Risk Claims Manager

Claims Management

• Develop litigation strategies for management of claims
• Work with outside counsel on engagement of experts, life care planners, structure brokers and settlement strategies
• Establish claims files immediately
• Conduct all interviews within specified timeframes
• Work with outside counsel on gathering information for defense
• Respond to discovery demands
• Manage reserve process by reviewing case with Vice President
• Check adequacy of reserves by reviewing with defense counsel semi-annually
• Track the litigation, anticipate trial dates, discovery dates, disclosure dates, etc. in accordance with Litigation Management Guidelines
• Manage expert retention according to established process
• Schedule, internal and external to the office, for related litigation meetings, pre-depositions, depositions, trial related
• Data Management
• Absorbs day-to-day responsibility for data entry of all claims/suits/potentials in Stars
• Maintains regulatory compliance with reporting/updating all MMERS/MMDCS within DOH system
• Prepare clinical service reports for Vice President to present claims data to Department Chairmen
• Maintain accuracy of Sharepoint – litigation tracker for electronic requests and audit trails
• Complete PPR/Joint Commission standards in AMP system

Scheduling

• Maintains current trial calendar
• Ensures timely notification of claims to insurance carriers
• Collaborate with IS/legal on Litigation Notification Response procedure
• Oversees service of summons, subpoenas, preservation requests and search warrants
• Manage malpractice verifications and claims history requests
• Maintain file on Recall Notifications

Qualifications

• Bachelor's Degree BS in Business, Law related field - Required
• Master's Degree - preferred