Job Details

Senior Manager, Claims Remote

Candidates residing in Alaska, Washington, Montana, Oregon, California, Texas, or New Mexico are encouraged to apply.

Overview

The Senior Manager, Claims role is responsible for management and supervision of a team handling multi?line health provider and institutional claims. This position oversees file management, stewardship, outcomes, regulatory compliance, stakeholder presentations, and team development throughout Providence St. Josephs Health.

Responsibilities

• Manage file outcomes and stewardship for the team.
• Ensure accurate regulatory compliance and adherence to departmental policy and procedures.
• Present to stakeholders and provide actionable insights.
• Coach and guide the team on high exposure, complex matters such as medical negligence, organizational negligence, directors & officers, fiduciary, general liability, and similar types.
• Participate in procuring and sharing conclusions with key stakeholders.
• Collaborate with various teams to provide consultation, oversight, risk avoidance and mitigation recommendations, data analytics, and efficiency execution.
• Coordinate with operational staff to ensure efficient outcomes.

Required Qualifications

• Bachelors Degree or equivalent combination of education and experience.
• Formal education or training in supervision, management, or leadership.
• 7 years of documented direct management or supervisory experience in a medical negligence and multi?line setting.
• 7 years of claims experience.
• 2 years of experience in an insurance or managed care setting.
• Demonstrated experience in program planning, development, and evaluation.

Preferred Qualifications

• Masters Degree.
• Project management, Six Sigma, Lean, or Change Acceleration Process (CAP) experience.
• Experience with HEDIS, CAHPS, Medicare 5?Star Rating, NCQA, and/or URAC accreditation.

Salary Range by Location

• AK: Anchorage: Min: $56.40, Max: $89.04
• AK: Kodiak, Seward, Valdez: Min: $58.79, Max: $92.82
• California: Humboldt: Min: $57.64, Max: $92.79
• California: All Northern California Except Humboldt: Min: $65.96, Max: $104.13
• California: All Southern California Except Bakersfield: Min: $58.79, Max: $92.82
• California: Bakersfield: Min: $56.40, Max: $89.04
• Idaho: Min: $50.19, Max: $79.23
• Montana: Except Great Falls: Min: $45.41, Max: $71.69
• Montana: Great Falls: Min: $43.02, Max: $67.91
• New Mexico: Min: $45.41, Max: $71.69
• Oregon: Non?Portland Service Area: Min: $52.58, Max: $83.01
• Oregon: Portland Service Area: Min: $56.40, Max: $89.04
• Texas: Min: $43.02, Max: $67.91
• Washington: Western Except Tukwila: Min: $58.79, Max: $92.82
• Washington: Southwest Olympia, Centralia & Below: Min: $56.40, Max: $89.04
• Washington: Min: $58.79, Max: $92.82
• Washington: Eastern: Min: $50.19, Max: $79.23
• Washington: South Eastern: Min: $52.58, Max: $83.01

Benefits

We offer a comprehensive benefits package, including retirement 401(k) with employer matching, health care (medical, dental, vision), life insurance, disability insurance, paid parental leave, vacations, holidays, health?issues time off, voluntary benefits, and well?being resources. Learn more at providence.jobs/benefits.

Equal Opportunity Employer

Providence is proud to be an Equal Opportunity Employer. We are committed to an environment free from discrimination and harassment on the basis of race, color, gender, disability, veteran status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by law.

Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.