Risk Claims Manager

100 Albany Med Health System; City of Albany (NY); On-site; USD 77,000 - 119,000; Full time

Job summary

Albany Med Health System, based in Albany, NY, seeks a risk management professional to develop litigation strategies and manage claims with outside counsel and experts. The role covers discovery responses, reserve reviews, and regulatory reporting.

Responsibilities include establishing claims files, coordinating interviews, and tracking litigation milestones while ensuring data accuracy in the organization’s systems. This is a full-time, on-site position with growth opportunities.

Qualifications

• Education as specified: HS degree required and higher degrees preferred.
• Experience in litigation management and claims handling.
• Ability to work with outside counsel and experts.
• Familiarity with regulatory reporting and audits.

Responsibilities

• Establish claims files promptly and maintain updates.
• Coordinate interviews within set timeframes and with counsel.
• Respond to discovery demands and manage reserve processes.
• Track litigation timelines and manage expert retention.
• Maintain data entries in claims systems and regulatory reports.

Skills

Litigation strategy

Claims management

Outside counsel coordination

Discovery response handling

Data management

Education

High School Degree

BS in Business, Law or related field

Master’s preferred in Health Law

Tools

Stars

Sharepoint

AMP system

DOH system

Job description

Department/Unit: Risk Management Work Shift: Day (United States of America) Salary Range: $77,075.00 - $119,466.00

Develop litigation strategies for management of claims, work with outside counsel on engagement of experts, life care planners, structure brokers and settlement strategies.

Minimum Qualifications

Education: High School Degree required BS in Business, Law or related field required Master’s preferred, Health Law Claims Management: Develop litigation strategies for management of claims, work with outside counsel on engagement of experts, life care planners, structure brokers and settlement strategies.

Responsibilities

• Establish claims files immediately
• Conduct all interviews within specified timeframes
• Work with outside counsel on gathering information for defense
• Respond to discovery demands
• Manage reserve process by reviewing case with Vice President
• Check adequacy of reserves by reviewing with defense counsel semi-annually
• Track the litigation, anticipate trial dates, discovery dates, disclosure dates, etc. in accordance with Litigation Management Guidelines
• Manage expert retention according to established process
• Scheduling, internal and external to the office for related ligation meetings, pre-depositions, depositions, trial related
• Data Management: Assumes day to day responsibility for data entry of all claims/suits/potentials in Stars
• Maintains regulatory compliance with reporting/updating all MMERS/MMDCS within DOH system
• Prepare clinical service reports for Vice President to present claims data to Department Chairmen
• Maintain accuracy of Sharepoint – litigation tracker for electronic requests and audit trails
• Complete PPR/Joint Commission standards in AMP system

Thank you for your interest in Albany Med Health System!

Albany Med Health System is an equal opportunity employer.

This role may require access to information considered sensitive to Albany Med Health System, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes.

Information Security Requirements

• Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties.
• Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose.
• Reasonable efforts, consistent with Albany Med Health System policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.

Albany Medical Center is the centerpiece of medicine, research, and medical education in New York’s Capital Region and is the area's largest private employer with more than 10,000 employees.

Albany Medical Center offers excellent career opportunities in a wide range of roles in both patient care and administration.

We value all our staff members and offer outstanding employee benefits including:

• Excellent health care coverage with no copay at Albany Medical Center providers
• A wide array of services and programs to support emotional, physical, and mental wellbeing

Anchored in the state’s historic capital city, Albany Medical Center offers a full range of inpatient and outpatient care and is home to the region’s largest hospital, only Level 1 adult and pediatric trauma centers, and only children’s hospital.

The downtown campus also offers opportunities at Albany Medical College.

Albany Medical Center, along with Columbia Memorial Health, Glens Falls Hospital, Saratoga Hospital, and the Visiting Nurses, form the Albany Med Health System, serving more than three million people over 25 counties.