SalemRecruiter Since 2001
the smart solution for Salem jobs

Claims Manager

Company: PeaceHealth
Location: Salem
Posted on: December 5, 2019

Job Description:

PeaceHealth is seeking a Claims Manager for a 1.0 full time equivalent Exempt position. This position will be working Day shift with shift durations of 8 Hours. Req ID: 174936 JOB SUMMARY Position is responsible for the investigation, evaluation, adjudication and resolution of claims and lawsuits presented against PeaceHealth consistent Premier claims management expectations. ESSENTIAL FUNCTIONS Investigates significant events, claims and lawsuits presented against caregivers, physicians and facilities for liability, causation and damages. Interviews principal defendants, fact and expert witnesses completes required captioned reports. Analyzes and evaluates completed investigation and makes recommendations regarding settlement authority, trial or Alternative Dispute Resolution methods. Contacts non-represented claimants presenting demands for compensation beyond waiver of medical bills and analyzes liability, causation and damages to determine exposure and resolves claims by denial, settlement or alternative resolution. Establishes reserves for all litigated and non-litigated claims and lawsuits according to the claims procedure policy. Contacts claimant’s attorneys when notified of legal representation and exchanges discoverable information, based upon HIPPA and federal and state privacy rules to permit evaluation of claims and resolves such claims by denial or settlement with the claimant’s attorney. Manages litigated cases including directing defense attorneys, attending key depositions, mediations, settlement conferences and select portions of trials. Determines the utilization of adjunct claims management services such as litigation stress consultants, witness preparation consultations, focus groups, mock juries and other independent consultants as needed in each case. Coordinates the production of documents, interviews of witnesses and depositions with the regional risk managers. Reviews requested documents before releasing to defense counsel. Attends quarterly claims strategy conference calls. Participates in conference calls with excess insurance carriers as needed. Provides progress reports to physicians and key nursing staff as investigation develops. Informs all targeted practitioners of the impact of federal (NPDB), state (MQAC), insurance and PeaceHealth underwriting guidelines concerning settlements, awards and verdicts. Compiles high-level reports from events, claims and lawsuits using sophisticated data analytic tools. Enters data into the STARS data system for document management. Provides advice to practitioner and administrators. Performs other duties as assigned. QUALIFICATIONS EDUCATION: Bachelor’s degree in Business Administration, Insurance, Legal or Healthcare related field and/or equivalent education/experience is required. Clinical background and/or Juris Doctorate strongly preferred. EXPERIENCE/TRAINING: A minimum of five years in the negotiation and settlement of physician medical malpractice liability claims and management of litigated professional liability cases is required. Experience in the resolution of complex medical malpractice cases, involving potential exposure required. Sophisticated data management experience and skills for presentation and reporting such as SQL, SAP, Crystal Reports, Excess, Access, Tableau, etc. OTHER SKILLS: Excellent face to face interview skills. Strong written and verbal communication skills. Ability to work with physicians and nurses of all specialties. Ability to lead practitioners to a committed resolution in litigated and non-litigated cases. Excellent stewardship skills. Ability to objectively collect and analyze data. Proficient with MS Office applications. SYSTEM SERVICES - PHYSICAL/COGNITIVE REQUIREMENTS: Work requires fairly light physical exertion from up to 65% of the time. Ability to lift objects weighing 30 lbs. or less. Work is performed under normal working conditions with adequate lighting and ventilation. Job duties frequently require intense concentration and attention to detail (up to 65% of work time). Please apply online to be considered. For full consideration of your skills and abilities, please attach a current resume with your application. About PeaceHealth PeaceHealth, based in Vancouver, Wash., is a not-for-profit Catholic health system offering care to communities in Washington, Oregon, and Alaska. PeaceHealth has approximately 16,000 caregivers, a multi-specialty medical group practice with more than 900 providers and 10 medical centers serving both urban and rural communities throughout the Northwest. In 1890, the Sisters of St. Joseph of Peace founded what has become PeaceHealth. Today, PeaceHealth is the legacy of its founding Sisters and continues with a spirit of respect, stewardship, collaboration and social justice in fulfilling its Mission. We offer competitive compensation, a robust benefits package and a collaborative, Mission-driven work environment! To learn more about working at PeaceHealth and the Vancouver community please visit our homepage: www.peacehealth.org/careers . Get a feeling for the Spirit of PeaceHealth through this three-minute video , and visit us on Facebook or LinkedIn ! Questions? Review our Employment FAQ or email Recruitment@peacehealth.org . Please note this email does not accept resumes or applications. Location: Vancouver, Shared Services Center (802) Job Category: Business, Administrative & Facilities Shift: Day Shift Length: 8 Hours FTE: 1.0 Work Type: Full Time Required Certifications/Licensure: PeaceHealth is committed to providing equal employment opportunities to all qualified job applicants and employees without regard to the following statuses: protected veteran; qualified individual with a disability; race; ethnicity; religion; gender; pregnancy; gender identity; national origin; age; genetic information; sexual orientation; or any other protected status in accordance with local, state, or federal laws. The above information is intended to indicate the general nature and level of work performed by this position. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of caregivers assigned to this job. Posting Notes: Vancouver || Business, Administrative & Facilities || Risk Management & Quality || Full Time || RISK MANAGEMENT Nearest Major Market: Portland Oregon Nearest Secondary Market: Tacoma Job Segment: Claims, Underwriter, Medical, ERP, Social Media, Insurance, Healthcare, Technology, Marketing

Keywords: PeaceHealth, Salem , Claims Manager, Other , Salem, Oregon

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Other Jobs


Dimensional Inspector - Swing
Description: Summary: br br br br The Dimensional Inspector provides dimensioning investment castings using micrometers, height gages, vernier calipers, UT Equipment and inspection fixtures. br br br (more...)
Company: ATI Metals
Location: Albany
Posted on: 12/12/2019

CDL A Local Company Driving Jobs - Dedicated Routes
Description: GARDNER TRUCKING IS HIRING COMPANY DRIVERS LOCAL AND DEDICATED ROUTES AVAILABLE CALL US TODAY 888 346-1575 TRUCK DRIVER BENEFITS:Local/dedicated routehome most
Company: Gardner Trucking
Location: Corvallis
Posted on: 12/12/2019

Do you want to work from home?
Description: We have two open positions available. We are seeking multi talented, driven individuals to serve as benefit consultants. Our
Company: Professional Career Advantage
Location: Albany
Posted on: 12/12/2019


Production Controller, Strategic Manufacturing
Description: Creating Long-Term Value Thru Relentless Innovation reg br br br br ATI is a global manufacturer of technically advanced specialty materials and complex components. Our products support diverse (more...)
Company: ATI Metals
Location: Albany
Posted on: 12/12/2019

Regional Truck Driver | Up to $0.51 cpm | Up to $2,500 Sign-on Bonus
Description: bonus driver regional trucks trucking Regional Van Truckload drivers earn up to 0.47 per mile starting pay, averaging 2,400 miles per week and 420 miles per haul staying within the Western 11 states. (more...)
Company: Schneider
Location: Albany
Posted on: 12/12/2019

Team Truck Driver | Up to $0.59 cpm
Description: bonus driver trucks trucking Team truck driver compensation is among the highest in Schneider's fleet. Earn up to 0.55 per mile starting pay and average 5,500 miles per week and average 1,100 miles (more...)
Company: Schneider
Location: Albany
Posted on: 12/12/2019

Maintenance Reliability Engineer
Description: Creating Long-Term Value Thru Relentless Innovation reg br br br br ATI is a global manufacturer of technically advanced specialty materials and complex components. Our products support diverse (more...)
Company: ATI Metals
Location: Albany
Posted on: 12/12/2019

Training CDL B Bus Driver - Great Benefits! - Corvallis, OR (Albany)
Description: Student Transportation of America is growing We are seeking a safe driver to transport children to and from school each day on established routes. Additional extracurricular runs sports and
Company: Student Transportation of America
Location: Albany
Posted on: 12/12/2019

Registered Client Associate - Private Client Group
Description: Job Description br Important Note: During the application process, ensure your contact information email and phone number is up to date and upload your current resume when submitting your application (more...)
Company: Wells Fargo
Location: Corvallis
Posted on: 12/12/2019

Travel Operating Room Nurse (OR RN), New Hampshire
Description: Travel Operating Room Nurse OR RN New Hampshire Location: New Hampshire Start Date: 12/9/2019 Shift Details: 8H Days 7:00 AM-3:00 PM 40 hours
Company: Triage Staffing
Location: Corvallis
Posted on: 12/12/2019

Log In or Create An Account

Get the latest Oregon jobs by following @recnetOR on Twitter!

Salem RSS job feeds