Claims Program Manager

Summary of Primary Function/General Purpose of Position

Effectively and efficiently manages complex and large exposure medical malpractice claims, including hospital and employed physician claims and claims covered by the deductible polices.  Acts as the BSMH representative at pre-trial hearing, mediations, arbitrations and attends most trials. Manages and directs staff in accordance with organizational objectives and goals.

Essential Job Functions

• Manages the analysis of defense counsel effectiveness on an annual basis

• Implements and tracks claims related to the Early Liability Review Program

• Timely setting of accurate reserves based on formula (where possible)

• Identification of potential claims at the time of reporting and appropriate follow up such as expert evaluation prior to suit or notice of potential suit

• Works extensively with outside defense counsel to manage the claims

• Verifies accurate billing of outside defense counsel

• Manages policy reviews to assure appropriate scope of coverage within commercial policies and assure congruence of coverage between commercial policies and the Captive.

• While working with market and group senior leaders explain the risks and alternatives regarding various claim options.

• Works closely with employed physicians when the physicians are named in a lawsuit

• Works closely with the Risk management related to claim management

• Manages closely with the insurance staff regarding coverage issues

• Manages staff to meet organizational objectives. Provides direction and oversight of assigned duties and projects.

• This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job related duties as required by their supervisor, subject to reasonable accommodation.

Employment Qualifications

• Required Minimum Education: Bachelors

• Preferred Education: Insurance Courses CPCU/AIC/ARM/INS Institute

• Minimum Qualifications: 7 years handling Professional Liability Claims

Range:
 

Minimum: $46.76
Maximum: $74.81