Managing Director Strategic Claims Oversight Healthcare Severity

Essential Duties & Responsibilities

Performs a combination of dutiesin accordance withdepartmental 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 disciplineterminationand other personnel actions.

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

• Develops andmaintainscollaborative working relationships with internal and external business partners including Operations Underwriting Actuary and Risk Control and regularly shares claims outcomes trends legaldevelopmentsand other relevant business updates.

• Responsible for the ongoing management of staff by attracting talent setting clear direction providingappropriate guidance managing performance recognizing contributions and developingcapabilities .

• Ensuresquality by assuring compliance with best practices and developing and delivering training as needed.

May performadditionalduties 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 specificexpertise claims resolutionskilland knowledge of insurance and claims principlespracticesand 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 andmaintainconfidential and sensitive information.

• Excellent analytical andproblem solvingskills and senior levelskillin 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 andobjectivesin order toachieve 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.
  Helpsotherto 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 coachmentorand develop subordinate staff.

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

Education & Experience

• Bachelors degree with JD preferred or equivalent experience.

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

• Typicallya minimum of ten years of claims or legal experience with a proventrack recordof positive results.