Manager, Risk Management and Claims

Senior Lifestyle•Chicago, IL

About The Position

The Manager, Risk Management and Claims oversees incident review, factual investigations, insurance reporting, and claims and litigation coordination across Senior Lifestyle communities and lines of coverage. The position partners with the General Counsel, operations, clinical and HR teams, community management, providers, brokers, adjusters, carriers, and counsel. It investigates incidents promptly, identifies and escalates potential claims, supports timely resolution, guides compliance with applicable regulations, assists with dispute resolution, and helps implement corrective actions. This hands-on role requires senior living or healthcare liability experience, sound judgment, confidentiality, and consistent follow-through. The manager reviews incident reports, conducts or coordinates investigations, maintains investigation files and a claims register, supports insurance notices and litigation preparation under counsel’s direction, monitors claims and deadlines, analyzes trends, and works with clinical and operations leaders on corrective actions and process improvements. The role also trains community teams on reporting, documentation, and investigation expectations. Travel to communities is required.

Requirements

Minimum five years of experience.
Risk and claims management experience, including at least two years of insurance experience, such as with a carrier, broker, or third-party administrator.
Experience with MS Office, including Word, Excel, PowerPoint, and Access.
Effective verbal and written communication skills and the ability to interact with internal and external business partners.
Strong analytical and problem-solving skills.
Excellent organizational skills, including the ability to prioritize and coordinate multiple tasks and projects.
Ability to make independent decisions and solve problems based on precedents and established guidelines.
Ability to recognize when to refer issues to a supervisor and when to handle them independently.
Ability to work both in a team environment and independently.
Ability to maintain confidentiality.
Ability to interact professionally and effectively with all levels of the organization.
Travel to communities is required.

Nice To Haves

Bachelor’s degree from a four-year college, or an equivalent combination of education and training.
Relevant background in corporate or regional risk management for a senior living operator, professional liability claims work for a carrier, broker, or third-party administrator, or healthcare risk consulting.
Experienced litigation paralegals with demonstrated insurance reporting and incident investigation experience will also be considered.
A nursing background is a plus but is not required.
Excellent knowledge of claims management, HR practices, and workers’ compensation laws and regulations.

Responsibilities

Review incident reports for completeness, accuracy, severity, and liability exposure; obtain missing information and assist communities with accident investigations and reporting.
Conduct and coordinate factual investigations, including interviews, timelines, records review, and witness identification.
Work with clinical and operations leaders to assess contributing factors and immediate follow-up needs.
Escalate matters under established criteria to the General Counsel, clinical and operations leadership, or carriers.
Maintain organized investigation files and track open items to completion.
Preserve records, communications, video, and other evidence under established protocols and counsel’s direction.
Review claims in online systems daily, identify reportable incidents, claims, and circumstances, and assist the General Counsel with timely, accurate insurance notices and supporting materials.
Track acknowledgments and follow-up requests, and maintain a claims register with status, key dates, assigned adjusters and counsel, and action items.
Monitor claims activity and deadlines, obtain updates, escalate significant developments or delays, and assist counsel with factual summaries for evaluation, mediation, and resolution.
Under counsel’s direction, coordinate discovery records, factual information, and identification of witnesses and custodians.
Protect sensitive information and follow counsel’s instructions regarding confidentiality, privilege, and document preservation.
Analyze incident and claims trends, frequency, and severity by region and community; identify recurring causes and reporting gaps and report significant matters, trends, and corrective actions to the General Counsel.
Partner with clinical and operations leaders to develop and track corrective actions and initiatives to reduce claim frequency and severity.
Improve policies, reporting, investigations, escalation criteria, and claims workflows.
Train and guide community teams on reporting, documentation, and investigation expectations.
Perform other duties as assigned.