Claims Manager

Advocate Health • Charlotte, NC

3d • $48 - $71 • Remote

About The Position

The Claims Manager manages and executes the enterprise claims and litigation management program for assigned sites and serves as the site expert and resource for claims-related subjects. In collaboration with site and medical staff leadership, the role implements risk-reduction and financial loss-prevention strategies and shares claims and risk data reports to support tracking and trending.

The position executes strategies for professional and general liability claims, promotes consistent and effective claims handling aligned with enterprise goals, ensures appropriate financial reserves, and provides timely notice and communication for claims insured under Advocate Health reinsurance programs. It monitors claims activity, including attending court in person for trial management.

The Claims Manager collaborates with Claims and Risk leaders on risk management education, enters and maintains accurate and timely data in the claims management system, and carries out strategy and platform improvement initiatives. The role is mostly remote, with a need to travel in Charlotte, North Carolina, for court, mediations, and other onsite needs. Applicants should be based in North Carolina. The position is full-time, dayshift, Monday through Friday, for 40 hours per week.

Requirements

• Bachelor’s degree in healthcare administration, law, or a related field.
• Typically five years of claims, insurance, legal, or risk management experience in a healthcare setting.
• Demonstrated ability to lead collaborative activities, chair meetings, and present to physicians and executive leadership.
• Ability to work effectively in a complex corporate system environment and communicate with people from diverse backgrounds and organizational levels.
• Ability to communicate effectively and compassionately with patients, claimants, and family members about difficult topics.
• Strong decision-making and critical-thinking skills.
• Ability to manage multiple teams and projects simultaneously.
• Proficiency in Microsoft Office, including Excel, Access, PowerPoint, and Word, or similar products.
• Expertise in statistical and data analysis, data presentation, organization, and attention to detail.
• Ability to draft comprehensive reports and memos related to Risk functions.

Nice To Haves

• Certified Professional in Health Care Risk Management designation from the American Hospital Association, or similar license or certification; this is to be obtained within one year.
• Juris doctor or master’s degree in healthcare administration or a related field.
• Legal, nursing, or other clinical knowledge, background, and experience.

Responsibilities

• Manage and execute the enterprise claims and litigation management program at assigned sites.
• Serve as the site expert and resource for claims-related subjects.
• Work with site and medical staff leadership to implement risk-reduction and financial loss-prevention strategies.
• Disseminate claims and risk data reports for tracking and trending.
• Execute strategies for professional and general liability claims to support the best possible resolution.
• Promote best practices and consistent, effective claims handling aligned with enterprise goals.
• Ensure claims are appropriately financially reserved and provide timely notice and communication for claims insured under Advocate Health reinsurance programs.
• Monitor claims activity, including in-person court attendance for trial management.
• Collaborate with Claims and Risk leaders on a coordinated, comprehensive, high-quality enterprise Risk Management Education Program.
• Enter claims data accurately and promptly in the claims management system, and execute strategy and platform improvement initiatives.

Benefits

• Paid time off programs.
• Medical, dental, vision, life, and short- and long-term disability benefits.
• Flexible Spending Accounts for eligible healthcare and dependent-care expenses.
• Adoption assistance and paid parental leave.
• Defined contribution retirement plans with employer match and other financial wellness programs.
• Educational Assistance Program.
• Competitive compensation, possible premium pay and incentive pay for select positions, and opportunity for annual performance-based increases.
• Career development programs.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager