Risk Claims Manager

Albany Medical Center • Albany, NY

8d • $77,075 - $119,466 • Onsite

About The Position

The Risk Claims Manager will be responsible for developing litigation strategies, managing claims, and ensuring regulatory compliance. This role involves working with outside counsel, experts, and various internal departments to effectively handle claims and suits. The position requires meticulous data management, accurate record-keeping, and adherence to established guidelines and standards. The successful candidate will play a crucial role in the Risk Management department, contributing to the overall operational efficiency and legal defense of the organization.

Requirements

• Bachelor's Degree
• BS in Business or Law related field
• Access to information considered sensitive to Albany Med Health System, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes.
• Access to information must be based on a “need to know” and be the minimum necessary to properly perform assigned duties.
• Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose.
• Reasonable efforts, consistent with Albany Med Health System policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.

Nice To Haves

• Master's Degree

Responsibilities

• Develop litigation strategies for the management of claims.
• Work with outside counsel on engagement of experts, life care planners, structure brokers, and settlement strategies.
• Establish claims files immediately.
• Conduct all interviews within specified timeframes.
• Work with outside counsel on gathering information for defense.
• Respond to discovery demands.
• Manage the reserve process by reviewing cases with the Vice President.
• Check the adequacy of reserves by reviewing with defense counsel semi-annually.
• Track litigation, anticipate trial dates, discovery dates, and disclosure dates in accordance with Litigation Management Guidelines.
• Manage expert retention according to established processes.
• Schedule internal and external meetings for related litigation, pre-depositions, depositions, and trial-related activities.
• Assume day-to-day responsibility for data entry of all claims/suits/potentials in Stars.
• Maintain regulatory compliance with reporting/updating all MMERS/MMDCS within the DOH system.
• Prepare clinical service reports for the Vice President to present claims data to Department Chairmen.
• Maintain accuracy of SharePoint – litigation tracker for electronic requests and audit trails.
• Complete PPR/Joint Commission standards in the AMP system.
• Maintain a current trial calendar.
• Ensure timely notification of claims to insurance carriers.
• Collaborate with IS/legal on the Litigation Notification Response procedure.
• Oversee the service of summons, subpoenas, preservation requests, and search warrants.
• Manage malpractice verifications and claims history requests.
• Maintain a file on Recall Notifications.

Benefits

• Excellent health care coverage with no copay at Albany Medical Center providers
• A wide array of services and programs to support emotional, physical, and mental wellbeing

What This Job Offers

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