Claims Manager Patient Safety - Patient Safety | Location: | Seattle, WA | | Last Updated: | 02/06/2010 |
Job Description:
Manager, Claims
Patient Safety
Seattle, WA
Full-time
Day Shift
Competitive Salary + DOE
Known for innovations in patient care, and named a recipient of the 2006 Healthgrades Distinguished Hospital Award for Clinical Excellence, Virginia Mason Medical Center is a regional referral, teaching and research center. Our vision to be the Quality Leader in healthcare is achieved by adopting best practices as standard work and by improving systems via the Virginia Mason Production System, which uses Lean principles pioneered by Toyota. At VMMC, we strive to provide the finest health care through an interdisciplinary approach we call “Team Medicine”, which gives every individual the chance to contribute to the well-being of our patients and the continuing success of our medical center.
The Manager, Claims is responsible for the general management of the Claims Section within the Patient Safety Office, including budget preparation and management of day-to-day operations. This job also oversees the claims management process.
1.- Provides leadership and direction for the general management of the Claims Section within the Patient Safety Office, including development and implementation of assigned area-specific policies, procedures, standard work, and performance standards. On a regular basis, provides to designated leadership reports related to claims frequency, severity, select claims management standards, reserving practices and development, and claims trends.
2. - Manages complex professional and general liability, automobile, and other select liability, property or fiduciary claims. Develops and manages outside defense counsel relationships. Establishes and applies performance standards to regularly assess the performance of outside defense counsel.
3. - Performs all aspects of human resource management, including recruitment and retention, analyzing staff mix and deploying staff, ensuring competency of staff through development and regular evaluation, and providing disciplinary counseling.
4. - Develops and implements specific customer service, human resource, and financial goals and objectives consistent with VM strategic plan and goals. Leads and participates in improvement projects focused on achievement of annual goals and lean initiatives; ensures implementation of and adherence to improvement changes and performance standards.
5. - Manages vendor contract(s) and provides oversight of claims database, including management and report generation.
6. - Performs special projects as assigned.
Bachelor's degree in Risk Management, Insurance or a related field; or equivalent. At least 10 years experience working in insurance, claims or risk management; management experience strongly preferred. Strong working knowledge of insurance claims, database management, clinical issues and risk management consultation and education. Strong computer skills, including MS Office. Excellent written and verbal communication skills; strong human resource, conflict and relationship management, and team building skills; strong project management skills; and strong contract negotiation skills required. Ability to adapt to change quickly and positively. Orientation towards continuous improvement and process redesign.
Preferred qualifications include an RN degree; an MS, MBA or JD degree; diploma or certification in Risk Management; leadership experience in risk management or patient safety within a hospital or integrated healthcare delivery system; and the ability to facilitate speaking engagements before large groups and interact with all levels of the organization.
Be a part of the Virginia Mason team where we offer you not only a competitive salary and comprehensive benefit package including relocation assistance, but also a wonderful place to live. Seattle, home to Virginia Mason, is a city that offers its residents the best of everything — from first-rate restaurants, shopping, and theatre to a wealth of recreation, outdoor activities and weekend getaways.
For more information or to apply online, visit our website at www.VirginiaMason.org. We are an equal opportunity employer. |
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