Adventist Health-posted 2 months ago
Roseville, CA
5,001-10,000 employees

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect. Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work. The position involves analyzing complex and/or technically challenging medical malpractice/general liability claims and resolving complex and/or severe injury claims. It requires coordinating case management within established standards and industry best practices while managing total claim costs and providing high levels of customer service.

  • Analyzes nature and extent of investigation necessary to evaluate liability and damages.
  • Determines the need for and retains experts to evaluate the standard of care/damages.
  • Develops, updates and executes case specific investigation plan and negotiates settlement of the claim.
  • Applies advanced technical knowledge to solve complex problems for a department.
  • Coordinates legal defense by assigning counsel and coordinates support for investigation.
  • Reviews attorney invoices and monitors counsel for compliance with organization policies and guidelines.
  • Calculates and assigns timely and appropriate reserves for claims.
  • Monitors reserve adequacy throughout the life of the claim.
  • Recommends and implements settlement strategies.
  • Involves structured settlement professionals as necessary to maximize settlement and identifies opportunities for subrogation, contribution, recovery and other case management opportunities to mitigate total claim costs.
  • Ensures claim file documentation is timely and accurate.
  • Creates initial notice to reinsurers and provides timely updates on case status.
  • Performs other job-related duties as assigned.
  • Bachelor’s degree or equivalent combination of education/related experience: Required
  • Master’s Degree or Juris Doctor: Preferred
  • Seven years’ liability claims management experience: Preferred
  • One year's leadership experience: Preferred
  • Experience with legal matters and complex litigation: Preferred
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