Description:
At A Health Care Partner, what you do mattersAs part of the A Health Care Partner team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, A Health Care Partner is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care.
Why you will love working here:
- Strong track record of providing excellent work/life balance.
- Comprehensive benefits package and competitive compensation.
- Commitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect.
Responsibilities:
- Daily management and handling of assigned claims and legal matters that are part of the company claims and litigation program.
- Support efficiency in departmental operations related to all types of litigation, all pending claims, and all prospective claims/litigationon
- Perform all appropriate claim reviews with leadership for recommendations regarding claim progress and direction
- Participation and management, with leadership oversight, of medical malpractice defense claims
- Participation and management, with leadership oversight, of assigned general liability defense claims
- Participation and management, with leadership oversight, of assigned company collection claims
- Direct administration of claims and litigation through direction and negotiation within defined authority parameters
- Attendance and participation in mediations and resolution meetings on behalf of organization and/or insured providers
- Attendance and participation in trials on behalf of organization and/or insured providers
- Coordination with assigned counsel and litigation leadership for collaborative claim direction
- Coordination with claim and litigation team for assurance of accurate and timely reporting on all pending claims and litigation
- Refer cases for authority under established guidelines, doing so with the appropriate case summary and documentation to justify recommendations.
- Review claim files for irregularities and trending, ensuring appropriate litigation strategies
- Participate in claim calls with assigned counsel
- Organize and conduct appropriate meetings and communications with third parties for claim mitigation and/or resolution
- Understand claim programs, policies, and procedures as to reporting, investigation, financial analysis, trending, forecasting and litigation management up to and through the resolution/outcome of claims.
- Seek to support and further the mission and vision of the Litigation Division, Legal Department and the company.
- Develop, maintain and foster productive relationships with external persons and entities such as defense and plaintiff counsel, litigation management companies, claimants, insurers, insureds, brokers, and patient compensation funds.
- Assist with miscellaneous legal matters, including legal research, responding to legal inquiries, fielding questions from providers or employees, and providing advise as needed and appropriate
- Perform in a manner that enhances the operations of the department and the organization and promotes quality patient care.
Qualifications:
Knowledge, Skills, and Abilities: Excellent analytical, research, writing and interpersonal skills; Strong negotiation skills; Knowledge and/or familiarity with medical and insurance professions
Education: Juris Doctorate from Accredited Law Center
Work Experience/Qualifications:
- Legal/Insurance experience – 0-3 years required / 3 -5 years preferred
- Familiarity with medical records/terminology
- Familiarity with insurance practice