PeaceHealth is seeking a System Director Claims Administration for a Full Time, Day position.
Who we are:
PeaceHealth is a faith-based 10-Hospital System in the Pacific Northwest, providing whole person care to Alaska, Oregon, and Washington since 1890.
What you’ll be doing:
- Responsible for developing, overseeing, and managing an effective, system-wide claims management program including reviewing, researching, investigating, negotiating, processing, and adjusting claims.
- Developing strategies and implementing and administering programs to oversee the resolution of claims via a vigorous defense for non-meritorious claims and resolution for meritorious claims.
- Providing strategic and managerial oversight for claims staff.
- Collaborating with the System Vice President of Risk Management in the evaluation and implementation of future claims strategies.
- Working in direct collaboration and influence with senior-level leaders across PeaceHealth to drive ideation, strategy, execution, and delivery.
- Provides guidance and direction for the claims team with emphasis on reserve accuracy, claim resolution, and compliance to our internal and customer standards. Manages the work activities, performance, and development of assigned staff.
- Manages relationships with business partners and/or vendors. Serves as a subject matter expert on all client specific guidelines, specifications, policies, and procedures.
- Coordinates activities of defense counsel to assure effective and expedient handling of lawsuits in as cost effective a manner as possible. Manages and coordinates release and information in response to subpoenas, court orders, attorney requests, state and federal agencies, and other inquiries from outside.
- Provides direction to legal counsel and other personnel involved in claims management. Approves payment of fee for defense counsel and other experts. Makes recommendation to the System VP of Risk Management regarding funding levels and coverage limits.
- Ensures appropriate reporting to all required outside agencies including NPDB, HIPBD, CMS, and primary and excess insurance carriers.
- Monitors loss adjustment expense and takes steps to minimize or negate expenses to achieve loss adjustment expense objectives.
What you’ll bring:
See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility.
For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state, or federal laws.