the smart solution for Irving jobs

Clinical Regional Claims Manager

Company: Christus Health
Location: Irving
Posted on: July 11, 2018

Job Description:

DescriptionPOSITION SUMMARY:A CHRISTUS Clinical Regional Claims Manager represents CHRISTUS Health and its facilities and providers and provides support to the Vice President of Litigation, the other Clinical Regional Claims Managers and the Claims Team in the investigation, management, resolution and defense of claims, appeals, arbitrations or any other form of disputes. The duties are varied including support of matters in litigation as well as matters wherein litigation is anticipated and other legal matters including subpoenas, court appearances, mediations and trial appearances. Travel is a requirement (50-60%). Location will be Irving System Office.Serves as liaison to all affiliated health care centers in the investigation, resolution and defense of claims.MAJOR RESPONSIBILITIES:Provides support to the Vice President of Litigation, other Clinical Regional Claims Mangers and the Claims Team in the investigation, management, resolution and defense of claims, appeals, arbitrations or any other form of disputes.Evaluates and investigates patient and claimant complaints and demands and communicates recommendations to CHRISTUS Vice President of Litigation, other Clinical Regional Claims Mangers, the Claims Team, Regional and Facility Risk Managers. Prepares privileged reports with clinical analysis regarding same and provides recommendations to the team for handling.Negotiates settlements within designated authority; prepare settlement agreements using language of settlement agreements approved by the CHRISTUS Vice President of Litigation.Attends mediations and negotiate settlements at mediation or directly with claimant or plaintiff's counsel within designated authority and draft settlement agreements.Identifies and evaluates trend and report analysis of quality and risk issues to assist in reducing the frequency of preventable adverse occurrences. Prepares presentations to facility leadership concerning trends and recommendations for improvement.Evaluates claimant demands and communicate recommendations to CHRISTUS Vice President of Litigation and Regional and Facility Risk Managers.Determines if claims require additional investigation, settlement, settlement, or denial.Investigates all assigned Events, UPLE, Injured Asserts, Attorney Asserts, Medical Review Panels and Suits.Conducts medical, legal and regulatory research.On assigned claims, conducts interviews of witnesses, associates, physicians, and claimants.Recommends reserves with first investigative report and adjustments to reserves as indicated by any follow-up investigation.Documents claims or event data.Provides liability analysis and investigative support to defense counsel on commencement of litigation.Prepares monthly activity status reports (closed/open claims). Prepared powerpoints relative to active claims based on regional assignments.Monitors trials, mock trials, jury studies and depositions and provide analysis and recommendations regarding litigation management to the CHRISTUS Vice President of Litigation.Monitors and participates in MMSEA compliance and reporting with the support of internal and external counsel.Interacts regularly with both internal and external attorneys related to the oversight and management of claims and all matters in litigation.Coordinates, Plans and Participates in facility quarterly (telephonic) and in person on site annual claims reviews.Participates in Teaching events across the system as needed including teaching nursing residents on matters related to legal claims.Participates in risk management surveys of facilities.Has $10,000 settlement authority to negotiate and resolve claims that are determined to present liability exposure. RequirementsPOSITION QUALIFICATIONS:A. Education/Skills:BSN required. RN required.Leadership and problem solving skillsComputer literacy, Powerpoint/Excel skills a plus.Demonstrated, organizational and interpersonal skillsEnjoys teaching and public speaking.B. Experience:Three to Five years in a health care setting with exposure to some combination of clinical care, risk management or operationsSome legal experience (i.e. Paralegal, Legal Nurse Consultant) Preferred. C. Licenses:RN required. Paralegal Certificate Preferred. JDs will be considered.Adjuster licensure and/or CPHRM certification a plus

Keywords: Christus Health, Irving, Clinical Regional Claims Manager, Executive, Irving, Texas

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category

Other Executive Jobs

Mobile Product Manager
Description: Contract 9 Months We have an exciting new job opening for a Mobile Product Manager. The Mobile Product Manager will be responsible for planning, prioritizing and overseeing the product management of (more...)
Company: Alleare Consulting
Location: Dallas
Posted on: 07/22/2018

Project Manager (Military Veterans Wanted!)
Description: Job Title Project Manager Job Description Summary Provides professional project management experience to designated projects and assignments at a client site, campus, and facilities. Interacts with client (more...)
Company: Cushman & Wakefield
Location: Dallas
Posted on: 07/22/2018

Restaurant Manager - Mesquite, TX
Description: Overview At the direction of the General Manager, oversee the day-to-day activities of the restaurant. Assists the General Manager with developing and implementing plans to ensure the long-term success (more...)
Location: Mesquite
Posted on: 07/22/2018

Salon Manager - Lewisville Towne Center - Store
Description: Responsible for meeting or exceeding salon service and pro-hair sales
Company: Ulta Beauty
Location: Lewisville
Posted on: 07/22/2018

Database and Data Manager
Description: Robert Half Technology is looking for a Database / Data Manager that will act as a enterprise Data Steward and will oversee the Global Data Management processes and procedures necessary for effective (more...)
Company: Robert Half Technology
Location: Dallas
Posted on: 07/22/2018

Area VP of Sales Texas/New Mexico Region
Description: The Area Vice President, Sales is responsible for the Company portfolio: accountable for leading the overall management of sales strategies, activities, operations, Distributor relationships and budgets (more...)
Company: Pharmaceuticals, Dallas, TX
Location: Dallas
Posted on: 07/22/2018

Imaging Manager, Radiology, ARRT, ASRT, North Tx.
Description: Manager of Imaging, Radiology needed for healthcare organization in North Texas. No state income tax,
Company: Southern Medical Recruiters
Location: Arlington
Posted on: 07/22/2018

Professional Services Sales Manager
Description: As a member of the Palo Alto Networks sales leadership team you will report to the Sr. Manager, Services Sales for North America. You will be responsible for building and driving the Services Sales teams (more...)
Company: Palo Alto Networks
Location: Plano
Posted on: 07/22/2018

Program Manager of Clinical Strategies
Description: DescriptionThe Program Manager for Clinical Strategies is responsible for day-to-day operational management of all activities and functions in the designated program area within the Information Management (more...)
Company: Christus Health
Location: Irving
Posted on: 07/22/2018

Physician: 100% Pain Management Anesthesiology Job in Dallas TX Area
Description: One of Texas's leading private practices in pain management needs additional pain management support. The community has growing demand, so the group is reviewing new candidates. A strong existing patient (more...)
Company: CompHealth
Location: Dallas
Posted on: 07/22/2018

Log In or Create An Account


Forgot password?

Find us on Facebook

Find us on LinkedIn

Get the latest Texas jobs by following @recnetTX on Twitter!

Irving RSS job feeds