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Claims Manager

Company Name:
Humana
## Description
Role: Claims Manager
Assignment: Legal
Location: Louisville
Assignment Capsule
The Claims Manager reports to the Law Department through Humana''s wholly owned insurance subsidiary, Managed Care Indemnity, Inc. This role is responsible for the day-to-day management of professional and general liability and errors & omissions claims that occur throughout the country.
Responsibilities Include:
Daily management of professional and general liability and errors & omissions claims for the company in various jurisdictions
Creation of routinely scheduled written reports to Claims Director
Assignment to and management of outside counsel, including directing and developing claim management strategy
Accurate reserve setting and management
Risk identification
Root cause analysis
Successful resolution of claims through various methods including trial, mediation and dismissal
Monitoring and updating RMIS
Working with various internal and external partners to successfully investigate, evaluate and negotiate claims
Preparation of accurate, meaningful reports for excess carriers, fronting arrangements and management on an ongoing basis
Understanding of insurance coverage issues
Coverage determination analysis
Identifying subject matter experts and other information resources to aid in the defense of claims
Key Competencies
Builds Trust: Work is performed in a way that avoids surprises; adequately manages portfolio with appropriate identification regarding risks. Makes choices consistent with Humana''s ethical principles.
Communication: Effectively communicates with others through oral and written communication; understands the audience and tailors delivery accordingly
Acts Strategically: Has vision, anticipates future consequences and trends accurately; creates effective claim resolution plan and employs a disciplined approach to execution of chosen strategy.
## Qualifications
Role Essentials:
Bachelor''s Degree
5-7 years' experience handling healthcare professional and general liability claims, preferably involving various healthcare delivery settings
Adjuster''s license preferred; ability to obtain license required
Proven organizational skills, including ability to complete multiple projects in designated timeframe while adjusting to meet portfolio''s needs.
Ability to work independently following training
Schedule: Full-time
Primary Location: US-KY-Louisville
Role: Legal
Req ID: 122935
Work Environment Type: Office

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