Claims Program Manager

Mercy Health BSMH•Covington, KY

11d•$47 - $75

About The 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.

Requirements

Bachelors
7 years handling Professional Liability Claims

Nice To Haves

Insurance Courses CPCU/AIC/ARM/INS Institute

Responsibilities

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 the 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.