Medical Malpractice Claims Manager

Overview

 

 

We have an exciting Medical Professional Liability (Medical Malpractice) Claims Manager career opportunity and we are looking for an dynamic individual with a strong background in Medical Malpractice Claims to join our team. Pediatrix Medical Group is one of the nation’s largest providers of prenatal, neonatal and pediatric services.

 

Talented business professionals from diverse backgrounds choose Pediatrix because we are a company that focuses on a team approach to improve the lives of patients everywhere.  We offer a diverse range of opportunities and a commitment to clinical excellence, we are confident that you'll love being a part of the Pediatrix team. 

Responsibilities

• Receive and investigate adverse occurrences and potential compensatory events, medical malpractice claims, patient complaints and highly sensitive billing disputes and analyze for risk liability exposure.
• Manage medical malpractice claims and collaborate with TPAs and defense attorneys on strategy recommendations,including attending mediations, case evaluations, and providing recommendations to department leader. 
• Collaborate with our Clinical Services Division and Chief Medical Officers with tracking/trending of adverse outcomes and medical malpractice claims in order to improve quality of care and advance patient safety.
• Prepare materials and participate in claims committee meeting, carrier meetings, and operational meetings, as assigned.
• Evaluate medical malpractice claims history of healthcare professionals for credentialing and re-credentialing purposes.
• Conduct Risk Management orientation training as needed. Develop and make recommendations for educational Risk Management programs based on needs assessment. 
• Responsible for claims audit process in collaboration with department leader, including management and preparation of audit materials, SOX reports, loss runs, quarterly audit reports
• and letters, and provide recommendations for any audit concerns.
• Oversight of department claims analyst(s).
• Attend strategy meetings with defense counsel and internal expert reviewers.
• Generate and analyze reports, including trending reports, financial reports and claims history reports.
• Participate in quarterly status calls with providers, medical directors and operations.
• Work collaboratively with the insurance and legal departments.
• Other responsibilities as designated.

Qualifications

Education:

Certified Professional in Healthcare Risk Management (CPHRM) or ability to obtain designation is required.

Medical malpractice claims adjusters will also be considered.

 

Skills/Experience:

3-5 years claims management experience in a healthcare or large medical group practice or with medical malpractice claims required.

Strong verbal/written communication skills required.

Proficiency with computer software systems.

Benefits and Compensation

Benefits for Full Time employee and qualified dependents:

 

• Health Insurance including prescription drugs
• Dental Insurance
• Vision Insurance
• Life Insurance
• Short- and Long-Term disability options
• Employee stock purchase program – 15% discount*
• 401k with company match**
• Long Term Care (LTC)
• Pre-tax Health Savings Account (HSA)
• Pre-tax Flexible Spending Accounts (FSA)
• Aflac Hospital, Critical Illness and Accident plans
• Identity Protection
• Employee Assistance Program (EAP)

 

*Part Time Regular employee classifications also receive this benefit

** Available to part-time regular and part-time casual employees age 21 and over

About Us

 

Pediatrix® Medical Group, Inc. (Pediatrix) is the nation’s leading provider of physician services. Pediatrix-affiliated clinicians are committed to providing coordinated, compassionate and clinically excellent services to women, babies and children across the continuum of care, both in hospital settings and office-based practices. Specialties include obstetrics, maternal-fetal medicine and neonatology complemented by more than 20 pediatric subspecialties, as well as pediatric primary and urgent care clinics. The group’s high-quality, evidence-based care is bolstered by significant investments in research, education, quality-improvement and safety initiatives. The physician-led company was founded in 1979 as a single neonatology practice and today provides its highly specialized and often critical care services through more than 5,000 affiliated physicia