Area Claims Manager

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

📋 Description

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

• Co-manage uninsured litigation throughout the organization.

• Create and oversee claim investigation procedures.

• Assess claims related to liability, causation, and damages.

• Formulate resolution strategies to settle claims and lawsuits fairly and justly.

• Review incidents and open claims as necessary.

• Evaluate coverage and obtain formal coverage analysis when required.

• Design and implement investigation plans.

• Initiate and complete timely reviews of indemnity and expense reserves.

• Develop claim resolution strategies and negotiate or guide negotiations to conclusion.

• Inform excess insurers and provide updates on files.

• Keep claim diaries and update claim files consistently.

• Engage in Regional Claims Review and Large Loss meetings.

• Act as a representative of Health Ministry/Trinity Health during case evaluations, settlement discussions, mediations, and trials.

• Hire, direct, and oversee outside defense counsel; review attorney reports, fees, and litigation costs.

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

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

• Maintain and refresh the Clearsight database while reviewing monthly reports for precision, data integrity, and reserves.

• Serve as a point of contact for senior leadership regarding ongoing issues and potential exposure.

• Participate in committees and offer claims subject matter expertise.

• Stay updated on legislation, court rulings, and emerging claims-litigation trends.

• Set individual goals and attend team and department meetings.

⛳️ Requirements

• Bachelor's degree in a related 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.

• Proficiency in using the IRMS claim database (Clearsight).

• Familiarity with medical terminology.

• Strong analytical abilities.

• Capability to organize and communicate information effectively, both orally and in writing, at all organizational levels.

• Initiative and the ability to manage responsibilities independently.

• Capacity to meet deadlines and adapt to changing priorities.

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

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

• Capability to work independently from a remote location.

• Flexibility to adapt to frequently changing work priorities and perform under pressure.

• Ability to undertake moderate physical activity, including lifting and bending.

🏝️ Benefits

• Comprehensive health and wellness programs.

• Competitive salary and performance-based incentives.

• Retirement plans with company matching.

• Opportunities for professional development and continuous learning.

• Generous paid time off and holiday policies.