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Stanford Health Care

Claims Manager - Employment

Reposted 4 Days Ago
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Remote
Hiring Remotely in CA
Senior level
Remote
Hiring Remotely in CA
Senior level
The Claims Manager oversees Employment Practices Liability claims, manages litigation, coordinates with stakeholders, investigates claims, and maintains compliance with insurance policies.
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Day - 08 Hour (United States of America)

This is a Stanford Health Care job.
A Brief Overview
Under the direction of the Director, Claims & Litigation Strategy, the Claims Manager is primarily responsible for handling Employment Practices Liability (EPL) claims for Stanford Health Care, Stanford Health Care Tri-Valley, and Stanford Children's Health. Claims include those involving allegations of discrimination, retaliation, hostile work environment, and wrongful termination. This position requires coordination with internal stakeholders and external partners. Assists Director, Claims & Litigation Strategy in other EPL claims-related projects as requested.
Locations
Stanford Health Care
What you will do

  • Manage pre-suit and litigated claims. Evaluate EPL coverage and ensure timely reporting to carriers. Retain outside counsel for litigated matters, attend mediation, evaluate reserves, monitor litigation costs, prepare discovery responses, and oversee decisions regarding discovery, strategy, and ultimate resolution.

  • Investigate pre-suit claims, including conducting witness interviews. Evaluate claims for early resolution, as appropriate, and directly negotiate settlements with opposing counsel and/or claimants when warranted. Prepare responses to administrative charges.

  • Serve as liaison with other Stanford departments, including Human Resources and Employee & Labor Relations, and external partners, such as defense counsel, insurance brokers, and insurance carriers, to coordinate issues impacting claim resolution. Maintain timely and consistent communication with insurance carriers regarding substantive and procedural claim updates, and ensure compliance with all policy requirements.

  • Manage electronic claims files. Input all work product and case information into the claims database to ensure that files contain updated information.

  • Responsible for review and timely submission of EPL-related invoices.

Education Qualifications

  • Bachelor’s degree required.

  • Juris Doctor (JD) preferred.

Experience Qualifications

  • Five (5) years of progressively responsible and directly-related work experience in EPL claim management required.

Required Knowledge, Skills and Abilities

  • Ability to analyze and develop solutions to complex problems.

  • Ability to apply judgment and informed decisions.

  • Ability to communicate effectively in written and verbal formats including summarizing data and presenting results.

  • Ability to establish and maintain effective working relationships.

  • Ability to work effectively both as a team player and leader.

  • Ability to utilize computer systems and software, such as Riskonnect, to manage electronic claim files.

  • Knowledge of local, state and federal laws and regulatory requirements related to EPL claims handling.

Licenses and Certifications

  • BAR - CA Attorney preferred

These principles apply to ALL employees:
SHC Commitment to Providing an Exceptional Patient & Family Experience
Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanford’s patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery.
You will do this by executing against our three experience pillars, from the patient and family’s perspective:

  • Know Me: Anticipate my needs and status to deliver effective care

  • Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health

  • Coordinate for Me: Own the complexity of my care through coordination

Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.

Base Pay Scale: Generally starting at $66.52 - $88.14 per hour

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.

Top Skills

Riskonnect

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