at Illinois Health and Hospital Association in Naperville, Illinois, United States
Job Description
Main Function:
Responsible for the management of professional and general liability claims and litigation for member hospitals and insured physicians. Management of large hospital accounts and/or self-insured accounts requiring a high level of expertise and independence.
Outline of Responsibilities:
Manage claims and litigation for hospital members, insured physicians and physician groups
Presuit evaluation of claims including investigation, medical record review, liability analysis, expert retention and discussion with insureds and clients
Retention and supervision of outside defense counsel for claims in litigation
Responsible for case strategy and implementation and oversight of case action plan in collaboration with defense counsel
Analyze claim submissions from clients and establish and maintain claim files and reserves
Notification to excess/reinsurers as required and discuss claims as requested
Evaluation of excess and captive layers including monitoring of aggregate erosion
Negotiate settlements with claimants, families or attorneys as appropriate and within prescribed authority levels
Evaluation of defense counsel bills and authorize invoices or settlement check requests for payment
Communicate with AVP regarding loss reserve increases, large losses, adverse claim development, and status of litigation and trials
Prepare and present claims at quarterly reviews and for roundtable discussions with staff
Prepare and present claims to Claims Committee or Board as required for settlement authority
Attend self-insured clients' board, committee or claim meetings as requested
Attend pre-trials, mediations or trials as required
Prepare reports for MMSEA, Illinois Department of Insurance, Illinois Department of Financial and Professional Regulation and the National Practitioner Data Bank
Prepare for and participate in client board, committee or claim meetings as requested
Prepare and present educational presentations for risk management meetings and/or for clients as requested
Assist AVP with contract and subpoena reviews
Provide guidance and direction to claims consultants
Collaborate with risk management and underwriting staff regarding claim trends and renewal issues
Responsibilities may include assignment to manage and coordinate all claims reporting required by the Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA, Section 111), including education of staff and clients, registration, testing, monthly queries and reporting
May be called upon to provide back-up support in the AVP's absence for EPCS and Acuity approvals
Other duties as defined
Qualifications:
Bachelor's Degree and at least 5 years of prior claims or litigation experience required. Juris Doctor with medical malpractice litigation experience preferred. Knowledge of Illinois law and insurance principles a plus. Proficient in Microsoft Office Suite. Excellent verbal and written communication skills required. Must possess and exercise analytical and critical thinking skills and be a team player who can manage multiple projects. Routine travel within Illinois is required.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other legally protected status.
We offer a competitive compensation package, including excellent benefits. Qualified candidates must apply online: .
Equal Opportunity Employer - race, sex, veteran or disability status, gender identity, sexual orientation
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