Posted on: December 5, 2019
PeaceHealth is seeking a Claims Manager for a 1.0 full time
equivalent Exempt position. This position will be working Day shift
with shift durations of 8 Hours.Req ID: 174936 JOB SUMMARYPosition
is responsible for the investigation, evaluation, adjudication and
resolution of claims and lawsuits presented against PeaceHealth
consistent Premier claims management expectations. ESSENTIAL
- Investigates significant events, claims and lawsuits presented
against caregivers, physicians and facilities for liability,
causation and damages. Interviews principal defendants, fact and
expert witnesses completes required captioned reports. Analyzes and
evaluates completed investigation and makes recommendations
regarding settlement authority, trial or Alternative Dispute
- Contacts non-represented claimants presenting demands for
compensation beyond waiver of medical bills and analyzes liability,
causation and damages to determine exposure and resolves claims by
denial, settlement or alternative resolution. Establishes reserves
for all litigated and non-litigated claims and lawsuits according
to the claims procedure policy.
- Contacts claimant?s attorneys when notified of legal
representation and exchanges discoverable information, based upon
HIPPA and federal and state privacy rules to permit evaluation of
claims and resolves such claims by denial or settlement with the
- Manages litigated cases including directing defense attorneys,
attending key depositions, mediations, settlement conferences and
select portions of trials. Determines the utilization of adjunct
claims management services such as litigation stress consultants,
witness preparation consultations, focus groups, mock juries and
other independent consultants as needed in each case.
- Coordinates the production of documents, interviews of
witnesses and depositions with the regional risk managers. Reviews
requested documents before releasing to defense counsel.
- Attends quarterly claims strategy conference calls.
Participates in conference calls with excess insurance carriers as
- Provides progress reports to physicians and key nursing staff
as investigation develops. Informs all targeted practitioners of
the impact of federal (NPDB), state (MQAC), insurance and
PeaceHealth underwriting guidelines concerning settlements, awards
- Compiles high-level reports from events, claims and lawsuits
using sophisticated data analytic tools. Enters data into the STARS
data system for document management.
- Provides advice to practitioner and administrators.
- Performs other duties as assigned. QUALIFICATIONS
- Bachelor?s degree in Business Administration, Insurance, Legal
or Healthcare related field and/or equivalent education/experience
- Clinical background and/or Juris Doctorate strongly preferred.
- A minimum of five years in the negotiation and settlement of
physician medical malpractice liability claims and management of
litigated professional liability cases is required.
- Experience in the resolution of complex medical malpractice
cases, involving potential exposure required.
- Sophisticated data management experience and skills for
presentation and reporting such as SQL, SAP, Crystal Reports,
Excess, Access, Tableau, etc. OTHER SKILLS:
- Excellent face to face interview skills.
- Strong written and verbal communication skills.
- Ability to work with physicians and nurses of all
- Ability to lead practitioners to a committed resolution in
litigated and non-litigated cases.
- Excellent stewardship skills.
- Ability to objectively collect and analyze data.
- Proficient with MS Office applications. SYSTEM SERVICES -
- Work requires fairly light physical exertion from up to 65% of
- Ability to lift objects weighing 30 lbs. or less.
- Work is performed under normal working conditions with adequate
lighting and ventilation.
- Job duties frequently require intense concentration and
attention to detail (up to 65% of work time). Please apply online
to be considered. For full consideration of your skills and
abilities, please attach a current resume with your application.
About PeaceHealth PeaceHealth, based in Vancouver, Wash., is a
not-for-profit Catholic health system offering care to communities
in Washington, Oregon, and Alaska. PeaceHealth has approximately
16,000 caregivers, a multi-specialty medical group practice with
more than 900 providers and 10 medical centers serving both urban
and rural communities throughout the Northwest. In 1890, the
Sisters of St. Joseph of Peace founded what has become PeaceHealth.
Today, PeaceHealth is the legacy of its founding Sisters and
continues with a spirit of respect, stewardship, collaboration and
social justice in fulfilling its Mission. We offer competitive
compensation, a robustbenefits package and a collaborative,
Mission-driven work environment! To learn more about working at
PeaceHealth and the Vancouver community please visit our
homepage:www.peacehealth.org/careers. Get a feeling for the Spirit
of PeaceHealth through this three-minute video, and visit us on
Facebook or LinkedIn! Questions? Review ourEmployment FAQ or email
Recruitment@peacehealth.org. Please note this email does not accept
resumes or applications. Location: Vancouver, Shared Services
Center (802)Job Category: Business, Administrative & Facilities
Shift: DayShift Length: 8 HoursFTE: 1.0Work Type: Full TimeRequired
Certifications/Licensure: PeaceHealth is committed to providing
equal employment opportunities to all qualified job applicants and
employees without regard to the following statuses: protected
veteran; qualified individual with a disability; race; ethnicity;
religion; gender; pregnancy; gender identity; national origin; age;
genetic information; sexual orientation; or any other protected
status in accordance with local, state, or federal laws. The above
information is intended to indicate the general nature and level of
work performed by this position. It is not designed to contain or
be interpreted as a comprehensive inventory of all duties,
responsibilities, and qualifications required of caregivers
assigned to this job. Posting Notes: Vancouver -- Business,
Administrative & Facilities -- Risk Management & Quality -- Full
Time -- RISK MANAGEMENT Nearest Major Market:Portland OregonNearest
Secondary Market:TacomaJob Segment: Claims, Underwriter, Medical,
ERP, Social Media, Insurance, Healthcare, Technology,
Keywords: PeaceHealth, Eugene , Claims Manager, Executive , Eugene, Oregon
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