Professional Liability Claims Manager

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Professional Liability Claims Manager

The candidate manages a Professional Liability and General Liability caseload, from inception to closure, of Hartford HealthCare’s claims and suits through HHC’s Claims Management Department. Responsible to assist in the implementation, monitoring and maintaining of medical claim insurance program (the “Captive”), which consists of professional liability and general liability claim management for program insureds. Assists in maintaining financial security of said insurance program while fostering its growth by handling medical professional liability claims/suits to conclusion. Should have working knowledge of insurance coverage, medical and legal terminology and application. Builds a strong foundation for each claim in order to apply coverage properly, determine liability, and make claim settlements as necessary within authority. Requires independent judgment in determining when to consult claims management when confronted with non-routine situations or problems. Possesses the ability to work in a fast-paced, growing and changing environment. Consistently exhibits behaviors and communication skills consistent with core values. Interacting with claimants, insureds, attorneys, risk management and underwriting. Verifying coverage information and/or resolving coverage issues. Gathering loss information and evaluating medical liability exposures, case value and reserve accuracy. Presenting complex litigation, reserve and strategy recommendations to claims leadership if necessary. Attending defense meetings, settlement conferences, trials and mediations as directed. Directing outside counsel, developing and monitoring defense budgets, applying legal billing guidelines in analysis of invoices, and reviewing and approving defense charges. Directing and implementing defense tactics and strategies. Promptly communicating with Department Director regarding areas where quality improvement activities and/or risk mitigation initiatives affecting firm may be warranted. Should have College Degree, prefer a Master’s Degree, JD. Should have 5+ years insurance claim management/risk management handling Professional Liability claims including medical malpractice, from start to closure, including initial investigation, establishing reserves, and negotiation of settlements. Should have 7+ years healthcare claim management/risk management or 5 years healthcare claim experience with JD. Proven ability to mediate and negotiate settlements is preferred. Licensure, Certification, Registration: CT State Multi-Line Casualty License or equivalent Insurance Industry Certifications.LEAN certification is preferred. Demonstrated knowledge of the healthcare and insurance industries including insurance coverage, claim handling principles, insurance/legal statutes, medical and legal terminology, and regulatory environment. Must possess strong analytical, problem-solving and organizational/time-management skills. Knowledge of Microsoft Office applications and ability to learn new software programs.

Additional Information

Requisition ID: 19162886

Company info

Hartford HealthCare.
One State Street, Suite 19
Hartford
Connecticut
United States 06103
Website : https://hartfordhealthcare.org