Regional Claims Manager manages the operations of an insurance claims department to meet operational, financial, and service requirements. Oversees the intake and processing of insurance claims for personal, property, or casualty loss based on coverage, appraisal, and verifiable damage. Being a Regional Claims Manager manages appraisal and examination staff and processes. Assures timely and proper disposition of claims based on policy provisions. Additionally, Regional Claims Manager recommends and implements best practices to ensure complete and thorough claim settlements, legal reviews, and investigations following company policies and insurance industry regulations. Determines the value of settlements for escalated claims. Manages negotiations of settlements and administration of claims in litigation. Typically requires a bachelor's degree. Typically reports to top management. The Regional Claims Manager typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. To be a Regional Claims Manager typically requires 3+ years of managerial experience. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. (Copyright 2024 Salary.com)
Description
Department: Infection Prevention SRH
Exempt: Yes
Schedule: DAYS
Position Type: Full Time >=0.6
FTE: 1.000000
Base Wage: $ 50.00 to $ 75.01
Location: Skagit Valley Hospital
The information described in this job description has been designed to indicate the general nature of the work performed. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job.
Other information:
Job Summary
Partners within all areas of SRH (including Cascade Valley Hospital, Skagit Valley Hospital, Clinic, Outpatient Surgery Center) to further develop a system of care that promotes sound and scientific infection prevention principles and practices. Provides expert clinical advice and leadership on infection control to ensure patients are protected from the risk of acquiring Health Care Associated Infections (HCAs) and Caregivers are practicing in a safe environment. In partnership with the Infection Disease team, coordinates surveillance and data collection/analysis of organization’s infection-control program. Refinement of policies and procedures to promote rigorous infection control standards that meet DNV, OSHA, Public Health Department and Center for Disease Control Standards. The information described in this job description has been designed to indicate the general nature of the work performed. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job. Skagit Regional Health offers a comprehensive benefit package including medical, dental, vision, 457b/401a (retirement), long term disability, and paid time off to all employees holding an FTE of 20 or more hours per week. Eligible employees also receive sick time pay.
Essential Functions
Leads, develops, and maintains an effective and comprehensive infection prevention plan and program for the organization. Trains and develops the Infection Prevention team. Ensures that surveillance and data collection/analysis takes place and are appropriately reported out, including the incidence of infections related to device use, as part of the on-going surveillance using Center for Disease Control (CDC) infection criteria throughout the organization. Provides education regarding findings and directs and/or coordinates current infection prevention practices to all locations throughout SRH. Assists to lead the organization’s Infection Prevention Committee and participates in other committees as assigned. Investigates nosocomial infections through review of admission diagnosis, microbiology culture results, orders, patient records, consultation request, post-discharge surveillance, and autopsy findings. Reports epidemiologically significant findings as appropriate through the Quality Management System. Applies epidemiologic principals and statistical methods to identify target populations, analyze trends and design and evaluate prevention and control strategies. Leads the SRH environmental infection prevention surveillance rounds in inpatient and outpatient areas. Collects data on the incidence of infections related to device use. Participates in investigations of unusual infection outbreaks and high risk situations utilizing the microbiology reports, consultation with Medical staff, County Public Health Departments and when necessary the Center for Disease Control. Reports epidemiologically significant findings as appropriate. Evaluates the effectiveness of the surveillance plan and modify as necessary and at least annually. Coordinates reporting with the laboratory to the county and/or state health department and maintain appropriate records as required. Compiles, interprets and provides comprehensive surveillance reports to the Infection Prevention Committee and other Committees as appropriate. Participates in quality/performance improvement activities by assessing, monitoring and measuring nosocomial infections outcomes. Maintains compliance with national standards and regulating bodies such as DNV, CDC and OSHA. Coordinates construction review with Plant Services, assuring that infection control precautions are observed. Maintains plans, policies, and procedures for infection prevention. Develops and updates isolation techniques and procedures in accordance with current standards of practice, rules and regulations. Complies with all SRH policies and procedures. Performs other duties as assigned by Director or Designee.
Education
Bachelors of Science in Nursing, Laboratory Science, Public Health, or other health-related field required. Masters in Nursing, Laboratory Science, Public Health or other Health care related field is preferred.
Experience/Training
Minimum of five years of Infection Prevention experience required and minimum of three years of applicable leadership strongly preferred. Electronic Health Record experience required, Epic experience preferred.
License/Certifications
Current Registered Nurse licensure in the State of Washington required. Certification in Infection Control required. Valid driver’s license required.
Other Skills
Emotional maturity and professional ability to develop positive interpersonal relationships with patients, staff, and visitors. Must communicate effectively in both verbal and written form. Familiarity with general hospital and/or clinic functions and structure.
Physical Demands and Work Environment
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to interact with others and to communicate effectively. It requires the employee to talk and hear, and at times to be active with an ability to move through-out the facility. While performing the duties of this job, the employee is also required to sit for periods of time; when working in an office. Repetitive tasks such as typing, sitting, answering phones, and interacting with computers and computer systems is a function of the position. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to focus. This position requires working in an indoor, environmentally controlled environment when in the office.Skagit Regional Health offers a comprehensive benefit package including medical, dental, vision, 457b/401a (retirement), long term disability, and paid time off to all employees holding an FTE of 20 or more hours per week. Eligible employees also receive sick time pay.
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