Full-Time
Sr. Professional Liability Medical Claims Manager Remote
Many States Eligible
Posted on 9/11/2025
Providence
10,001+ employees
Not-for-profit health system with hospitals
No salary listed
Tukwila, WA, USA
Hybrid
Remote stated in description but many states eligible; multiple listed states in description; only Renton WA appears as city in provided Location fields; infer remote but not fully remote: hybrid? The description shows Remote Many States Eligible; however location entries include renton, wa. The job title says Remote Many States Eligible. Travel requirement HYBRID vs REMOTE: The description says remote; instruction says fully remote if 100% work from home. It says remote; but many states eligible implies remote possible. We'll mark REMOTE as travel_requirements? The rules say remote true only if candidate can work from home 100% of the time. Since many states eligible remote, but there are in-person? Unclear. We'll set travel_requirements=REMOTE and remote true in location. But locations array should include Renton WA with remote true. Ok set remote true. additional_location_info include
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- Bachelor's Degree in Business Administration, Finance, or another related field of study -OR- equivalent combination of education and experience in the insurance industry; claims management; or legal handling of claims issues.
- 7 years of relevant general and professional liability claims processing or management experience
- Investigate, evaluate, and manage professional, general, and other liability claims under the PSJH Insurance Program: Communicate with patients, claimants, caregivers, providers, leadership
- Review and analyze medical records, interview witnesses, assist with the discovery process and communicate with facility risk manager regarding evaluation and investigation
- Be responsible for writing insurance policy coverage letters
- Analyze insurance policy documents to address coverage
- Set appropriate indemnity and expense reserves
- Select appropriate medical experts for case review
- Develop a plan of action for assigned claims and update the claims file following all material changes in status
- Review and approve statements for services and take proper steps to pay vendors
- Inform Senior Manager Operations of large or complex claims and claims with potential for media exposure
- Report claims with potential excess exposure to excess insurers
- Ensure compliance with relevant claims reporting procedures and required regulations
- Work with defense attorneys specializing in defense of medical negligence claims
- Have direct responsibility to foster teamwork, operational excellence, and effective communication within the claims team, including other Claims Managers, Claims Reps and Claims Specialists
- Maintain complete documentation for each matter: Develop and document for each claim or lawsuit a plan of action for resolution by settlement, trial, or other means
- Maintain the electronic file including all material communication, correspondence, analysis, expert opinions, interview summaries and all other material documents in accordance with the Claims Policies and Procedures Manual
- Coordinate with facility leadership, risk managers, defense counsel and others: Select defense counsel when appropriate from approved counsel list
- Coordinate and consult with risk management on disclosure conversations with patients and families
- Obtain authority for settlement or trial in accordance with policies and procedures or facilitate claims roundtables
- Assist in Regional CEO Conferences with Senior Manager Operations
- Facilitate and participate in case reviews with Risk Managers upon request
- Resolve claims in accordance with policies and regulations: Negotiate settlements
- Monitor trials and advise on disclosure and early resolution opportunities
- Report to relevant federal, state, and local regulatory agencies as required
- Close files in accordance with internal policies and procedures and facilitate appropriate reporting to NPDB and state agencies
- Participate in department and claims team projects as assigned to develop and improve procedures, policies; to improve efficiency of department work; and to assist the SVP Chief Risk Officer and Senior Manager Operations as needed
- Provide Input to Reduce Risk: Provide feedback and recommendations, evaluations, litigation trends, department policies and procedures, system-wide claims and litigation processes, and appropriate System risk management issues
- Provide input for quality and patient safety projects, through the Risk & Integrity Services division and Risk, Claims, & Insurance department
- Certified Professional Healthcare Risk Management (CPHRM)
- 10+ years of medical malpractice experience
- Insurance Carrier Experience
- Third Party Professional Negligence Claims Experience
- Experience handling Medical Negligence Professional Liability Claims
- Experience handling Complex General Liability Claims
- Experience Investigating, evaluating, and negotiating medical negligence claims
- Experience working with defense attorneys specializing in defense of medical negligence claims
- Experience analyzing medical professional and general liability insurance policy documents and addressing coverage
- Experience writing medical professional and general liability insurance policy coverage letters
- STARS / Riskonnect or similar claims management software experience
Providence Health & Services runs a large network of not-for-profit hospitals and clinics across seven western states, delivering a full range of health and social services. It provides inpatient and outpatient care, home and hospice services, substance abuse programs, and mental health treatment through its integrated network, reinvesting revenue back into care. Its not-for-profit, faith-based model means earnings are directed toward community care rather than shareholders, and the system focuses on scale and efficiency to serve more people. Its goal is to improve financial stability while expanding access and quality of care for a broad range of communities through higher patient volumes and cost-saving measures.
Company Size
10,001+
Company Stage
N/A
Total Funding
N/A
Headquarters
Renton, Washington
Founded
1859
Simplify's Take
What believers are saying
- Higher patient volumes narrowed Providence’s operating loss in fiscal 2025.
- ARPA-H participation gives Providence access to behavioral-health AI research and data partnerships.
- Workforce training investments can improve retention and reduce access constraints.
What critics are saying
- Washington’s pregnancy-accommodation lawsuit creates legal, back-pay, and monitoring exposure.
- Providence’s reimbursement pressure and rising labor costs keep margins under strain.
- Behavioral-health data collection faces consent, privacy, and patient-adoption risks.
What makes Providence unique
- Providence operates 51 hospitals and 1,000+ clinics across seven western states.
- Its not-for-profit, faith-based mission emphasizes care for poor and vulnerable communities.
- It is standardizing advanced-practice onboarding with ThriveAP across its APP workforce.
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Providence Seward Mountain Haven ranks No. 2 among Kenai Peninsula County nursing homes in Q1. Providence Seward Mountain Haven was recognized as the No. 2 largest nursing home in Kenai Peninsula County for the first quarter of 2026, the Centers for Medicare and Medicaid Services (CMS) reported. The nursing facility offered 40 beds, three fewer than the Kenai Peninsula County average during the same period, and accommodated an average of 39.1 residents in Q1 2026. Providence Seward Mountain Haven received an overall score of 3 out of 5 from the CMS, trailing behind Alaska's statewide average nursing home rating of 3.2. Heritage Place ranked as the largest nursing home in Kenai Peninsula County in the first quarter, providing 60 beds. South Peninsula Hospital LTC was third by size with 28 beds available. No fines or penalties were reported for Providence Seward Mountain Haven during the first quarter of 2026. Kenai Peninsula County, Alaska, was home to two public nursing homes in total. The U.S. Census Bureau estimates that the nation's older adult population continues rising while the number of younger Americans declines. From 2020 to 2024, the population age 65 and up climbed by 13%, and the number of people under 18 decreased by 1.7%. Over the past century, the country's older population surged from 4.9 million in 1920 to more than 61 million by 2024. A 2021 study found that close to half of Americans in this age group, or about 28 million people, may require long-term services and supports, with more than a third projected to eventually need nursing home care. "Living a long life is something that many of us want and could get," said Jesse Slome, executive director of the American Association for Long-Term Care Insurance, an insurance education organization. "But when we live a long life, the chances of us needing long-term care increase exponentially. But when you need that type of care, there are limited options." Nursing Homes in Kenai Peninsula County as of Q1 | Rank | Nursing Home | Overall Rating | | 1 | Heritage Place | 4 | | 2 | Providence Seward Mountain Haven | 3 | | 3 | South Peninsula Hospital LTC | 5 | Information in this article was obtained from the Centers for Medicare and Medicaid Services. The source data can be found here.
Healthcare veteran Matt Ducsik joins linguava as COO. * 26 May 2026 At a glance AI-assisted overview, optimised for journalists, search & news aggregators Linguava has appointed Matt Ducsik as Chief Operating Officer to enhance its interpreting and translation services for health systems nationwide. Ducsik, previously a Vice President at Providence, will focus on improving interpreter response times and operational support in healthcare settings. This move is significant as it addresses the growing need for reliable interpreter access in emergency and specialty care, aiming to improve patient communication and care quality. Portland, OR - May 26, 2026 Linguava has appointed Matt Ducsik, MPH, as Chief Operating Officer. Ducsik joins the company after more than a decade at Providence, where he most recently served as Vice President of Clinical Institutes, overseeing operational initiatives for service lines across 51 hospitals and 1,000 clinics. The hire comes as health systems face growing pressure to manage interpreter access more reliably across emergency departments, specialty care, and inpatient settings. At Linguava, Ducsik will oversee daily operations as the company expands its interpreting and translation services to additional health systems nationwide. At Providence, Ducsik managed a portfolio representing approximately $14 billion in annual service line revenue and led systemwide initiatives across 51 hospitals and 1,00 clinics. At Linguava, he will focus on strengthening interpreter response times and operational support in high-acuity care settings. "Matt has worked inside large health systems where delays, staffing constraints, and communication breakdowns affect patient care every day," said David Brackett, CEO of Linguava. "He understands the operational realities hospitals are managing because he's been responsible for them himself. That experience will help us work more effectively alongside health systems as they expand language access across clinical settings." Ducsik said his decision to join Linguava was driven by the operational role language access plays in patient care. "In a large health system, a communication breakdown is a clinical risk," Ducsik said. "Language services work best when they're integrated into the way care teams already operate. In settings like emergency medicine or specialty care, clinicians need to be able to connect quickly and communicate clearly without adding more complexity to the workflow." Ducsik holds a Master of Public Health from Portland State University and serves on advisory boards focused on healthcare technology and AI. At Linguava, he will lead operational strategy, technology implementation, and network expansion efforts as the company continues growing beyond the Pacific Northwest. Notes to editors Linguava is a healthcare-focused language services partner that helps providers, health systems, and organizations improve communication, patient experience, and health equity through interpreting, translation, training, and language access solutions. We combine responsive service, qualified interpreters, and deep healthcare expertise to help our clients deliver better outcomes for the communities they serve. Learn more about our services at linguava.com. For more information or to schedule an interview with Matt Ducsik, contact Linguava at [email protected] Get more news like this on Google. Set News By Wire as a 'Preferred News Source' to get quicker access to news that's important.
Providence's Dr. Brian Chesebro named 'Visionary Changemaker' for environmental stewardship. Thursday, May 14, 2026 Award recognizes leadership driving innovation in healthcare sustainability and emissions reduction RENTON, Wash. [May 14, 2026] - Brian Chesebro, M.D., medical director of environmental stewardship at Providence, received the 2026 Visionary Changemaker award today at CleanMed, a national conference for leaders in healthcare sustainability. The award, given by Practice Greenhealth and Health Care Without Harm, is for trailblazing leaders who are driving transformation and innovation in the climate-smart healthcare movement. "It is an honor to be recognized by Practice Greenhealth and Health Care Without Harm for our work at Providence to create a healthcare system that benefits our patients and protects our planet," Dr. Chesebro said. "This award is a testament to the dedication of our entire environmental stewardship team, who are steadfast in driving focused innovation for positive change." A standout achievement by Dr. Chesebro is his landmark research on the environmental toll of commonly used inhalers and development of an innovative tool that makes their chemical and emission impacts easier to compare. The tool translates complex data on greenhouse gases used in metered-dose inhalers into practical information, allowing clinicians to consider safety, effectiveness, cost and patient needs in their usage. The comparison tool is publicly available through the Providence Center for Environmental Stewardship's Toolkits and Resources page as part of the organization's WE SHARE initiative. Dr. Chesebro's leadership and expertise has helped Providence make notable progress in chemical reduction and commitment toward carbon negative by 2030. Since 2019, Providence has reduced carbon emissions by 27 percent, volatile anesthetic gases by 75 percent and nitrous oxide emissions by 90 percent. "Dr. Chesebro is a key leader in achieving Providence's vision of Health for a Better World," said Beth Schenk, chief environmental stewardship officer at Providence. "It is wonderful to see his efforts and impact amplified through this award, and we're grateful to Practice Greenhealth and Health Care Without Harm for that acknowledgement. I look forward to Dr. Chesebro's continued leadership to help Providence steward positive change in healthcare." Visit the Providence Center for Environmental Stewardship for more information about Providence's commitment toward carbon negative.
Providence to participate in federally funded research for early detection of a behavioral health crisis. Thursday, May 14, 2026 Providence will recruit patients to help develop a new AI framework to manage and predict mental health crises, using an app and patient health records RENTON, Wash. [May 14, 2026] - Providence is joining a nationwide, federally funded research project to develop a Large Health Behavior Model, a new class of artificial intelligence designed to advance the prediction, prevention and management of mental health and substance use disorders. The Proactive Health Office of the Advanced Research Projects Agency for Health (ARPA-H) has awarded a $17.9-million contract award under their EVIDENT initiative to Ksana Health of Eugene, Ore. to develop the model. Providence is partnering with Ksana to recruit up to 25,000 adult patients to participate in data collection to inform the model. "Research participants will download Ksana's health behavior app on their smartphone and participate in the app activities for three months," said Staci Wendt, Ph.D., director of research for the Providence Health Research Accelerator. "Participants will also consent to have their health records included in the project." Recruitment will begin this summer across Providence's seven-state footprint. All Providence patients 18 years or older, will be eligible to participate in the two-year project. Despite the enormous burden of behavioral health conditions, which contribute to an estimated 8% loss of annual GDP, the current tools for screening and early intervention are limited. Measurement-based care is rarely implemented in behavioral health settings, and the approaches that do exist rely heavily on the patient discussing their situation with their provider. Patients and providers then navigate a time-consuming trial-and-error process to find effective treatments, with clinicians often unable to reliably predict patient outcomes using clinical judgment alone. Providence, Ksana and other project partners want to change this by developing AI models trained on continuous behavioral data from smartphones and wearables, including patterns of physical activity, sleep, mobility, social connection, and language use linked to large-scale electronic health records. The approach draws on three converging technological advances: the ability to measure behavior at population scale through ubiquitous mobile devices, the aggregation of digitized medical records, and breakthroughs in foundation model architectures that can learn powerful representations from multi-modal data. "Behavioral factors are a leading cause in a large majority of patient conditions that the health care industry treats," said Bill Wright, Ph.D., chief research officer, Providence. "Given the proliferation of smart phones and watches, if we can harness the sensing capabilities of those devices and link behavioral signals to patient health records, we can build a new model of personalized, proactive behavioral health care. This innovation be a major component of the delivery model of the future." MedStar Health Research Institute of Columbia, Md., will recruit patients from its East Coast footprint to bring geographic diversity to the project. The University of Washington's Paul Allen School of Computer Science & Engineering will spearhead the computational modeling effort.
Providence delivers third consecutive quarter of operating gains. Monday, May 11, 2026 Following a positive second half of 2025, the health system continued its turnaround with $111 million in operating income in Q1 RENTON, Wash., [May 11, 2026] - Providence, a not-for-profit health system serving the Western U.S., today announced results for the first quarter ended March 31, 2026. After years of significant headwinds across the health care sector, Providence has been executing a focused turnaround strategy that has delivered its third consecutive quarter of operating gains, including $111 million in net operating income in Q1. Over the past year and a half, Providence has taken deliberate steps to address the polycrisis facing health care in the U.S. by improving its operations, such as streamlining its leadership structure, reducing duplication of services, renegotiating commercial payer contracts and sharpening its focus on core services - including transferring ownership or partnering with others on non-core services. In addition, Providence has improved access to care, length of stay, productivity, expense management and other key operating measures. Together, these efforts are helping Providence build a more resilient and affordable delivery model, one that is well positioned to continue serving local communities in an era of inflation and reduced reimbursement. "I am deeply grateful for the momentum we have created at Providence," said Erik Wexler, president and CEO. "As we have made changes to strengthen our operations, our caregivers have kept the focus exactly where it belongs - on delivering high-quality, compassionate care for our patients. That commitment is paying off and allowing us to continue investing in our Mission, so we can be here for those who are most vulnerable for the long term." For the three months ended March 31, 2026, Providence reported growth in operating revenues, driven primarily by higher patient volumes, improvements in length of stay and increased productivity compared to the prior year. Inpatient admissions increased 5 percent, while case-mix-adjusted admissions also rose 5 percent. Operating revenues totaled $7 billion, up 6 percent year over year[1], reflecting increased volumes and improved rates, while operating expenses decreased 1 percent. Operating EBIDA and net operating income were $482 million and $111 million, respectively, representing improvements of $378 million and $360 million compared to the prior year. These results reflect operational improvements, revenue enhancement and expense management efforts undertaken across the system. Financial market performance generated investment gains of $34 million during the quarter. Remaining steadfast to its Mission, Providence invested $526 million in community benefit during the first quarter of 2026. "Thanks to the dedication of our 119, 000 caregivers and their commitment to focus and discipline, we have begun turning a corner - ensuring our Mission remains strong and Providence is well positioned to serve for the long term," said Providence CFO Greg Hoffman. About Providence Providence is a national, not-for-profit Catholic health system comprising a diverse family of organizations and driven by a belief that health is a human right. With 51 hospitals, more than 1,000 physician clinics, senior services, supportive housing and many other health and educational services, the health system and its partners employ more than 119,000 caregivers serving communities across Alaska, California, Montana, New Mexico, Oregon, Texas, and Washington, with system offices in Renton, Wash., and Irvine, Calif. Learn about its vision of health for a better world at Providence.org. [[1]] Normalized to reflect the formation of partnerships related to its Home & Community Care entities in the first quarter of 2025.