Providence Health Plan Group
Claims Manager *Remote. Most States Eligible*
Providence Health Plan Group, Oregon, Wisconsin, United States, 53575
Overview
Description and role summary for the Claims Manager position. Remote role with encouragement for candidates in AK, WA, MT, OR, CA or TX to apply. The Claims Manager oversees day-to-day general and professional liability claims in accordance with the System's claims program policies and procedures within an assigned region or scope, including investigating, evaluating, and managing claims, maintaining up-to-date claims files, coordinating with facility leadership, risk managers, defense counsel, and others, ensuring compliance with reporting procedures and regulations, and providing feedback to the Director of Risk & Claims on evaluations, litigation trends, and risk management issues. The role emphasizes teamwork and effective communication within the claims team and with related staff. Responsibilities
Oversee day-to-day handling of general and professional liability claims within the assigned region or scope. Investigate, evaluate, and manage professional and other liability claims in accordance with established policies and procedures. Maintain up-to-date and accurate claims files, including summaries, action plans, and claims status in the claims data management software. Coordinate with facility leadership, risk managers, defense counsel, and other stakeholders. Ensure compliance with relevant claims reporting procedures and required regulations. Provide feedback and recommendations to the Director of Risk & Claims on evaluations, litigation trends, department policies and procedures, system-wide claims and litigation processes, and risk management issues. Foster teamwork, operational excellence, and effective communication within the claims team (including other Claims Managers, Claims Technicians, and Claims Specialists). Differentiate the role from senior management by handling claims with smaller loss potential and less complexity. Required Qualifications
Bachelor's Degree in Business Administration, Finance, or a related discipline, or an equivalent combination of education and experience in the insurance industry, claims management, or legal handling of claims issues. 5 years of relevant general claims processing or management experience, or an equivalent combination of direct legal work (e.g., as a litigator or paralegal), health care or general risk management, and insurance claims handling. Preferred Qualifications
Upon hire: Certified Professional Healthcare Risk Management (CPHRM). Experience with a mix of general liability claims, including at least 10 claims with significant bodily injury and experience with STARS software. Healthcare experience. Salary Range by Location
AK: Anchorage — Min: 45.14, Max: 70.07; AK: Kodiak, Seward, Valdez — Min: 47.05, Max: 73.04; California (Humboldt) — Min: 47.05, Max: 73.04; All Northern California (excluding Humboldt) — Min: 52.79, Max: 81.94; All Southern California (excluding Bakersfield) — Min: 47.05, Max: 73.04; Bakersfield — Min: 45.14, Max: 70.07; Montana (except Great Falls) — Min: 36.34, Max: 56.41; Great Falls — Min: 34.43, Max: 53.44; Oregon (Non-Portland Service Area) — Min: 42.08, Max: 65.32; Oregon (Portland Service Area) — Min: 45.14, Max: 70.07; Texas — Min: 34.43, Max: 53.44; Washington (Western except Tukwila) — Min: 47.05, Max: 73.04; Washington (Southwest - Olympia, Centralia & Below) — Min: 45.14, Max: 70.07; Washington (Tukwila) — Min: 47.05, Max: 73.04; Washington (Eastern) — Min: 40.16, Max: 62.35; Washington (South East) — Min: 42.08, Max: 65.32. Why Join Providence?
Our best-in-class benefits are designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. About Providence
At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” We support career growth for every role, foster an inclusive workplace where diversity is valued, and serve across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington with over 120,000 caregivers. We are committed to continuing our long tradition of serving the poor and vulnerable. The base pay range is listed above; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, and bonus opportunities. Benefits and Equal Opportunity
Providence offers a comprehensive benefits package including retirement 401(k) with employer matching, health care benefits, life and disability insurance, paid time off, and voluntary benefits. We are an Equal Opportunity Employer and value diversity and inclusion. Applicants in the Unincorporated County of Los Angeles will be considered in accordance with local fair chance ordinances. About the Team
Providence Shared Services provides functional and system support services across the Providence family of organizations to support our Mission and shared expertise.
#J-18808-Ljbffr
Description and role summary for the Claims Manager position. Remote role with encouragement for candidates in AK, WA, MT, OR, CA or TX to apply. The Claims Manager oversees day-to-day general and professional liability claims in accordance with the System's claims program policies and procedures within an assigned region or scope, including investigating, evaluating, and managing claims, maintaining up-to-date claims files, coordinating with facility leadership, risk managers, defense counsel, and others, ensuring compliance with reporting procedures and regulations, and providing feedback to the Director of Risk & Claims on evaluations, litigation trends, and risk management issues. The role emphasizes teamwork and effective communication within the claims team and with related staff. Responsibilities
Oversee day-to-day handling of general and professional liability claims within the assigned region or scope. Investigate, evaluate, and manage professional and other liability claims in accordance with established policies and procedures. Maintain up-to-date and accurate claims files, including summaries, action plans, and claims status in the claims data management software. Coordinate with facility leadership, risk managers, defense counsel, and other stakeholders. Ensure compliance with relevant claims reporting procedures and required regulations. Provide feedback and recommendations to the Director of Risk & Claims on evaluations, litigation trends, department policies and procedures, system-wide claims and litigation processes, and risk management issues. Foster teamwork, operational excellence, and effective communication within the claims team (including other Claims Managers, Claims Technicians, and Claims Specialists). Differentiate the role from senior management by handling claims with smaller loss potential and less complexity. Required Qualifications
Bachelor's Degree in Business Administration, Finance, or a related discipline, or an equivalent combination of education and experience in the insurance industry, claims management, or legal handling of claims issues. 5 years of relevant general claims processing or management experience, or an equivalent combination of direct legal work (e.g., as a litigator or paralegal), health care or general risk management, and insurance claims handling. Preferred Qualifications
Upon hire: Certified Professional Healthcare Risk Management (CPHRM). Experience with a mix of general liability claims, including at least 10 claims with significant bodily injury and experience with STARS software. Healthcare experience. Salary Range by Location
AK: Anchorage — Min: 45.14, Max: 70.07; AK: Kodiak, Seward, Valdez — Min: 47.05, Max: 73.04; California (Humboldt) — Min: 47.05, Max: 73.04; All Northern California (excluding Humboldt) — Min: 52.79, Max: 81.94; All Southern California (excluding Bakersfield) — Min: 47.05, Max: 73.04; Bakersfield — Min: 45.14, Max: 70.07; Montana (except Great Falls) — Min: 36.34, Max: 56.41; Great Falls — Min: 34.43, Max: 53.44; Oregon (Non-Portland Service Area) — Min: 42.08, Max: 65.32; Oregon (Portland Service Area) — Min: 45.14, Max: 70.07; Texas — Min: 34.43, Max: 53.44; Washington (Western except Tukwila) — Min: 47.05, Max: 73.04; Washington (Southwest - Olympia, Centralia & Below) — Min: 45.14, Max: 70.07; Washington (Tukwila) — Min: 47.05, Max: 73.04; Washington (Eastern) — Min: 40.16, Max: 62.35; Washington (South East) — Min: 42.08, Max: 65.32. Why Join Providence?
Our best-in-class benefits are designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. About Providence
At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” We support career growth for every role, foster an inclusive workplace where diversity is valued, and serve across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington with over 120,000 caregivers. We are committed to continuing our long tradition of serving the poor and vulnerable. The base pay range is listed above; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, and bonus opportunities. Benefits and Equal Opportunity
Providence offers a comprehensive benefits package including retirement 401(k) with employer matching, health care benefits, life and disability insurance, paid time off, and voluntary benefits. We are an Equal Opportunity Employer and value diversity and inclusion. Applicants in the Unincorporated County of Los Angeles will be considered in accordance with local fair chance ordinances. About the Team
Providence Shared Services provides functional and system support services across the Providence family of organizations to support our Mission and shared expertise.
#J-18808-Ljbffr