duties and projects.
This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job related duties as required by their supervisor, subject to reasonable accommodation.
Employment Qualifications
Required Minimum Education: Bachelors
Preferred Education: Insurance Courses CPCU/AIC/ARM/INS Institute
Minimum Qualifications: 7 years handling Professional Liability Claims
Bon Secours Mercy Health is an equal opportunity employer.
As a Bon Secours Mercy Health associate, you’re part of a Mission that matters. We support your well-being – personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way.
What we offer
Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
Medical, dental, vision, prescription coverage, HSA/FSA options, life insurances, mental health resources and discounts
Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders
Tuition assistance, professional development and continuing education support
Benefits may vary based on the market and employment status.
Department:
SS Risk & InsuranceIt is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a). Accordingly, all applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you’d like to view a copy of the affirmative action plan or policy statement for Mercy Health– Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employer, please email [email protected]. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at [email protected].