Managing Director Strategic Claims Oversight - Healthcare Severity

Essential Duties & Responsibilities 

Performs a combination of duties in accordance with departmental guidelines: 

• Leads and directs the work activities and has full management responsibility for the performance of the Severity Team.  Exercises full management authority, including performance reviews, pay decisions, recruitment, discipline, termination and other personnel actions. 

• Oversees the most complex investigations of claims, liability and damages and determines claim strategy, including if claim should be settled or litigated. Develops and directs the execution of the litigation management strategy. 

• Develops and maintains collaborative working relationships with internal and external business partners including Operations, Underwriting, Actuary and Risk Control and regularly shares claims outcomes, trends, legal developments and other relevant business updates.   

• Responsible for the ongoing management of staff by attracting talent, setting clear direction, providing appropriate guidance, managing performance, recognizing contributions, and developing capabilities .    

• Ensures quality by assuring compliance with best practices, and developing and delivering training as needed. 

May perform additional duties as assigned. 

Reporting Relationship 

AVP or above 

Skills, Knowledge & Abilities 

• Senior level knowledge of the theories, principles, practices and procedures of claim and litigation management within an insurance organization.     

• Excellent technical and product specific expertise, claims resolution skill and knowledge of insurance and claims principles, practices and procedures.    

• Excellent verbal and written communication and presentation skills.  

• Excellent negotiation, consultative and facilitation skills with the ability to effectively interact with all internal and external business partners.     

• Ability to exercise independent judgment, and to work with and maintain confidential and sensitive information.   

• Excellent analytical and problem solving skills, and senior level skill in managing ambiguous situations and issues.    

• Creativity in resolving unique and challenging business problems  

• Proven ability to take a proactive long-term view of business goals and objectives in order to achieve strategic business results.     

• Knowledge of Microsoft Office Suite and other business-related software.   

• Value driven to provide superior solutions to internal and/or external customers.  

• Acts with a sense of urgency to advance priorities of the organization.   
  Helps other to excel through collaboration and building strong relationships.   

• Raises expectations of self and others by continuously learning and broadening industry and technical skills. 

• Strong management skills with the ability to coach, mentor and develop subordinate staff.  

• Independent judgment and ability to effectively manage internal and external business relationships.  
    

Education & Experience 

• Bachelor's degree with JD preferred or equivalent experience. 

• Admission to the bar of at least one state preferred.    

• Typically a minimum of ten years of claims or legal experience with a proven track record of positive results.