Senior Legal Medical Malpractice Examiner

Job Summary:

Responsible for the administration of medical malpractice and other professional and general liability claims made during the course of conducting company business across the enterprise, having a material impact on legal reserves that are listed as a separate line item on the company's financial statements. The collective value of claims settled, as influenced by this job function, has direct implications for KP's bottom line. The resolution of these claims can also have ramifications for KP's reputation as well as potential regulatory involvement. Ensure claims are handled appropriately within the National Claims Guidelines and successfully resolved, including retention of outside defense counsel, in-house resolution, monitoring of legal fees, costs and settlement expenses, attendance at court proceedings, provision of claims analysis in leadership committees and identification of insurance coverage applicability.

Essential Responsibilities:

• Promotes learning in others by proactively providing and/or developing information, resources, advice, and expertise with coworkers and members; builds relationships with cross-functional/external stakeholders and customers. Listens to, seeks, and addresses performance feedback; proactively provides actionable feedback to others and to managers. Pursues self-development; creates and executes plans to capitalize on strengths and develop weaknesses; leads by influencing others through technical explanations and examples and provides options and recommendations. Adopts new responsibilities; adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; champions change and helps others adapt to new tasks and processes. Facilitates team collaboration to support a business outcome.
• Completes work assignments autonomously and supports business-specific projects by applying expertise in subject area and business knowledge to generate creative solutions; encourages team members to adapt to and follow all procedures and policies. Collaborates cross-functionally and/or externally to achieve effective business decisions; provides recommendations and solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Supports the development of work plans to meet business priorities and deadlines; identifies resources to accomplish priorities and deadlines. Identifies, speaks up, and capitalizes on improvement opportunities across teams; uses influence to guide others and engages stakeholders to achieve appropriate solutions.
• Managing defense and facilitating in direction and strategy by: preparing materials for the defense and disposition of matters and reviewing materials, advice, and policies; and providing written actionable feedback to Lead Division Counsel.
• Performing legal risk assessment and managing risk by: promoting strict compliance with the terms and conditions of the programs policy of self- and excess liability insurance and considering the financial exposure, regulatory impact, and reputational risk; and proposing solutions to improve internal matter resolution and notifying relevant parties of significant matter developments.
• Investigating matters and facilitating resolution by: building and maintaining processes and analyses and leveraging advanced knowledge to review, analyze, and prepare medical, legal, and internal KP business and policy documents, external defense counsel reports, and preparing legal reports regarding the resolution of the matter; addressing moderately complex issues in pre-litigation or active litigation and working on process improvements to promote efficiencies in matter management; facilitating the resolution of moderately complex legal matters; making recommendations in obtaining and deploying settlement authority; and attending mediations as the KP representative with authority to resolve matters.
• Mitigating risk and resolving matters by: identifying, recommending, and securing strategic solutions to standard and unique issues in risk avoidance and quality improvement that could impact the Program financially; and ensuring compliance regarding reporting requirements with internal SOX guidelines and regulatory and licensing agencies.