Manager, Patient Claims

Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You’ll also have access to: Career development with an international company where you can grow the career you dream of. Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year. An excellent retirement savings plan with a high employer contribution Tuition reimbursement, the Freedom 2 Save student debt program, and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree. A company recognized as a great place to work in dozens of countries worldwide and named one of the most admired companies in the world by Fortune. A company that is recognized as one of the best big companies to work for as well as the best place to work for diversity, working mothers, female executives, and scientists. The Opportunity Abbott is seeking an experienced professional to manage patient claims related to its Medical Device businesses. This role leads day‑to‑day claim adjudication, drives compliant, consistent claim resolution, and plays a critical role in protecting Abbott’s legal, regulatory, financial, and reputational interests. This position works out of our Sylmar, CA; Minneapolis, MN; or Austin, TX corporate office. What You’ll Work On The Manager performs the following responsibilities with general direction from Legal leadership: Claim Intake and Triage Direct and manage the complete lifecycle of U.S. patient product liability claims where the claimant is not represented by counsel, encompassing claim intake, investigation, evaluation, negotiation, and resolution. Communicate with claimants on claim intake, provide updates, request necessary consents and documents, and deliver decisions while maintaining a professional and empathetic tone. Ensure proper escalation of matters presenting regulatory, litigation, or safety risk. Investigation and Evaluation Execute comprehensive investigations of medical records, operative notes, product history, complaint data, field reports, and physician/hospital information to determine causation, product involvement, and claim valuation. Assess potential exposure and develop recommendations aligned with established precedent and organizational risk tolerance. Claim Resolution Manage timelines, resources, and cross‑functional workflows to ensure timely resolution, regulatory compliance, and alignment with organizational objectives. Negotiate settlements within designated authority levels; elevate novel, complex, or high‑exposure matters to Legal leadership for strategic guidance. Deliver claim decisions in a professional and empathetic manner. Compliance, Governance, and Risk Management Ensure full compliance with FDA regulations, U.S. privacy/HIPAA requirements, anti‑kickback statutes, and Abbott's complaint reporting processes. Oversee CMS Medicare Secondary Payer Section 111 reporting for all applicable patient settlements, ensuring complete, timely, and accurate Responsible Reporting Entity submissions. Maintain accurate, comprehensive, and audit‑ready case files, settlement documentation, correspondence, and system records. Cross‑Functional Leadership and Continuous Improvement Lead or contribute to medical device legal team projects, including but not limited to, process improvement initiatives, system implementations, policy development, and special investigations requiring coordination across multiple stakeholders. Influence commercial teams through consultative engagement to ensure proper escalation protocols and compliant patient interactions. Contribute to tactical planning and execution for high‑volume claim periods, advisories/recalls, and patient communications initiatives. Analyze industry and Abbott‑specific claims to identify patterns and trends; recommend data‑driven process enhancements and risk mitigation strategies and train stakeholders on best practices. Position Requirements Ability to evaluate complex product claims and determine reasonable settlements. Ability to exercise sound judgment in ambiguous or high‑risk situations, including determining when matters require immediate Legal, Regulatory, Quality, or Compliance escalation. Ability to communicate effectively and empathetically with patients (over the phone or through written correspondence), including in high‑emotion or adversarial situations, while maintaining appropriate legal and regulatory boundaries. Knowledge of US privacy laws, anti‑kickback, and medical device reporting. Demonstrated ability to work in fast‑paced, matrixed environment Excellent verbal and written communication skills. Strong organizational skills with attention to detail. Minimum Required Qualifications Bachelor's Degree 5+ years product liability claims, medical device legal operations, insurance claims, risk management, or a closely related regulated environment. Experience evaluating and resolving medical, technical, or regulatory claims or issues. Preferred Qualifications Experience in medical devices, pharmaceuticals, or other FDA‑regulated industries Paralegal Certification, preferred Strong investigative skills, including medical record review Experience in CMS Section 111 reporting Learn more about our health and wellness benefits, which provide the security to help you and your family live full lives: Abbott is an Equal Opportunity Employer, committed to employee diversity. The base pay for this position is $129,300.00 – $258,700.00. In specific locations, the pay range may vary from the range posted. #J-18808-Ljbffr Abbott Laboratories