Risk Claims Manager
About The Position
This role is responsible for developing litigation strategies for the management of claims, working with outside counsel on the engagement of experts, life care planners, structure brokers, and settlement strategies. The position also involves establishing claims files, conducting interviews, gathering information for defense, responding to discovery demands, managing the reserve process, and tracking litigation timelines. Additionally, the role requires managing expert retention, scheduling meetings, and assuming day-to-day responsibility for data entry of all claims in the Stars system. It also involves maintaining regulatory compliance with reporting requirements, preparing clinical service reports, maintaining accuracy of the litigation tracker, and completing PPR/Joint Commission standards in the AMP system.
Requirements
- High School Degree required
- BS in Business, Law or related field required
- Claims Management experience
- Data Management experience
Nice To Haves
- Master’s preferred, Health Law
Responsibilities
- Develop litigation strategies for 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 reserve process by reviewing case with Vice President
- Check adequacy of reserves by reviewing with defense counsel semi-annually
- Track the litigation, anticipate trial dates, discovery dates, disclosure dates, etc. in accordance with Litigation Management Guidelines
- Manage expert retention according to established process
- Scheduling, internal and external to the office for related litigation meetings, pre-depositions, depositions, trial related
- Assumes day to day responsibility for data entry of all claims/suits/potentials in Stars
- Maintains regulatory compliance with reporting/updating all MMERS/MMDCS within DOH system
- Prepare clinical service reports for 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 AMP system
Benefits
- Equal opportunity employer
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
