Senior Risk Manager / Claims Manager - Hybrid

Surgery Partners, Inc•Brentwood, TN

9d•Hybrid

About The Position

This is a hybrid position based at our beautiful corporate office located in Brentwood, TN, with on-site work required Monday through Wednesday. The Senior Claims Manager ensures disciplined, timely, and consistent handling of every claim by serving as the centralized point of contact for all malpractice matters—from intake through closure. They manage all insurer communications, update each claim every 30 days with status summaries, legal counsel reports, and next steps, and ensure complete and accurate documentation. The role also involves completing and maintaining a required claim evaluation checklist for every claim, overseeing the strategic trajectory of each claim through investigation and analysis, and supporting Centers and the Enterprise by providing high-level claims handling expertise and risk trend analysis. A critical function is generating analytical reporting and trend evaluation for cost reduction initiatives, conducting post-mortem analysis for continuous improvement, and identifying systemic patterns in claims to reduce future losses and insurance costs.

Requirements

5-10 years of experience in medical malpractice claims (with either healthcare risk management or insurance carrier), or self-insured public health care company
Bachelor's degree in nursing, business, finance and/or economics preferred or equivalent work experience
Proficiency in insurance claims management software and systems
Familiarity with Microsoft Office Suite (Excel, Word, Outlook) and other productivity tools.
Detail Oriented - Capable of carrying out a given task with all necessary details to get the task done well
Team Player - Works well as a member of a group
Self-Starter - Inspired to perform without outside help
Excellent communication skills and ability to take a global approach to resolving difficult situations.
Understanding of financial implications to a company for losses and claims
Partnering with carriers and/or third-party claims administrator, counsel, and operators for loss prevention and claims management

Responsibilities

Serving as the centralized point of contact for all malpractice matters—from intake through closure.
Managing all insurer communications, including first notice reporting, large‑loss notifications, and reserve recommendations.
Updating each claim every 30 days with status summaries, legal counsel reports, and next steps and expected timelines.
Ensuring complete and accurate documentation to support both defense efforts and insurance carrier expectations.
Completing and maintaining a claim evaluation that addresses settlement value range and reserve adequacy, jury verdict research for comparable cases, likelihood of defense success at trial, relationship and employment status of co‑defendants, deductible and annual retention remaining, and exposure to excess layers and carrier involvement.
Collecting and analyzing medical records, treatment details, statements, and internal documents.
Sequestering medical equipment and records as needed.
Monitoring and challenging litigation strategies to ensure alignment with corporate risk and financial objectives.
Documenting all investigatory steps, coverage analysis, settlement positions, and final resolutions.
Guiding Centers through the claims process and required documentation.
Providing insight into how each claim affects exposure, reserves, and future premiums.
Educating leadership teams on emerging litigation trends and best practices.
Serving as a resource for clinical, HR, and legal leaders when adverse events arise.
Identifying systemic patterns in claims (procedure type, provider involvement, documentation gaps, etc.).
Providing actionable recommendations to reduce future claims exposure and improve clinical processes.
Developing strategies to reduce ALAE (Allocated Loss Adjustment Expenses) through early intervention, negotiation positioning, mediation strategy, and creative settlement approaches.
Supporting the insurance renewal process by demonstrating strong internal controls and documented oversight.
Conducting a post-mortem review for every significant claim that is settled to assess what went wrong clinically, operationally, or procedurally, whether documentation or communication issues contributed, whether early resolution would have reduced cost, and what corrective actions can prevent recurrence.