Claims Manager - Risk and Insurance - System Wide

Thank you for considering a career at Bon Secours Mercy Health!

Scheduled Weekly Hours:

40

Work Shift:

Days (United States of America)

Summary of Primary Function/General Purpose of Position

Effectively and efficiently manages liability claims, including hospital and employed physician claims, as well as claims covered by the deductible polices including but not limited to Cyber Liability, D&O/EPL, Regulatory and Property/ADP, to protect the assets of the ministry by resolving those claims within the parameters of the available insurance coverages.  Is the BSMH representative at pre-trial hearings, mediations, arbitrations and trials. Manages and directs defense counsel in accordance with organizational objectives and goals. Independently evaluates, reserves and resolves claims and litigated matters within designated authority.

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.
• Ability to consistently apply technical aspects of claim handling and documentation in accordance with best practices
• Demonstrated advanced analytical, decision making and negotiation skills
• Maintain frequent interaction internal leaders, outside counsel and vendors, and commercial carriers to communicate claim developments and obtain necessary discovery information
• Utilize knowledge of insurance contracts, claims investigations, and vendor management to make appropriate claim reserve recommendations
• Proactively work toward economic resolution of Cyber claims and effectively control litigation and expense management
• 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, with a preference of at least 2 years within a technical / complex litigation specialty including Cyber, D&O, EPL, Fiduciary, or Medical Malpractice claims

Bon Secours Mercy Health is an equal opportunity employer.

Many of our opportunities reward* your hard work with:

• Comprehensive, affordable medical, dental and vision plans
• Prescription drug coverage
• Flexible spending accounts
• Life insurance w/AD&D
• Employer contributions to retirement savings plan when eligible
• Paid time off
• Educational Assistance
• And much more

*Benefits offerings vary according to employment status.

Department:

SS Risk & Insurance

It is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a). Accordingly, all applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you’d like to view a copy of the affirmative action plan or policy statement for Mercy Health– Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employer, please email [email protected]. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at [email protected].