Risk Claims Manager

Department/Unit:

Work Shift:

Salary Range:

Minimum Qualifications:

Education:

High School Degree required

BS in Business, Law or related field required

Master’s preferred, Health Law

Claims Management:

Develop litigation strategies for management of claims, work with outside counsel on engagement of experts, life care planners, structure brokers and settlement strategies.

• Establish claims files immediately
• Conduct all interviews within specified timeframes
• Work with outside counsel on gathering information for defense
• Respond to discovery demands
• Manage reserve process by reviewing case with Vice President
• Check adequacy of reserves by reviewing with defense counsel semi-annually
• Track the litigation, anticipate trial dates, discovery dates, disclosure dates, etc. in accordance with Litigation Management Guidelines
• Manage expert retention according to established process
• Scheduling, internal and external to the office for related ligation meetings, pre-depositions, depositions, trial related

Data Management:

• Assumes day to day responsibility for data entry of all claims/suits/potentials in Stars
• Maintains regulatory compliance with reporting/updating all MMERS/MMDCS within DOH system
• Prepare clinical service reports for Vice President to present claims data to Department Chairmen
• Maintain accuracy of Sharepoint - litigation tracker for electronic requests and audit trails
• Complete PPR/Joint Commission standards in AMP system

Thank you for your interest in Albany Med Health System!

Albany Med Health System is an equal opportunity employer.

This role may require access to information considered sensitive to Albany Med Health System, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that:

Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Health System policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.