Sr. Medical Malpractice Claims Manager - Professional Liability •Remote •

Providence; New Mexico; Remote; USD 80,000 - 120,000; Full time

Job summary

Join a leading healthcare organization as a Sr. Medical Malpractice Claims Manager, overseeing the investigation and management of liability claims. This remote position emphasizes collaboration with facility leaders and compliance with claims regulations, providing a vital role in patient safety and risk management.

Benefits

Comprehensive benefits package

Professional growth opportunities

Support for well-being and financial security

Qualifications

• 7+ years of liability claims processing/management experience.
• 5+ years of supervisory or management experience.

Responsibilities

• Investigate and manage professional, general, and other liability claims.
• Negotiate settlements and monitor trials.
• Coordinate with facility leadership and risk managers.

Skills

Claims Management

Negotiation

Risk Management

Communication

Education

Bachelor's Degree in Business, Finance, or related field

Tools

Claims management software (e.g., STARS, Riskonnect)

Job description

Providence caregivers are not simply valued – they’re invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Providence is calling a Sr. Medical Malpractice Claims Manager - Professional Liability who will :

• Investigate, evaluate, and manage professional, general, and other liability claims under the PSJH Insurance Program.
• Communicate with patients, claimants, caregivers, providers, and leadership.
• Review and analyze medical records, interview witnesses, assist with discovery, and communicate with facility risk managers regarding evaluations and investigations.
• Write insurance policy coverage letters and analyze policy documents to address coverage.
• Set appropriate indemnity and expense reserves.
• Select medical experts for case review and develop plans of action for claims.
• Update claims files following material changes in status.
• Review and approve service statements and coordinate payments.
• Inform senior management of large or complex claims and potential media exposure.
• Report claims with potential excess exposure to insurers.
• Ensure compliance with claims reporting procedures and regulations.
• Work with defense attorneys specializing in medical negligence defense.
• Foster teamwork, operational excellence, and effective communication within the claims team.

Maintain complete documentation for each matter :

• Develop and document plans for claim resolution.
• Maintain electronic files with all relevant communications and analysis.

Coordinate with facility leadership, risk managers, defense counsel, and others :

• Select defense counsel and coordinate disclosures with patients and families.
• Obtain authority for settlement or trial and facilitate claims roundtables.
• Assist in regional conferences and case reviews.

Resolve claims according to policies and regulations :

• Negotiate settlements, monitor trials, and advise on resolution opportunities.
• Report to regulatory agencies as required and close files per policies.
• Participate in projects to improve procedures and policies.

Provide input to reduce risk :

• Offer feedback on litigation trends, policies, and risk management issues.
• Support quality and patient safety initiatives.

Providence welcomes 100% remote work for residents in most U.S. states, excluding Hawaii, Massachusetts, New York, Ohio, and Pennsylvania.

Required qualifications :

• Bachelor's Degree in Business, Finance, or related field.
• 7+ years of liability claims processing/management experience.
• 5+ years of supervisory or management experience.

Preferred qualifications :

• CPHRM certification.
• 10+ years of medical malpractice experience.
• Experience with third-party negligence claims, complex liability claims, and defense of medical negligence claims.
• Experience analyzing insurance policies and writing coverage letters.
• Claims management software experience (e.g., STARS, Riskonnect).

Salary ranges vary by location, with specifics provided for multiple states and regions.

Why Join Providence?

Our benefits are designed to support your well-being, professional growth, and financial security. We prioritize taking care of you so you can focus on delivering exceptional care to our communities.