Description

Senior Manager Claims \Hybrid

Candidates residing in the greater Seattle, WA; Renton, WA; Spokane, WA; Portland, OR; Santa Rosa, CA; or Irvine, CA areas are encouraged to apply.

The Senior Manager, Claims role is responsible for management and supervision of a team handling multi-line health provider and institutional claims. This position is responsible for file management, stewardship and file outcomes of the team in collaboration with key system leadership throughout Providence St. Joseph's Health. Also, the role is responsible for ensuring accurate regulatory compliance, adherence to department policy and procedures, stakeholder presentations, and team development.

This role utilizes expertise to coach to best outcomes for high exposure, complex matters including medical negligence, organizational negligence, directors and officers, fiduciary, general liability and similar matter types. The role participates in procuring and sharing conclusions to provide actionable insights to key stakeholders across the organization. There is collaboration with various teams to provide consultation, oversight, risk avoidance and mitigation recommendations, data analytics, and efficiency execution. The role also coordinates with operational staff as needed to ensure efficient outcomes.

This role works hybrid and the candidate will need to work on site 4 days each week.

Providence caregivers are not simply valued theyre invaluable. Join our team at Integrity Compliance Audit Services 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.

Required qualifications:

• Bachelors Degree or an equivalent combination of education and experience.



• Coursework/Training: Formal education or training in supervision, management, or leadership.



• 7 years of documented direct management or supervisory experience in a in a medical negligence and multi-line setting.



• 7 years of Claims experience.



• 2 years of experience in an insurance or managed care setting.



• Demonstrated experience in program planning, development and evaluation.

Preferred qualifications:

• Master's Degree



• Project management, Six Sigma, Lean, Change Acceleration Process (CAP) experience.



• Experience with HEDIS, CAHPS, Medicare 5-Star Rating, NCQA and/or URAC accreditation.

Salary Range by Location:

California: All Northern California - Except Humboldt: Min: $65.96, Max: $104.13

California: All Southern California - Except Bakersfield: Min: $58.79, Max: $92.82

Oregon: Portland Service Area: Min: $56.40, Max: $89.04

Washington: Western : Min: $58.79, Max: $92.82

Washington: Eastern: Min: $50.19, Max: $79.23

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.

About Providence

At Providence, our strength lies in Our Promise of Know me, care for me, ease my way. Working at our family of organizations means that regardless of your role, well walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits.

Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

About the Team

Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.

Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

Requsition ID: 416039

Company: Providence Jobs

Job Category: Claims

Job Function: Revenue Cycle

Job Schedule: Full time

Job Shift: Day

Career Track: Leadership

Department: 4008 SS RIS

Address: WA Renton 1801 Lind Ave SW

Work Location: Providence Valley Office Park-Renton

Workplace Type: Hybrid

Pay Range: $See Posting - $See Posting

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.