Area Claims Manager

This is a fully remote position, open to applicants in Illinois.

📋 Description

• Develop and execute cost-efficient strategies for managing Hospital Professional Liability, General Liability, and Employment Practices Liability claims and litigation.

• Co-manage uninsured litigation throughout the system.

• Design and oversee investigations into claims.

• Assess claims for liability, causation, damages, witness credibility, expert evaluations, and overall claim value.

• Establish and review reserves for indemnity and expenses.

• Determine strategies for claim resolution, including trial options, and negotiate or guide negotiations towards resolution.

• Notify excess insurers and provide updates on files.

• Maintain claim diaries and ensure claim files are updated following best-practice protocols.

• Participate in regional claims reviews and meetings regarding large losses.

• Represent Trinity Health in case evaluations, settlement discussions, mediations, and trials.

• Retain, manage, and supervise outside defense counsel; review attorney reports, recommendations, fees, and litigation costs.

• Ensure compliance with Medicare, NPDB, and state reporting regulations.

• Collaborate with Loss Control Directors and colleagues in Health Ministry Risk Management/Patient Safety.

• Interact with senior leadership concerning pending issues, potential exposures, authority requests, high-exposure claims, and media-sensitive topics.

• Direct and supervise Claims staff in maintaining and updating the ClearSight database.

• Review monthly ClearSight reports for accuracy, data integrity, and reserve evaluations.

• Act as a subject matter expert in IRMS and Trinity Health committees.

• Monitor relevant legislation, court rulings, and emerging trends in claims litigation.

• Set individual goals and engage in team and departmental meetings.

⛳️ Requirements

• Bachelor’s degree in a relevant field or an equivalent combination of education and experience.

• Three (3) to five (5) years of experience as a liability claims professional adjuster, defense malpractice attorney, or hospital risk manager.

• Familiarity with medical terminology.

• Proficient in using the IRMS claim database (ClearSight).

• Advanced knowledge and established relationships in risk management, quality management, and improvement are advantageous.

• Strong analytical capabilities.

• Ability to organize and articulate information both orally and in writing to all organizational levels.

• Initiative and capacity to manage responsibilities independently.

• Ability to meet deadlines and adapt to changing priorities.

• Ability to thrive in a collaborative, shared leadership setting.

• Willingness to travel to various Trinity Health locations up to 50% of the time.

• Capability to work independently in a remote setting.

• Ability to adjust to frequently changing work priorities and perform under pressure.

• Must be able to engage in moderate physical activities, including lifting and bending.

🏝️ Benefits

• Commitment to Equal Opportunity Employment.

• Option for remote work arrangements.

• Opportunities for travel across Trinity Health locations.