Claims Manager

Department:

11204 Enterprise Corporate - Risk Management

Status:

Full time

Benefits Eligible:

Yes

Hou rs Per Week:

40

Schedule Details/Additional Information:

Full Time Dayshift Monday - Friday. This position will mostly be remote with need to assist in Charlotte NC travel to court mediations etc. Seeking applicants within NC based on local onsite needs.

No relocation and no sponsorship or transfer of visa for this position now or in the future.

Pay Range:

$47.50 - $71.25

Major Responsibilities:

• Managesand executesthe multi-million-dollarenterprise claims and litigation management programat assigned site(s).Siteexpertandresourcefor all claims-relatedsubjects.
• In collaboration withsite and medical staff leadershipexecutessystem-wideprogramfor developing and implementing risk reduction andfinancial lossprevention claims and risk data reports for assigned site(s) for tracking/trending.
• Executesstrategyforall professional and general liability claimsto ensure the best resolution practices and consistent effective claims handling in alignment with enterprise all claimsare appropriately financially fortimelynotice and communicationfor all claims insured under the Advocate Health reinsurance all aspects ofclaims activity including in-person court attendance for trial management.
• CollaborateswithClaims and Risk leaders in ensuring acoordinated comprehensivehigh qualityenterprise Risk Management Education Program at assigned site(s).
• Executesall data entry in claims management system ensuring accuracy and timeliness of claims and platform improvement initiatives.

Licensure Registration and/or Certification Required:

• None Required.

Education Required:

• Bachelors degree in healthcare administration lawor related fieldrequired.

Experience Required:

• Typically requires5years of claims insurance legal or risk management experience in a healthcare setting.

Licensure Registration and/or Certification Preferred:

• Certified Professional in Health Care Risk Management designation issued by the American Hospital Association (AHA) needs to be obtained within 1 year orsimilar licenseor certification.

Education Preferred:

• Juris doctor of masters degree in healthcare administration or related field preferred.

Experience Preferred:

• Legalnursingor other clinical knowledge background and experience preferred.

Knowledge Skills & Abilities Required:

• Demonstrated abilityleadingcollaborative activities chairingmeetingsand making presentations to physicians and executive leadership.
• Demonstrated ability to work and function in a complex corporate system environment.
• Ability to communicate effectively with individuals of diverse backgrounds from all disciplines and levels of the organization. Must be comfortable and able toeffectively and compassionately communicate with patients claimants and family membersregardingdifficult topics.
• Strong decision-making and critical thinking skills.
• Strong ability to manage multiple teams of people and projects simultaneously.
• Must be proficient in Microsoft Office (Excel AccessPowerPointand Word) orsimilar products.
• Demonstratedexpertisein statistical/data analysis data presentation organizational ability and attention to detail.
• Demonstrated ability to draft comprehensive reports and memosregardingall areaspertaining tothe Risk function.

Physical Requirements and Working Conditions:

• Generally exposed to a normal office environment.
• Operates all equipment necessary to perform the job including computer use.
• Exposure toroad and weather hazards during job-related trips.
• Must be able to sit stand bend and liftfrequentlythroughout workday.
• Must be able to walk sufficiently to coverentiretyof site/facility.
• Must have clear speechhearingand vision.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

Our CommitmenttoYou:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs competitive compensation generous retirement offerings programs that invest in your career development and so much more so you can live fully at and away from work including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications skills relevant experience and/or training

• Premium pay such as shift on call and more based on a teammates job

• Incentive pay for select positions

• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs

• Health and welfare benefits such as medical dental vision life andShort- and Long-Term Disability

• Flexible Spending Accounts for eligible health care and dependent care expenses

• Family benefits such as adoption assistance and paid parental leave

• Defined contribution retirement plans with employer match and other financial wellness programs

• Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g. full-time part-time per diem temporary etc.); please ask a Recruiter for more information during an interview.

About Advocate Health

Required Experience:

Manager