Manager, Claims & Litigation

Summit Health CityMD•New Providence, NJ

12d•Hybrid

About The Position

This role provides complete national claim loss services for providers and employees of VillageMD and its associated entities. The Manager, Claims & Litigation will investigate and evaluate complex medical professional liability, general liability, and auto liability claims, keeping the Vice President apprised of all pending matters. This position also involves preparing and reviewing responses to written discovery, coordinating responses to subpoenas, assisting in identifying personnel for deposition testimony, and assisting in responding to medical record production requests. The role requires monitoring trials, attending pre-trial proceedings, mediations, and arbitrations as necessary, and interacting with other departments to facilitate and coordinate responses to trends in filed litigation. Additionally, the manager will identify potential issues in filed litigation and direct information to the appropriate staff. The role includes supervisory responsibilities, directly supervising and mentoring a Claims Coordinator responsible for managing complex dockets. The manager will provide expert direction on day-to-day claims management, offering specific, actionable guidance on evaluating claims and securing appropriate reserve and settlement authorities. They will also advise the coordinator on settlement negotiation tactics and review proposed settlements to ensure outcomes align with the organization's financial objectives. General job functions include claims management monitoring and supporting external counsel handling MPL and GL claims, maintaining litigation files and litigation tracking spreadsheets, and ensuring the confidentiality of all information.

Requirements

Bachelor’s Degree required
6+ years of experience in claims (medical malpractice experience preferred), or health care risk management insurance experience.
Knowledge of medical, legal, and insurance terminology is required.
Excellent assessment, communication, organization and teaching skills.
Ability to communicate in English, both orally and in writing
Ability to perform duties with time limitations with a high degree of accuracy.
Strong attention to detail.
Standard Office Equipment (Phone, Fax, Copy Machine, Scanner, Email/Voice Mail) and Office Technology in a Windows-based environment.

Nice To Haves

paralegal certificate and/or adjuster license preferred

Responsibilities

Provide complete national claim loss services for providers and employees of VillageMD and its associated entities.
Investigate and evaluate complex medical professional liability, general liability, and auto liability, keeping the Vice President apprised of all pending matters.
Interview providers, staff, witnesses, and other appropriate parties to obtain information used to assess liability exposure.
Document files regarding results of investigation.
Secure records for investigation and evaluation of cases.
Evaluates cases for appropriate disposition and seeks authority for settlement from Vice President.
Determines and implements negotiation strategy and negotiates settlements within authority level.
Manages third-party commercially insured claims in coordination with the retained TPA.
Directs and monitors activities of defense counsel, external insurance coordinators, and agent/brokers.
Prepare and review responses to written discovery including interrogatories, notices to produce, and requests for admission.
Coordinate responses to subpoena duces tecum and ad testificandum with appropriate departments.
Assist in identifying appropriate personnel for production for deposition testimony.
Assist in responding to medical record production requests in pending litigation.
Monitor trials and attend pre-trial proceedings, mediations, and arbitrations, as necessary.
Interact with other departments as necessary to help facilitate and coordinate responses to trends in filed litigation.
Identifies potential issues in filed litigation and direct information to the appropriate staff.
Directly supervise and mentor Claims Coordinator responsible for managing complex dockets encompassing medical malpractice, general liability, and auto claims.
Provide expert direction on day-to-day claims management, offering specific, actionable guidance on evaluating claims and securing appropriate reserve and settlement authorities.
Advise coordinator on settlement negotiation tactics and review proposed settlements to ensure outcomes align with the organization's financial objectives.
Claims management monitoring and supporting external counsel handling MPL and GL claims.
Maintains litigation files and litigation tracking spreadsheets for all claims handled.
Ensures confidentiality of all information at all times