Manager Litigation & Claims Job at Capital Health
Overview:
Join our Risk Management Team! The Manager Litigation & Claims provides support and service by managing various claims related to personal injury, professional liability, property damage and employment related matters. Works closely with captive insurance company and private insurance carriers and interfaces with outside counsel and internal stakeholders. Assists outside counsel with pleadings and discovery matters, subpoenas, records requests, and witness identification. Performs mandatory reporting to various state and federal agencies and governmental bodies. Assists Deputy General Counsel of Litigation in defense of all claims, assist in the resolution of claims as well as assist in efforts to prevent claims. Assists with setting and adjusting reserves depending upon case developments. Makes recommendations related to appropriate disposition of litigation matters. Attends hearings, conferences, depositions, and trial as indicated.
Responsibilities:
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Join our Risk Management Team! The Manager Litigation & Claims provides support and service by managing various claims related to personal injury, professional liability, property damage and employment related matters. Works closely with captive insurance company and private insurance carriers and interfaces with outside counsel and internal stakeholders. Assists outside counsel with pleadings and discovery matters, subpoenas, records requests, and witness identification. Performs mandatory reporting to various state and federal agencies and governmental bodies. Assists Deputy General Counsel of Litigation in defense of all claims, assist in the resolution of claims as well as assist in efforts to prevent claims. Assists with setting and adjusting reserves depending upon case developments. Makes recommendations related to appropriate disposition of litigation matters. Attends hearings, conferences, depositions, and trial as indicated.
Responsibilities:
- Investigates events that have a potential for litigation. Reviews safety reporting system to identify potential risk issues and follows through to resolution. Prepares reports and executive summaries as required. Identifies and participates in staff educational opportunities.
- Manages claims in collaboration with defense counsel including assessment of liability, ensuring establishment of appropriate reserves, maintaining complete and up-to-date case files, and assisting in procurement of medical records and documents necessary for evaluation and defense of cases. Facilitates timely response and investigation of adverse and significant events.
- Manages, collects, and evaluates data concerning incident reports, aggregates data summaries, and develops monthly and quarterly litigation and claims reports that provide a summary of current claims and litigation, to include an analysis of trends.
- Shares reports with appropriate leadership and advises and recommends actions for process improvement.
- Maintains an accurate, up-to-date database reflecting the status and essential elements of current claims and litigation.
- Assists Risk Management team with the design and implementation of risk management assessments and studies. Assists with surveys, studies, and special projects to promote proactive risk activities. Assists with periodic assessments of system risk management activities to determine program effectiveness.
- Collaborates with Risk Management team in the prompt, equitable resolution of claims. Provides consultative and resource support to staff regarding all aspects of risk management and claims. Prepares reports to outside agencies as required by regulatory agencies.
- Assists in maintaining compliance with DNV and state and federal regulatory agencies. Collaborates in the development, delivery and evaluation of educational programs or tools that relate to safety and risk management. Conducts risk management educational programs to both staff.
- Complies with various codes, laws, rules, and regulations concerning patient care, including those mandated by state and federal agencies; assisting with the investigation activities of federal, state, and local enforcement authorities. Seeks administrative approval for settlement of litigation and keeps administration informed of high exposure cases.
- Performs other duties as assigned.
- Bachelor's degree.
- Seven years of progressive experience in either a healthcare or insurance setting. Previous experience in a professional liability claims management environment required.
- Strong written and oral communication skills with good presentation skills. Team player with ability to interact with all levels of staff, often in sensitive situations. Detail oriented with excellent organizational skills. Ability to influence change without direct authority; demonstrate strong negotiation skills.
- Knowledge of statistics, data analysis and experience with claims and litigation management.
- Must be proficient in Microsoft Office (Excel, Word, Power Point, Access) or similar products.
Frequent physical demands include: Wrist position deviation , Pinching/fine motor activities , Keyboard use/repetitive motion
Occasional physical demands include: Sitting , Standing , Walking , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Taste or Smell , Talk or Hear
Continuous physical demands include:
Lifting Floor to Waist 15 lbs. Lifting Waist Level and Above 10 lbs.
Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Accurate Color Discrimination, Accurate Depth Perception, Accurate Hearing
Our Network:
Occasional physical demands include: Sitting , Standing , Walking , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Taste or Smell , Talk or Hear
Continuous physical demands include:
Lifting Floor to Waist 15 lbs. Lifting Waist Level and Above 10 lbs.
Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Accurate Color Discrimination, Accurate Depth Perception, Accurate Hearing
Offers are contingent upon successful completion of our onboarding process and pre-employment physical. Capital Health will require all applicants (including contractors, travelers and consultants) to have an annual flu vaccine and to have a completed COVID-19 vaccine prior to start date, with the exception of individuals with medical and religious exemptions.
"Company will never ask candidates for social security numbers or date of birth during application phase. If you are asked for this information online, you may be a target for identity theft."
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