• Job Description

  Req#: MANAG001736

  The Doctors Company is currently seeking an experienced Claims Manager for our Region II team. This is a hybrid or telecommuter opportunity, depending on the candidate’s location.

  Position Mission

  Reporting to the AVP Claims, you will be responsible for developing high exposure claim handling strategies, assist in the development of claim processes, and identifying opportunities to achieve optimal cutting-edge solutions in the rapidly changing healthcare litigation environment.

  Qualifications

  • Bachelor’s degree or equivalent preferred (Bachelor’s Degree, Liberal Arts or Business Administration). JD preferred.
  • 6 years of medical malpractice claims experience required.
  • 4 years or high exposure ($250k and above) claims handling experience required
  • Experience with providing training to supervisory staff
  • Ability to train others
  • Computer experience with knowledge of Microsoft Word, Excel and Exchange
  • Ability to prioritize and meet guidelines
  • Ability to make presentations

  Responsibilities

  Claims Guidelines (Reserve Management, File Documentation Management)

  • Identifies the required information and manages the round table reserve review process.
  • Understands the venues, applicable law and reserving philosophy of TDC to properly evaluate the exposures contained within the assigned caseload.
  • Ensures effective documentation of established reserves.
  • Identify and elevate ERM exposure.
  • Assists in internal audit processes (e.g. file reviews).

  Claims Investigation / Analysis

  • Provides timely analysis of large exposure cases to regional leadership so as to establish appropriate reserves.
  • Determines the proper course of resolution based on the directed investigation by assigned staff and makes recommendations to regional leadership accordingly.
  • Gives appropriate insight and advice to insured members, staff and defense counsel on the best possible outcome for both the insured member and the company.
  • Completes coverage analysis and requests coverage review by general counsel as appropriate.
  • Makes appropriate and decisive decisions to establish a plan of action on all cases assigned to the team.
  • Ensures timely referral on any assigned high exposure case to regional leadership as needed.
  • Directs all reporting to High Exposure Committee, Regional Review and Reinsurers as necessary.

  Internal / External Customer Collaboration & Support

  • Interfaces with insured members in a professional manner necessary to achieve the best possible outcome.
  • Professionally engages both internal and external customers when necessary without prompting.
  • Uses internal resources to assist with problem solving.

  Litigation Management & Claims Resolution

  • Manages defense counsel for optimal outcomes.
  • Monitors and approves fees and expenses within authority to comply with company guidelines and state statutory guidelines.
  • Evaluates and assigns litigation matters to defense panel members based on ability and experience.
  • Determines the adequacy of discovery completed on any given case and makes recommendations for further work to be done by assigned legal counsel.
  • Evaluates Attorney work product and advises regional leadership of any need for corrective action or improvement.

  People Development & Deployment

  • Provides ongoing training to claims staff within authority.
  • Continuously analyzes claims metrics to make fiscally responsible recommendations to regional leaders to ensure proper staffing.
  • Makes course corrections in caseloads of assigned staff to ensure parity and proficiency.
  • Identifies any performance issues of direct reports and recommends solutions to regional leaders.
  • Mentors employees for optimal outcomes and deals with personnel issues as necessary.

  Policy / Procedures Development & Compliance

  • Maintains an understanding of the stated TDC policies and procedures so as to fully articulate same to customers and staff.
  • Evaluates the teams work product regularly to ensure compliance with company guidelines.
  • Audits claim files as directed and responds to findings.
  • Identifies opportunities for improvement and provides training and process improvements to improve compliance.

  Other duties as assigned

  • Makes oneself available for any and all duties.
  • Delegates tasks as necessary and appropriate.
  • Collaborates with internal customers to meet the BD needs and goals of TDC

  Salary Range: $119,329 - $139,217

  Compensation varies based on skills, knowledge, and education. We consider factors such as specialized skills, depth of knowledge in the field, and educational background to ensure fair and competitive pay.

  Benefits

  We offer competitive compensation, incentive bonus plans, outstanding career opportunities, an exceptional work environment, and an impressive benefits package, which starts with medical, family and bereavement leave; same-sex domestic partner benefits; short- and long-term disability programs; and an employee assistance program. There's more:

  • Health, dental, and vision insurance
  • Health care tax-free spending accounts with a company match
  • 401(k) and Roth IRA with company match, as well as catch-up plans for both
  • Vacation days, sick days, and paid personal days each calendar year (with vacation increases based on length of service)
  • Paid holidays each calendar year
  • Life and travel insurance
  • Tax-free commuter benefits
  • In-person and online learning opportunities
  • Cross-function career opportunities
  • Business casual work environment
  • Time off to volunteer
  • Matching donations to qualifying nonprofit organizations
  • Company-sponsored participation at non-profit events

  About The Doctors Company

  The Doctors Company is the nation’s largest physician-owned medical malpractice insurer. Founded and led by physicians, we are committed to advancing, protecting, and rewarding the practice of good medicine.

  The Doctors Company is proud to be Certified™ by Great Place to Work®.

  Equal Opportunity Employer
  This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

• About the company

  The Doctors Company is a medical malpractice insurance company headquartered outside Napa, California, USA.

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