Senior Manager Claims *Remote* jobs in United States
cer-icon
Apply on Employer Site
company-logo

Providence · 19 hours ago

Senior Manager Claims *Remote*

Providence is a comprehensive health care organization that is committed to patient-focused care. The Senior Manager, Claims role involves managing a team handling multi-line health provider claims, ensuring regulatory compliance, and collaborating with various teams to provide oversight and actionable insights.

Hospital & Health Care

Responsibilities

Management and supervision of a team handling multi-line health provider and institutional claims
Responsible for file management, stewardship and file outcomes of the team
Ensuring accurate regulatory compliance, adherence to department policy and procedures, stakeholder presentations, and team development
Utilizes expertise to coach to best outcomes for high exposure, complex matters including medical negligence, organizational negligence, directors and officers, fiduciary, general liability and similar matter types
Participates in procuring and sharing conclusions to provide actionable insights to key stakeholders across the organization
Collaboration with various teams to provide consultation, oversight, risk avoidance and mitigation recommendations, data analytics, and efficiency execution
Coordinates with operational staff as needed to ensure efficient outcomes

Qualification

Claims managementMedical negligence expertiseSupervisory experienceInsurance experienceProgram planningProject managementLeadership trainingData analyticsStakeholder presentationsTeam development

Required

Bachelor's Degree or an equivalent combination of education and experience
Coursework/Training: Formal education or training in supervision, management, or leadership
7 years of documented direct management or supervisory experience in a in a medical negligence and multi-line setting
7 years of Claims experience
2 years of experience in an insurance or managed care setting
Demonstrated experience in program planning, development and evaluation

Preferred

Master's Degree
Project management, Six Sigma, Lean, Change Acceleration Process (CAP) experience
Experience with HEDIS, CAHPS, Medicare 5-Star Rating, NCQA and/or URAC accreditation

Benefits

401(k) Savings Plan with employer matching
Health care benefits (medical, dental, vision)
Life insurance
Disability insurance
Time off benefits (paid parental leave, vacations, holidays, health issues)
Voluntary benefits
Well-being resources

Company

Providence

company-logo
Every day, 119,000 compassionate caregivers serve patients and communities through Providence St.

Funding

Current Stage
Late Stage

Leadership Team

leader-logo
Brad Henry
Chief Executive Officer at Providence Willamette Falls Medical Center
linkedin
leader-logo
Ranjit S. Hundal, MD, MBA, CPE, FACP, SFHM
Interim Chief Executive Officer
linkedin
Company data provided by crunchbase