General Liability Claims Manager, Healthcare *Remote*

Description Providence caregivers are not simply valued - they're invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Providence Health Plan is calling a General Liability Claims Manager, Healthcare who will: Be responsible for day-to-day oversight of general and professional liability claims in accordance with the System's claims program policies and procedures and within an assigned Region or scope of responsibility Be responsible for investigating, evaluating and managing professional and other liability claims against the organization as assigned Maintain up-to-date and accurate claims files, including summaries, action plans, and claims status in the claims data management software Coordinate with facility leadership, risk managers, defense counsel, and others; ensuring compliance with relevant claims reporting procedures and required regulations Provide feedback and recommendations to the Management on evaluations, litigation trends, department policies and procedures, system-wide claims and litigation processes, and appropriate System risk management issues Be directly responsible for fostering teamwork, operational excellence and effective communication within the claims team, including other Claims Managers, Claims Technicians and Claims Specialists Essential Functions: Investigate, Evaluate, and Manage Professional, General and other Liability Claims under the PSJH Insurance Program : Review and analyze medical records, interview witnesses, assist with the discovery process and communicate with facility risk manager regarding evaluation and investigation In collaboration with facility risk management, set appropriate indemnity and expense reserves including documentation of jury verdict research or similar analysis of exposure Select appropriate medical experts for case review Develop a plan of action for assigned claims and update the claims file following all material changes in status Review and approve statements for services and take proper steps to pay vendors Inform Management of large or complex claims and claims with potential for media exposure Report claims with potential excess exposure to excess insurers Maintain Complete Documentation for Each Matter: Develop and document for each claim or lawsuit a plan of action for resolution by settlement, trial or other means Maintain the electronic file including all material communication, correspondence, analysis, expert opinions, interview summaries and all other material documents in accordance with the Claims Policies and Procedures Manual Maintain up-to-date claims status and actions plans on all Potential Claims, Claims and litigated matters in the claims data management software Resolve Claims In Accordance with Policies and Regulations: Negotiate settlements Monitor trials Close files in accordance with internal policies and procedures and facilitate appropriate reporting to NPDB and state agencies Participate in department and claims team projects as assigned to develop and improve procedures, policies; to improve efficiency of department work; and to assist the Group Vice President and Director of Risk & Claims as needed Provide Input to Reduce Risk Provide feedback and recommendations to Management regarding claims trends and appropriate risk management responses Provide input for quality and patient safety projects, through the Risk & Integrity Services division and Risk, Claims, & Insurance department Providence welcomes 100% remote work for applicants who reside in one of the following States: Alaska Washington Or