Senior Manager Claims Remote

Providence • Renton, WA

2d • Remote

About The Position

Senior Manager Claims Remote Candidates residing in Alaska, Washington, Montana, Oregon, California, Texas or New Mexico are encouraged to apply. The Senior Manager, Claims role is responsible for management and supervision of a team handling multi-line health provider and institutional claims. This position is responsible for file management, stewardship and file outcomes of the team in collaboration with key system leadership throughout Providence St. Joseph's Health. Also, the role is responsible for ensuring accurate regulatory compliance, adherence to department policy and procedures, stakeholder presentations, and team development. This role utilizes expertise to coach to best outcomes for high exposure, complex matters including medical negligence, organizational negligence, directors and officers, fiduciary, general liability and similar matter types. The role participates in procuring and sharing conclusions to provide actionable insights to key stakeholders across the organization. There is collaboration with various teams to provide consultation, oversight, risk avoidance and mitigation recommendations, data analytics, and efficiency execution. The role also coordinates with operational staff as needed to ensure efficient outcomes. Providence caregivers are not simply valued – they’re invaluable. Join our team at Integrity Compliance Audit Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Requirements

• Bachelor’s Degree or an equivalent combination of education and experience.
• Coursework/Training: Formal education or training in supervision, management, or leadership.
• 7 years of documented direct management or supervisory experience in a in a medical negligence and multi-line setting.
• 7 years of Claims experience.
• 2 years of experience in an insurance or managed care setting.
• Demonstrated experience in program planning, development and evaluation.

Nice To Haves

• Master's Degree
• Project management, Six Sigma, Lean, Change Acceleration Process (CAP) experience.
• Experience with HEDIS, CAHPS, Medicare 5-Star Rating, NCQA and/or URAC accreditation.

Responsibilities

• management and supervision of a team handling multi-line health provider and institutional claims
• file management, stewardship and file outcomes of the team in collaboration with key system leadership throughout Providence St. Joseph's Health
• ensuring accurate regulatory compliance, adherence to department policy and procedures, stakeholder presentations, and team development
• coach to best outcomes for high exposure, complex matters including medical negligence, organizational negligence, directors and officers, fiduciary, general liability and similar matter types
• procuring and sharing conclusions to provide actionable insights to key stakeholders across the organization
• provide consultation, oversight, risk avoidance and mitigation recommendations, data analytics, and efficiency execution
• coordinates with operational staff as needed to ensure efficient outcomes

Benefits

• Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security.
• We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
• Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits.
• Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees