MedfordRecruiter Since 2001
the smart solution for Medford jobs

Claims Manager

Company: PeaceHealth
Location: Medford
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 and a collaborative, Mission-driven work environment! To learn more about working at PeaceHealth and the Vancouver community please visit our homepage:.

          Get a feeling for the Spirit of PeaceHealth through this , and visit us on or !

          Questions? Review our or email . 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, Medford , Claims Manager, Executive , Medford, Oregon

Click here to apply!

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

I'm looking for
in category
within


Other Executive Jobs


Registered Nurse - Case Manager
Description: Registered Nurse Peritoneal As a Peritoneal Dialysis Registered Nurse PD RN , you educate your patients on how to do their own dialysis from their homes, and you take responsibility for the complete (more...)
Company: Healthcare Partners - DaVita Medical Group
Location: Medford
Posted on: 12/7/2019

Director of Regulatory Compliance - Medford
Description: The Director of Regulatory Compliance oversees all Federal and State Government regulated requirements for products sold by Harry and David, Wolfermans, and Stockyards.--Regulatory bodies include the (more...)
Company: Harry & David
Location: Medford
Posted on: 12/1/2019

Unit Supply Specialist - Warehouse Manager (92Y)
Description: 92Y Unit Supply Specialist - Warehouse Manager Job ID: 1165875 Job Views: 36 Location: MEDFORD, Oregon, United States ZIP Code: 97501 Job Category: Supply and Logistics Posted: 12.06.2019 Age Requirements: (more...)
Company: Army National Guard
Location: Medford
Posted on: 12/11/2019


Director of Accounting, Shared Services
Description: OverviewDirector, Accounting Shared ServicesThe Director of Accounting Shared Services leads the organizations transactional accounting activities which include Accounts Payable, Accounts Receivable, (more...)
Company: Lithia Auto Stores
Location: Medford
Posted on: 12/6/2019

Recruiting Manager
Description: Overview Lithia Motors, Inc. The Recruiting Manager implements and manages the recruitment processes and employment programs as directed by the Sr. Recruiting Manager. Aligned with our core values to (more...)
Company: Lithia Auto Stores
Location: Medford
Posted on: 12/11/2019

Commercial Rel Manager 4
Description: Job Description 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 for (more...)
Company: Wells Fargo Bank
Location: Medford
Posted on: 12/6/2019

General Manager (Eureka, California)
Description: Position Description: The SBA Credit Servicing
Company: First Citizens Bank & Trust Company
Location: Medford
Posted on: 12/5/2019

Accounts Payable Manager
Description: OverviewLithia MotorsLithia is about.Earning customers for life Taking personal ownership Improving constantly Having fun If you share these goals, we want to talk to you Responsibilities: ul li Lead (more...)
Company: Lithia Auto Stores
Location: Medford
Posted on: 12/1/2019

Infantryman - Management Training (11B)
Description: 11B Infantryman - Management TrainingJob ID: Job Views: 127Location: MEDFORD, Oregon, United StatesZIP Code: 97501Job Category: Ground ForcesPosted: 11.19.2019Age Requirements: Must be between the ages (more...)
Company: Army National Guard
Location: Medford
Posted on: 12/8/2019

Consumer Public Relations Manager
Description: Description The Manager, Consumer Public Relations, Harry David ensures the brand reputation of Harry David a 1-800-Flowers company is enhanced through pro-active public relations programs and campaigns. (more...)
Company: 1-800-FLOWERS.COM, Inc.
Location: Medford
Posted on: 12/3/2019

Log In or Create An Account

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

Medford RSS job feeds