Senior Claims Manager; Remote - Professional Liability Program

Scheduled Hours

40 hours per week

Analyzes and evaluates complex incident reports and lawsuits, reviews medical records and interviews involved individuals to obtain needed information. Prepares complex investigative analytical reports for Director and Legal Counsel regarding potentially compensable incidents covered by the Self-Insured Professional Liability Program, and other reports as requested by Senior Management. Coordinates case development, case management, and participates in office management.

• Conduct internal claims investigations, plan defense strategies and negotiate disposition of assigned files with guidance of legal counsel. Conduct meetings with physicians, analyze medical record information and event reports; direct approved legal counsel and other legal personnel involved in the defense; evaluate liability and financial exposure, approve expert witness reviews; respond to discovery requests and answer interrogatories; coordinate witness preparations; make recommendations for resolution of claim;
  
  coordinate meetings with Director, defense counsel and Office of General Counsel to perform decision tree analysis to determine case value. Attend mediation, arbitration, and/or trial.
• Prepare and submit required reports to Department Heads, Office of General Counsel, Director of Risk Management, excess insurance carriers, and when applicable, coordinate with external agency investigations, i.e., professional Board inquiries. Respond to general claim inquiries.
• Establish indemnity and expense reserves based on the reserving policy. Negotiate settlements within authority. Review and approve defense counsel related invoices and expenses.
• Provide consultation and guidance on healthcare issues such as medical record release, subpoena responses, termination/transfer of care, patient complaints, and physician billing issues including accounts in litigation. Arrange for attorneys to attend depositions with physicians when necessary. Mentor less experienced claims managers.
• Perform other duties as assigned.

Normal office environment. Typically sitting at a desk or a table. Office equipment.

• Education
  :
  Bachelor's degree.
• Work Experience
  :
  Five years analyzing or medical or other technical evidence that compares in level of complexity to medical treatment.
• Skills
  :
  Not applicable.
• Driver's License
  :
  Not required.

• Analytical ability to evaluate facts and formulate questions in order to define problems and critical events in the medical care rendered.
• General knowledge of The Joint Commission and patient safety standards, diagnosis and treatment of human disease and injury, medical therapies, procedures and standard of medical care.
• Knowledge of methods and techniques of individual case study, recording and file maintenance.
• Seven years' experience in medical malpractice claims management.
gt;

Analytical Thinking, Defining Problems, Detail-Oriented, Disease Diagnosis, Disease Management, Group Presentations, Injury Treatment, Joint Commission Regulations, Organizational Savvy, Patient Safety, Report Preparation.

Up to 22 days of vacation, 10 recognized holidays, and sick time. Competitive health insurance packages. Free Metro transit U-Pass. 403(b) Retirement Savings Plan.

$65,900.00 - $ annually.

Washington University in St. Louis is committed to the principles and practices of equal employment opportunity and especially encourages applications by those from underrepresented groups. It is the University’s policy to provide equal opportunity and access to persons in all job titles without regard to race, ethnicity, color, national origin, age, religion, sex, sexual orientation, gender identity or expression, disability, protected veteran status, or genetic information.

Washington University is dedicated to building a community of individuals who are committed to contributing to an inclusive environment – fostering respect for all and welcoming individuals from diverse backgrounds, experiences and perspectives. Individuals with a commitment to these values are encouraged to apply.