Director, Claims, Litigation & Insurance

About the Role :

The Director of Claims, Litigation & Insurance is responsible for leadership, innovation, governance, and management necessary to identify, evaluate, mitigate, and monitor Sound Physicians’ operational and strategic risk as well as to monitor potential and filed legal matters received by the organization and provide timely response to specific requests or claims based upon internal guidelines.

The day-to-day operation of the position, include but are not limited to, clinical risk and insurance management, claims handling, and litigation management.

The Details : This is a virtual, work-from-home opportunity . This role will require some travel - approximately 2-3 short trips per year.

In this role, you will be responsible for :

Many or all of the following are done under the direction and in collaboration with the Deputy General Counsel and Chief Legal Officer.

The DGC and CLO are expected to appropriately delegate the following responsibilities and tasks to the Director of Claims, Litigation, and Insurance.

• Managing the purchase and design of insurance programs and loss control activities and managing relationships with third-party service providers including brokers, insurers, and claims leaders, preparing loss analyses, identifying exposures, recommending solutions, and promoting loss prevention
• Initiating and completing all aspects of the claims process, including but not limited to documentation in the claims management system, filing claims with appropriate insurance carriers, confirming attorney assignments, and documenting the litigation intake log in accordance with departmental guidelines
• Monitoring and analyzing risks within the company's business units and reporting on these risks to the DGC and CLO
• Developing and maintaining healthcare risk management tools, practices, and policies to analyze and report risks, and to manage risks according to an enterprise risk management framework in partnership with the Chief Audit Officer
• Drafting and reviewing healthcare risk management policies to ensure compliance with applicable regulations including, but not limited to, physician and advance practitioner licensing and patient safety, claims management and other healthcare risk management industry practices
• Monitoring and analyzing risks within Sound Physicians’ business and reporting these risks to ensure alignment with organizational objectives
• Participating in the coordination and development of business-wide programs for safe patient care and risk-free services utilizing internal and external safety trends

What we are looking for :

A successful candidate will have a demonstrated track record of a combination of these values, knowledge, and experience :

Values :

Collaborative : Demonstrates the ability to work well with others to accomplish a goal and get the work done; takes opinions of others into consideration;

includes others in the decision-making process

• Customer-focused : Puts customer (internal and external) needs first and makes customers their top priority
• Resourceful : Proactive willingness to utilize available information and tools to figure things out
• Communication : The ability to speak, write, and listen clearly and consistently
• Relationship Building and Maintenance : The ability to create and nourish healthy, strong relationships, as the face of Sound
• Teamwork : Demonstrates the ability to pull people together into highly effective teams along with ability to work in a highly matrixed organization
• Critical Thinking : Demonstrates the ability to be proactive, anticipate needs; ability to make good decisions with incomplete, ambiguous information
• Motivated : Demonstrates the ability to succeed and get things done at a high level of achievement
• Strategic Thinking : Demonstrates the ability to look at the big picture and proactively develop a plan of action
• Visionary : Demonstrates the ability to see, articulate and share the future of the organization in ways that engage and motivate those around them with a clear vision and plan for the future

Knowledge :

Bachelor’s degree in or related field

Experience :

5 years of in-house legal experience at a healthcare or hospital system or related law firm experience consisting of progressive experience as health care risk manager and experience in claims management and litigation

Sound Physicians is an Equal Employment Opportunity (EEO) employer and is committed to diversity, equity, and inclusion at the bedside and in our workforce.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, gender identity, sexual orientation, age, marital status, veteran status, disability status, or any other characteristic protected by federal, state, or local laws.

This job description reflects the present requirements of the position. As duties and responsibilities change and develop, the job description will be reviewed and subject to amendment.