TeamHealth is named among the Top 150 Places to Work in Healthcare by Becker's Hospital Review. Newsweek Magazine recognizes TeamHealth 'as one of the greatest workplaces for diversity, 2024' and TeamHealth is also ranked as 'The World's Most Admired Companies' by Fortune Magazine. TeamHealth, an established healthcare organization is physician-led and patient focused. We continue to grow across the U.S. from our Clinicians to Corporate Employees. Join us. This position is remote OVERVIEW: The Director of Claims is responsible for oversight of the Professional Liability Insurance (PLI) Claim Management Program for TeamHealth; supervision of the Claim Management technical (Claim Managers), and ensuring effective communication with National Support Center and Operational Group Leaders. The Director serves as the Claim Review Committee Secretary. The Director assists with claim management statistical analysis, Department strategic/operational planning including targeted goals and metrics, and evaluating and integrating M&A's. ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Provides strategic oversight of all technical claim management activities
- Provides technical and administrative supervision of the Claim Managers
- Performs analysis of historic claim data, in conjunction with the Vice President, Finance Team, Claim Data Analyst & Application Manager, and Chief Analytics Officer, to identify trends and outliers in order to develop risk mitigation strategies. Recommends development of additional metrics as needed
- Acts as a liaison between Claim Department and Group Operational Leadership
- Responsible for administrative oversight of approved panel counsel and TeamHealth Litigation Guidelines, including analyzing defense counsel performance
- Conducts routine training of Claims Management staff, affiliated clinicians, and operational leaders
- Assists in the preparation of large exposure claims to be submitted to the Claims Review Committee
- Conducts periodic file reviews to ensure claim data accuracy
- Oversees Gallagher Bassett activities an ensures compliance with TPA contract requirements and service expectations
- Assists with design and implementation of claim management business application, Origami Risk
- Completes special projects and other duties as assigned
- Creates protocols to ensure compliance with system security
- Updates claim inventory and transactional data from commercial insurers
- May directly manage a small inventory of active claims and litigation
- Maintain up to date knowledge on liability laws and practices and participates in professional organizations
QUALIFICATIONS / EXPERIENCE:
- Bachelor's degree in business, management sciences, Healthcare, or related/equivalent field experience.
- Minimum of 10 years of medical professional liability claims experience required with at least five years at a supervisory level
- Demonstrated leadership and management skills
- Advanced negotiation skills
- Advanced knowledge of insurance coverage, concepts and claim resolution process
- Intermediate proficiency with personal computers and Microsoft Office programs
- Excellent written and verbal communication skills
- Excellent organizational and interpersonal skills.
- Excellent analytical and detail skills; critical thinking relating to comparative data; strong organizational, judgement, problem solving and decision making skills
- Ability to work under tight deadlines, prioritize work; handle stress and conflict
- Resourcefulness, ingenuity, strong decision making and problem solving skills
- Ability to multi-task in a fast paced environment
- Ability to work in a team oriented environment