Pharmacists Mutual Insurance Company

Compensation

Full Description

Description Pharmacists Mutual Insurance has an opening for a Professional Liability Claims Manager. This position will ensure superior delivery of claims services and products. The manager will also direct, coordinate, and monitor the activities of a team of claims employees and/or other parties assigned to manage the Company's claims, such as Third-Party Administrators and MGAs. The manager will provide consulting and training resources and serve as a contact and technical resource to external and internal business partners. Claims Manager • Ensures timely and appropriate claim decisions and resolutions. • Engages with the Claims team leadership to develop and implement strategic programs that meet our Company's goals and objectives. • Assesses performance and growth needs of team members and engages in development discussions. Essential Functions Essential functions may include, but are not limited to the following: • Timely decision making and action to meet Company guidelines and goals. • Provides quality customer service by monitoring performance and establishing metrics. • Resolves complaints, problems, and coverage questions which have been escalated through the team. • Establishes focus of the team to properly manage Company indemnity & expenses. • Recommends appropriate cases for discussion for claims roundtable; Attends and/or presents at roundtables/ authority discussions for collaboration of technical expertise resulting in improved payout on indemnity and expenses. • Ensures that the Company’s claim quality, guidelines and metrics are successfully met. • Assigns staff to attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed. • Evaluates the work of assigned staff and prepares written performance evaluations; makes recommendations on personnel actions to include hiring, work assignments, training, and discipline. • Manages relationships with large accounts and brokers from a claims and risk management perspective. • Works with and manages a third party administrator and/or external business partners as applicable. Knowledge, Skills And Abilities • Understand principles and practices of insurance claims examination. • Knowledge of employee management principles including hiring, supervision, training, retention, and performance evaluation. • Conduct investigative interviews. • Understand employee management and developing standards. • Manage process, planning, and tracking of budgets. • Correct English usage, spelling, grammar, vocabulary and punctuation. • Ability and flexibility to work longer hours when workload fluctuations occur. • Research and stay up-to-date with trends and changes in the claims/insurance industry. • Communicate effectively with others (oral and written). • Analyze complex issues and make critical decisions. • Maintain records, prepare reports and conduct correspondence related to the work. • Interpret and apply laws, rules and regulation, as well as complex policy and contract coverage. • Obtain and use sensitive information discreetly and objectively, both internal and external. • Determine when to escalate concerns to the appropriate level of management. • Follow oral and written directions. • Work effectively with others in a team environment. • Contribute effectively to the accomplishment of team or work unit goals, objectives and activities. • Establish and maintain effective working relationships with those contacted in the course of work. • Excellent customer service skills. • Ability to organize and prioritize work. • Work independently and demonstrate drive and initiative. • Ability to handle multiple tasks at once. • Ability to meet definite deadlines and deal with pressure situations. • Collect, interpret, and input data efficiently and accurately. • Use computer and related software effectively. • Use Microsoft Office programs efficiently and effectively. • Expertise in Workers Compensation, Property, Subrogation, Auto & General Liability or Professional Liability claims. Qualifications Experience and Education Qualifications Claims Manager • High School Diploma or equivalent and 15 years of related experience; or • Associate’s Degree and 12 years of related experience; and • One of the following industry related certifications: AIC (Associates in Claims, AIC-M (Associates in Claims-Management), AIM (Associates in Management), CRM (Certified Risk Manager), or SCLA (Senior Claim Law Associate) OR • Bachelor’s Degree and 8 years of related experience; or • Master’s Degree and 5 years of related experience Special Requirements, Licenses and Certificates • Licensing required in some states. Preferred Qualifications • Advanced or specialized training/certifications preferred: SCLA, AIC, ARM, CPCU • Professional Liability background, specifically medical malpractice to include Dental, Pharmacy, and/or Veterinary. Work Environment • Primary work environment is in a climate-controlled office setting • Work may involve travel to attend meetings at other locations Benefits In addition to a competitive salary, eligible employees may receive an annual discretionary bonus and access to our benefits package including: • Health, Dental, Vision & Life coverage • 401(k) with Company Match • Paid Time Off • 8 Paid Holidays • Volunteer Time Off • Paid Parental Leave • Hybrid/Remote Work Options • Employee Assistance Program • Tuition Reimbursement Pharmacists Mutual Insurance Group is an Equal Opportunity Employer.