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DESCRIPTION:

Provide key system role in professional and general liability, workers compensation and employers liability claims review, investigation, management and disposition, including financial mitigation of indemnity payment and claim defense costs and management of System reputation Will work under the guidance of Senior Claims Managers, Senior Claims Consultant, Director of Insurance, and Vice President, to learn and develop the skills necessary for more independent work and decision making.

PRINCIPLE DUTIES AND RESPONSIBILITIES:

+ Conducts internal investigation, negotiation, and resolution of asserted professional and general liability, workers compensation and employer’s liability claims by patients, their attorneys or representatives.

+ Oversees and coordinates external investigation and resolution of claims, notices of intent and lawsuits and acts as a system representative of HFHS in cases before the courts, pretrial/settlement conferences, workers compensation bureau and trials.

+ Reviews and analyzes facts, medical records and medical opinions. Prepare statistical, financial and factual reports for audit and actuarial studies. Provide status reports to department chairmen on claims exposure.

+ Tracks case files and claims information which may typify trends or causal relationships for risk management analysis and provides period in-service education presentations and prepare periodic file summaries for claim documentation and presentation to HFHS Claims Review and Adjudication Committee or similarly constituted internal review committees and communicates progress/activity with supervisor with emphasis of trends and quality improvement. Inputs case information and updates information in Risk Finance and Insurance Services database.

+ Builds and maintains positive partnership with all office personnel.

+ Develop liaison relationships with System Risk Managers, Department and Division Heads, Medical Directors, treaters and system employees and managers while assisting them in crisis management, risk reduction and/or mitigation and other general related risk issues.

+ Manage & advise on issues & concerns regarding stolen property and accidents within our fleet vehicle program, which also includes valet and parking services

+ Determine our liability;

+ Communicate with 3rd party insurance companies;

+ Monitor our insurance carrier to assure accurate reporting and resolution.

+ Control and manage vendor payments

+ Examine defense firm billings and submit for payment;

+ Manage System wide insurance premiums, evaluate and pay;

+ Complete and file all required forms with workers compensation bureau

+ Submit surety bond payments and renewals.

+ Provides support to all HFHS staff regarding receipt of subpoenas

+ Liaison among witnesses, attorneys and law enforcement who issue subpoenas;

+ Provide advice to physicians/other staff on process of being served.

EDUCATION AND EXPERIENCE:

+ Bachelor's Degree in Business Administration, Healthcare or related field required.

+ 0 to 5 years of experience required, preferably in a healthcare or medical setting.

Additional Information

+ Organization: Corporate Services

+ Department: Risk Finance and Insurance Svc

+ Shift: Day Job

+ Union Code: Not Applicable

Additional Details

This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.

Overview

Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services – from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford’s care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation’s most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus. Learn more at henryford.com/careers .

Benefits

The health and overall well-being of our team members is our priority. That’s why we offer support in the various components of our team’s well-being: physical, emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan. Our team members enjoy a number of additional benefits, ranging from dental and eye care coverage to tuition assistance, family forming benefits, discounts to dozens of businesses and more. Employees classified as contingent status are not eligible for benefits.

Equal Employment Opportunity/Affirmative Action Employer

Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is

committed to the hiring, advancement and fair treatment of all individuals without regard to

race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,

weight, marital status, family status, gender identity, sexual orientation, and genetic information,

or any other protected status in accordance with applicable federal and state laws.