This position is incentive eligible.
Do you want to join an organization that invests in you as a Claims Director? At HCA Healthcare, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.
Job Summary and Qualifications
This position is one of the leadership roles in the HCI Claims Department and in the larger Risk & Insurance Department. As the Director of Claims, you will be responsible for the overall management of a segment of the Company's professional liability claims. This includes directly or indirectly supervising 4-10 claims professionals, conformance to department standards and performance against established metrics. You need solid experience managing healthcare liability claims, is familiar with hospital operations and has demonstrated management and leadership ability.
Job Responsibilities:
Quality
Handle high severity cases and perform file audits of professional claims staff and outside legal counsel.
Assure accountability among the department for appropriate documentation within and maintenance of the electronic claims system.
Enforce the department and company strategy and philosophy for effective claims management.
Ensure a regular diary process is maintained within the team.
Utilize monthly loss runs and/or auditing of claims assigned to team members to maintain performance accountability against established metrics.
Prepare Case Assessment Reports for recommendations for reserving and authority, as well as reviewing/assisting team members with reports to ensure presented in professional manner.
Service
Manage a segment of the Company's liability claims to achieve fair, efficient and timely resolution of all matters.
Maintain current licensure needed to perform duties as required in territory assigned.
Attend mediations and trials, strategically positioning the case to resolution.
Prepare staff for presentations for authority requests to be presented to management.
Perform other duties as assigned by the AVP of Claims.
People
Supervise a team of 4-10 claims professionals that collectively account for a segment of the Company's professional liability claims and responsibility and accountability for millions in case reserves.
Coach and mentor claims professionals, supporting and encouraging them in their personal development goals.
Hire and supervise directly and via the team: outside defense counsel and claim investigators within established guidelines.
Effectively participate and counsel team members as appropriate, in settlement negotiations, mediations, arbitrations and trials as required for optimal outcomes.
Maintain current knowledge of laws and rules affecting liability claims management decisions; educate and train staff.
Develop and maintain effective, efficient and respectful working relationships with local Risk Managers, Patient Safety Directors, CEOs and Division leaders.
Build and maintain strategic alliances and collaborative partnerships with the HCI Risk Management team, HCA Legal Department, Clinical and Physician's Services Group and other corporate departments that will mutually benefit the Claims Department and the organization
Serve as the chairperson and/or participate in committees or task forces as assigned.
Integrate and counsel team members on newly developed projects affecting claims and overall company operations (e.g. DCCP, PSO).
Finance
Responsibly utilize case reserving and settlement authority within established levels individually and for his/her team and ensure appropriate documentation of the same.
Assure accountability among the department for approval of claims expenses and litigation fees.
Identify appropriate cases and prepare those for presentation to the AVP, VP and Claims Committee for settlement authority and to excess and reinsurers as needed.
Requirements:
Bachelor's degree is required
7+ years of experience in claims' management, preferably in healthcare and preferably in a multi-state environment; knowledge of hospital and healthcare operations is required
Juris Doctorate is a plus
Certification in risk management or insurance, i.e. CPHRM, ARM, CPCU, etc is preferred
Adjuster's license in states in which HCI operates, especially Florida is preferred
Must be eligible to apply for and obtain adjuster's license(s) in assigned jurisdictions is required
The position may require up to 10% travel to meet with business associates, attend claims settlement meetings, seminars, mediations, trials and participate in committees, task forces, etc
Benefits
HCA Healthcare, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
Wellbeing support, including free counseling and referral services
Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
Savings and retirement resources , including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts
Learn more about Employee Benefits (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)
Note: Eligibility for benefits may vary by location.
HCA Healthcare (Corporate), based in Nashville, Tennessee, supports a variety of corporate roles from business operations to administrative positions. Like our colleagues in any HCA Healthcare hospital, our corporate campus employees enjoy unparalleled resources and opportunities to reach their potential as healthcare leaders and innovators. From market rate compensation to continuing education and career advancement opportunities, every person has a solid foundation for success. Nashville is also home to our Executive Development Program, where exceptional employees are groomed to take on CNO- and COO-level roles in our hospitals. This selective program focuses on ethics, leadership and the financial and clinical knowledge required of professionals at this level of the industry.
HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
"Good people beget good people."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Claims Director opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring!
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
