Administrator Claims Management
About The Position
Imagine a career at one of the nation's most advanced health networks. Be part of an exceptional health care experience. Join the inspired, passionate team at Lehigh Valley Health Network, a nationally recognized, forward-thinking organization offering plenty of opportunity to do great work. LVHN has been ranked among the "Best Hospitals" by U.S. News & World Report for 23 consecutive years. We're a Magnet(tm) Hospital, having been honored five times with the American Nurses Credentialing Center's prestigious distinction for nursing excellence and quality patient outcomes in our Lehigh Valley region. Finally, Lehigh Valley Hospital - Cedar Crest, Lehigh Valley Hospital - Muhlenberg, Lehigh Valley Hospital- Hazleton, and Lehigh Valley Hospital - Pocono each received an 'A' grade on the Hospital Safety Grade from The Leapfrog Group in 2020, the highest grade in patient safety. These recognitions highlight LVHN's commitment to teamwork, compassion, and technology with an unrelenting focus on delivering the best health care possible every day. Whether you're considering your next career move or your first, you should consider Lehigh Valley Health Network. Summary Manage potential and asserted Professional Liability and General Liability Claims involving entities and staff within the Lehigh Valley Region. The Administrator, Claims Management oversees the investigation, analysis and reporting of claims and acts as liaison with outside counsel in managing asserted claims from acceptance of service through to resolution.
Requirements
- Juris Doctor
- 5 years managing complex professional liability and general liability claims on behalf of a large health care network or litigation experience
- Active Law License in the State of Pennsylvania
Responsibilities
- Analyze all reports of adverse events and hold files to determine probability of litigation; report potential claims to Jefferson rRRG as indicated.
- Evaluate requests for depositions of insured, unnamed providers and staff to determine risk of liability and need to assign counsel to defend the deposition.
- Evaluate all new PL and GL claims for extent of liability and potential conflict among defendants; collaborate with SVP, Litigation and ERM for purposes of assigning outside counsel and setting legal/indemnity reserves.
- Ensure the reporting of new claims to the State Board of Medicine and indicated insurance carriers including MCARE.
- Oversee Claims Risk Manager in the creation of timeline of care and collection of relevant documentation for inclusion in new potential or asserted claim legal file.
- Provide notice and initial instructions to named defendants in cases.
- Attend outside counsel meetings and deposition preps with defendants and key witnesses in high reserve cases
- Attend pre-trial conferences, mediations and settlement conferences; negotiate resolutions within limit of authority
- Respond to letters of representation and requests for preservation of evidence; evaluate and negotiate resolution of claims pre-litigation up to approved amount of authority.
- Direct the acceptance of service for insured entities and individuals in Professional Liability (PL) and General Liability (GL) claims.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
Ph.D. or professional degree
