Manager, Claims & Litigation

Summit Health•New Providence, NJ

20h•$111,000 - $139,000•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 includes interviewing relevant parties, documenting investigations, securing records, evaluating cases for disposition, and negotiating settlements. The role also involves managing third-party claims, directing defense counsel, and preparing responses to written discovery and subpoenas. Additionally, the position will assist in identifying personnel for deposition testimony and responding to medical record production requests. The manager will monitor trials, attend pre-trial proceedings, mediations, and arbitrations as necessary, and interact with other departments to address litigation trends. The role also involves identifying potential issues in filed litigation and directing information to appropriate staff. Furthermore, the Manager, Claims & Litigation will directly supervise and mentor a Claims Coordinator responsible for managing complex dockets and will provide expert direction on claims management, evaluation, reserves, and settlement authorities. The manager will advise on negotiation tactics and review proposed settlements. General job functions include monitoring and supporting external counsel, maintaining litigation files and tracking spreadsheets, and ensuring 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.