VP, Claims

Jackson Healthcare • Alpharetta, GA

3d

About The Position

The VP, Claims will own the strategy and execution of our claims function across our 22 operating companies. This covers the medical professional liability exposures of physicians, advanced practice providers, nurses, therapists, pharmacists, and anesthesia professionals practicing in every state and virtually every clinical specialty, as well as the ancillary general liability, automobile, and cyber claims arising across the enterprise.

Requirements

• Significant senior leadership experience in healthcare medical professional liability claims, including direct litigation oversight and complex, multi-jurisdictional matters.
• Undergraduate degree in a related field.
• 10 – 15 years of demonstrated success leading claims teams, managing third-party administrators and defense counsel, and partnering with executive leadership on high exposure decisions.
• Deep working knowledge of reserving practices, captive and/or self-insured retention program economics, and the regulatory landscape governing healthcare claims.
• Comfort and curiosity with data, analytics, and technology — including the willingness to challenge analytic output, sponsor better tools, and lead a function in which insight from Origami and emerging AI is part of the daily fabric.
• A builder’s mindset — the willingness to question, to simplify, to design rather than maintain.

Nice To Haves

• A Juris Doctor (JD) — bringing the legal acumen to engage substantively with defense counsel and shape litigation strategy across jurisdictions.
• A Registered Nurse (RN) or comparable clinical credential — bringing the clinical fluency to engage credibly with physicians, advanced practice providers, and operating company leaders.
• Experience standing up or substantially reimagining a self-administered claims function, including the transition from a third-party-administered model.
• Working familiarity with Origami or comparable RMIS platforms, and fluency with claims analytics and emerging AI applications in claims operations and litigation support.
• Healthcare staffing, locum tenens, or multi-state delivery-model exposure.
• Industry credentials such as CPCU, ARM, AIC, or RPLU.

Responsibilities

• Partner closely with the Chief Risk Officer to set and execute the enterprise claims strategy across Medical Professional Liability (MPL), general liability, workers compensation, automobile, and cyber lines, aligning claims philosophy with business, clinical, and reputational priorities across the operating companies.
• Serve as Jackson Healthcare’s senior internal expert on healthcare professional liability, providing direct counsel to executive leadership and operating-company presidents on significant exposures, jurisdictional dynamics, and emerging risks across our national workforce.
• Advance our claims function from incident administration toward integrated risk intelligence — leveraging the Risk Team’s investment in Origami (RMIS) and analytics to identify patterns, inform actuarial and insurance-purchasing decisions, and close the feedback loop with operating companies and recruiting teams.
• Bring a forward-leaning posture toward technology, data, and emerging AI — comfortable consuming and challenging analytic output, championing tools that improve claim outcomes, and partnering with the Risk Team’s data and Origami specialists to translate insight into action.
• Design and lead the end-to-end claims lifecycle: intake, FNOL, investigation, reserving, litigation strategy, settlement, and closure — with governance, decision rights, and escalation pathways that scale across decentralized operating companies.
• Champion the continued maturation of Origami as the authoritative system of record —partnering with the Risk Team’s analytics resources to advance severity scoring, workflow automation, integrated data feeds, and the evaluation of emerging AI applications for triage, document review, summarization, and predictive insight.
• Develop and codify SOPs, role-delineation frameworks, and reporting cadences that bring discipline and clarity to a function operating across more than 20 companies.
• Lead defense counsel selection, litigation strategy, and legal-spend management across multi-jurisdictional matters spanning the country.
• Lead and develop our two in-house claims professionals — both deeply experienced, committed, and integral to Jackson Healthcare — into a high-performing strategic team, and thoughtfully grow the function as the operation scales.
• Manage the transition and ongoing relationship with our external claims administrator, ensuring continuity, knowledge transfer, and a smooth, respectful evolution toward a mostly self-administered model.
• Build constructive working relationships with operating-company presidents, medical staff services and HR leaders, defense counsel, brokers, and our captive insurance partners.
• Establish and report on the metrics that matter — cycle time, severity, indemnity leakage, litigation outcomes, expense management, vendor performance — at the executive and Board levels.
• Own the financial performance of the claims program, including reserve adequacy, loss forecasting, and total cost of risk.
• Strengthen audit readiness, regulatory reporting (NPDB, MMSEA Section 111, state specific requirements), and compliance discipline across the program.

Benefits

• We’re always looking to add new talent to our teams.
• We value diverse professionals at all levels and across multiple disciplines and areas of expertise, who have strong leadership skills, align with our culture, and are committed to excellence.

What This Job Offers

• Job Type: Full-time
• Career Level: Executive