The Director of Claims Management directs and oversees the operations of the Claims Department. Provides guidance and sets policies on insurance claims for personal, property, or casualty loss based on coverage, appraisal, and verifiable damage. Keeps abreast of any changes to legislation and regulations which pertain to insurance claims. Requires a bachelor's degree in a related area and at least 5 years of experience in medical malpractice claims management as either an adjuster, lawyer or combination thereof. Familiarity with a variety of the field's concepts, practices, and procedures. Performs a variety of tasks. A wide degree of creativity and latitude is expected. Relies on experience and judgment to plan and accomplish goals.
- Provides consultation and support to Carilion facilities for claims management functions.
- Maintains current knowledge regarding JCAHO, VIR and licensure standards relating to claims management
- Maintains current knowledge regarding various insurance policies on Carilion facilities.
- Works with individual facility directors, patient advocates and claims managers to assure consistent reporting of risk management data.
- Assists Carilion managers and physicians in the review of claims management issues.
- Assists in presenting organization-wide and hospital specific educational programs as requested in relation to claims management issues.
- Works with Legal Services to address legal issues including but not limited to the assessment and defense of claims.
- Coordinates Claims Management function with BRIC, defense attorneys, plaintiff attorneys, and any involved Carilion personnel.
Step up and lead with a regional leader. Advance your career with an award-winning organization that excels in helping our communities stay healthy and our region grow stronger. Make the most of your management talents at Carilion Clinic, an award-winning healthcare network that includes seven hospitals, multi-specialty physician practices, and affiliations with prestigious academic medical institutions.
Based in Roanoke Virginia, we offer compassionate care, medical education and research, and neighborhood outreach programs. Join and guide a team of caring individuals who embrace and reflect our values‐commUNITY, courage, commitment, compassion, and curiosity‐in all that we do. And realize the advantages of professional stability, strong technological resources, and true advancement potential.
Education: Bachelor's degree required; J.D. would be beneficial.
Experience: Five years of medical malpractice claims experience required.
Other Minimum Qualifications: Ability to be flexible, prioritize, organize and complete assignments in a timely manner. Advanced interpersonal skills necessary to interact with a variety of individuals.
Below are our core values that we strive to embody and expect of all our team members:
CommUNITY: Working in unison to serve our community, our Carilion family and our loved ones.
Courage: Doing what’s right for our patients without question.
Commitment: Unwavering in our quest for exceptional quality and service.
Compassion: Putting heart into everything we do.
Curiosity: Fostering creativity and innovation in our pursuit of excellence.
Requisition Number: 42234
Employment Status: Full time
Location: CASB – Carilion Administrative Services Building
Shift Details: Monday – Friday 8am-5pm. Additional hours as needed.
Recruiter: DAVID L NIVEN
Recruiter Phone: 540-983-4057
Recruiter Email: email@example.com
This is Carilion Clinic …
An organization where innovation happens, collaboration is expected and ideas are valued. A not-for-profit, mission-driven health system built on progress and partnerships. A courageous team that is always learning, never discouraged and forever curious.
Headquartered in Roanoke, Va., you will find a robust system of award winning hospitals, Level 1 and 3 trauma centers, Level 3 NICU, Institute of Orthopedics and Neurosciences, multi-specialty physician practices, and The Virginia Tech Carilion School of Medicine and Research Institute.
Carilion is where you can make your own path, make new discoveries and, most importantly, make a difference. Here, in a place where the air is clean, people are kind and life is good. Make your tomorrow with us.
Equal Opportunity Employer
Minorities/Females/Protected Veterans/Individuals with Disabilities/Sexual Orientation/Gender Identity
Carilion Clinic is a drug-free workplace.