SpokaneRecruiter Since 2001
the smart solution for Spokane jobs

Claims Manager

Company: PeaceHealth
Location: Spokane
Posted on: January 16, 2020

Job Description:

PeaceHealth is seeking a Claims Manager for a 1.0 full time equivalent Exempt position. This position will be working Day shift with shift durations of 8 Hours. Req ID: 174936 JOB SUMMARY Position is responsible for the investigation, evaluation, adjudication and resolution of claims and lawsuits presented against PeaceHealth consistent Premier claims management expectations. ESSENTIAL FUNCTIONS

  • Investigates significant events, claims and lawsuits presented against caregivers, physicians and facilities for liability, causation and damages. Interviews principal defendants, fact and expert witnesses completes required captioned reports. Analyzes and evaluates completed investigation and makes recommendations regarding settlement authority, trial or Alternative Dispute Resolution methods.
  • Contacts non-represented claimants presenting demands for compensation beyond waiver of medical bills and analyzes liability, causation and damages to determine exposure and resolves claims by denial, settlement or alternative resolution. Establishes reserves for all litigated and non-litigated claims and lawsuits according to the claims procedure policy.
  • Contacts claimant's attorneys when notified of legal representation and exchanges discoverable information, based upon HIPPA and federal and state privacy rules to permit evaluation of claims and resolves such claims by denial or settlement with the claimant's attorney.
  • Manages litigated cases including directing defense attorneys, attending key depositions, mediations, settlement conferences and select portions of trials. Determines the utilization of adjunct claims management services such as litigation stress consultants, witness preparation consultations, focus groups, mock juries and other independent consultants as needed in each case.
  • Coordinates the production of documents, interviews of witnesses and depositions with the regional risk managers. Reviews requested documents before releasing to defense counsel.
  • Attends quarterly claims strategy conference calls. Participates in conference calls with excess insurance carriers as needed.
  • Provides progress reports to physicians and key nursing staff as investigation develops. Informs all targeted practitioners of the impact of federal (NPDB), state (MQAC), insurance and PeaceHealth underwriting guidelines concerning settlements, awards and verdicts.
  • Compiles high-level reports from events, claims and lawsuits using sophisticated data analytic tools. Enters data into the STARS data system for document management.
  • Provides advice to practitioner and administrators.
  • Performs other duties as assigned. QUALIFICATIONS EDUCATION:
  • Bachelor's degree in Business Administration, Insurance, Legal or Healthcare related field and/or equivalent education/experience is required.
  • Clinical background and/or Juris Doctorate strongly preferred. EXPERIENCE/TRAINING:
    • A minimum of five years in the negotiation and settlement of physician medical malpractice liability claims and management of litigated professional liability cases is required.
    • Experience in the resolution of complex medical malpractice cases, involving potential exposure required.
    • Sophisticated data management experience and skills for presentation and reporting such as SQL, SAP, Crystal Reports, Excess, Access, Tableau, etc. OTHER SKILLS:
      • Excellent face to face interview skills.
      • Strong written and verbal communication skills.
      • Ability to work with physicians and nurses of all specialties.
      • Ability to lead practitioners to a committed resolution in litigated and non-litigated cases.
      • Excellent stewardship skills.
      • Ability to objectively collect and analyze data.
      • Proficient with MS Office applications. SYSTEM SERVICES - PHYSICAL/COGNITIVE REQUIREMENTS:
        • Work requires fairly light physical exertion from up to 65% of the time.
        • Ability to lift objects weighing 30 lbs. or less.
        • Work is performed under normal working conditions with adequate lighting and ventilation.
        • Job duties frequently require intense concentration and attention to detail (up to 65% of work time). Please apply online to be considered. For full consideration of your skills and abilities, please attach a current resume with your application. About PeaceHealth PeaceHealth, based in Vancouver, Wash., is a not-for-profit Catholic health system offering care to communities in Washington, Oregon, and Alaska. PeaceHealth has approximately 16,000 caregivers, a multi-specialty medical group practice with more than 900 providers and 10 medical centers serving both urban and rural communities throughout the Northwest. In 1890, the Sisters of St. Joseph of Peace founded what has become PeaceHealth. Today, PeaceHealth is the legacy of its founding Sisters and continues with a spirit of respect, stewardship, collaboration and social justice in fulfilling its Mission. We offer competitive compensation, a robust benefits package and a collaborative, Mission-driven work environment! To learn more about working at PeaceHealth and the Vancouver community please visit our homepage: . Get a feeling for the Spirit of PeaceHealth through this three-minute video , and visit us on Facebook or LinkedIn ! Questions? Review our Employment FAQ or email . Please note this email does not accept resumes or applications. Location: Vancouver, Shared Services Center (802) Job Category: Business, Administrative & Facilities Shift: Day Shift Length: 8 Hours FTE: 1.0 Work Type: Full Time Required Certifications/Licensure: PeaceHealth is committed to providing equal employment opportunities to all qualified job applicants and employees without regard to the following statuses: protected veteran; qualified individual with a disability; race; ethnicity; religion; gender; pregnancy; gender identity; national origin; age; genetic information; sexual orientation; or any other protected status in accordance with local, state, or federal laws. The above information is intended to indicate the general nature and level of work performed by this position. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of caregivers assigned to this job. Posting Notes: Vancouver -- Business, Administrative & Facilities -- Risk Management & Quality -- Full Time -- RISK MANAGEMENT PH123CPR Nearest Major Market:Portland Oregon Nearest Secondary Market:Tacoma Job Segment: Claims, Underwriter, Medical, ERP, Law, Insurance, Healthcare, Technology, Legal

Keywords: PeaceHealth, Spokane , Claims Manager, Executive , Spokane, Washington

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Executive Jobs


Insurance - Commercial Lines Account Manager
Description: Are you interested in joining a growing and dynamic insurance agency Are you an energetic, positive person looking for long term career
Company: Bell-Anderson Insurance
Location: Spokane
Posted on: 01/22/2020

Product Manager
Description: Are you a high energy individual ready to make a big contribution to a growing tech company in a hot space Our client is looking for a Senior Product Manager to become a key member of the Products Team. (more...)
Company: LaBine & Associates
Location: Spokane
Posted on: 01/19/2020

Nurse Manager - ED, ICU, NICU, OR, MedSurg
Description: PeaceHealth is now hiring Registered Nurses for incredible opportunities in Oregon, Washington, and Alaska We are a non-profit health care system with hospitals and clinics in Washington,
Company: PeaceHealth
Location: Spokane
Posted on: 01/23/2020


Manager, Center - Spokane, WA
Description: Summary: br br The position is responsible for operation of a Lincare center. br br Job Responsibilities: br br Attends work on a regular and predictable basis. br br Interview, (more...)
Company: Lincare Holdings
Location: Spokane
Posted on: 01/19/2020

Audit Manager
Description: Audit Manager Audit Manager - Skills Required - Audit, Accounting, Manager, PCAOB, Client Interaction, AssuranceIf you are a Audit Manager with experience, please read on Top Reasons to Work with UsOur (more...)
Company: CyberCoders
Location: Spokane
Posted on: 01/18/2020

Management Trainee
Description: Job DescriptionIf you're looking to start your career with a company that grows their managers and leaders from within the organization, then the Enterprise Management Training Program is for you. Whether (more...)
Company: Enterprise Holdings
Location: Spokane
Posted on: 01/22/2020

Route Service Manager - UniFirst
Description: ROUTE SERVICE MANAGER - UNIFIRST br br br br LOCATION: br br Spokane, Washington br br JOB ID br br 2000222 br br ROUTE SERVICE MANAGER br br UniFirst seeking a ROUTE SERVICE (more...)
Company: UniFirst
Location: Spokane
Posted on: 01/20/2020

Chief Executive Officer
Description: JOB TITLE:Chief Executive Officer CEO STATUS:Full-Time, Exempt SUPERVISOR:Generation Alive Board of Directors DESCRIPTION: Are you looking for exciting opportunity to join a dynamic and thriving organization (more...)
Company: Generation Alive
Location: Spokane
Posted on: 01/19/2020

Kiosk Manager-Wireless Sales Inside Costco
Description: US-WA-Spokane br br Headquartered in Seattle, Washington, Wireless Advocates is a third-party provider of wireless products and services both online and in approximately 600 retail locations nationwide. (more...)
Company: Wireless Advocates
Location: Spokane
Posted on: 01/22/2020

Retail Store Manager l - Whitworth University Campus Bookstore
Description: Join the Follett Team where employees are
Company: Follett Corp
Location: Spokane
Posted on: 01/22/2020

Log In or Create An Account

Get the latest Washington jobs by following @recnetWA on Twitter!

Spokane RSS job feeds