Manages professional, general liability and worker’s compensation claims asserted against Sinai Health System and its affiliates as well as ensures optimum risk management programs for the health system. Interacts with all level of personnel in the hospitals and clinics as necessary in the performance of the responsibilities of the position.
· Actively participates in the defense of cases through completion of written discovery including interrogatories and production requests and oral discovery in scheduling and preparing witnesses for deposition.
· Advises the third-party administrator of new cases and requests the appropriate carriers be put on notice of the new claims and set initial reserves.
· Review high acuity occurrence reports as a member of the ongoing quality improvement program looking for potential trends or opportunities for improvement.
· Identifies potential Risk vulnerabilities and works collaboratively to assess level of risk.
· Assist the System Director of Claims and Associate General Counsel in the attainment of the yearly goals established for the department in conjunction with the ongoing Quality improvement program.
· Will act as a resource on Risk related issues for caregivers and members of the hospital’s medical staff by answering questions posed through direct knowledge or by obtaining and conveying answers received from counsel.
· Conducts Risk in-services and staff orientation.
· Attends bi-annual Bordereau meetings with law firms to assess and value claims for risk financing and reserve purposes and report to senior leadership on the severity of cases as they develop over time. · Ensures that the System’s Claims Administration Guidelines are being adhered to and followed by outside defense counsel.
· Responsible for the review and approval of all invoices received related to any of the activities of the department including attorney invoices, expert witness fees, production of records requests, and funding of worker’s compensation program.
MINIMUM Education: Bachelor’s degree in a related field is required. J.D. Degree or Master’s degree is preferred
MINIMUM WORK EXPERIENCE: Minimum of three (3) years of experience in Health Care Claims, Risk Management or related field
KNOWLEDGE & SKILLS: Demonstrated ability to communicate both verbal and in writing claims and risk issues in a clear and understandable manner Possess a practical, hand-on, collaborative approach to resolving issues.
Internal Number: 1019
About Sinai Health System
Schwab Rehabilitation Hospital is a freestanding, not-for-profit, 102-licensed bed facility onChicago’s West and Southwest Side that offers comprehensive inpatient and outpatient programs foradults and children. Schwab is a proud member of Sinai Health System and the first fully licensed andaccredited rehabilitation hospital in the Midwest.Our therapists see patients through the entire continuum of care, from acute inpatient admissions atMount Sinai Hospital, to inpatient rehabilitation and outpatient therapy services at Schwab. We alsohave a hospital-based rehabilitation-focused short-term sub-acute unit at Schwab that provides boththerapy and nursing services with exceptional outcomes.Our rehabilitation team takes a holistic, interdisciplinary approach to address the physical, cognitiveand psychosocial needs of each patient. Each patient is assessed and provided with a personalized careplan tailored to help achieve maximal independence and function. Schwab offers seven treatmentgyms featuring private treatment rooms, a warm-water indoor therapy pool, and an award-winningtherapeutic roof top garden.