Senior Director, Claims and Legal

What you will be doing:

Premier Insurance provides management services to American Excess Insurance Exchange, RRG (AEIX), an excess professional liability reciprocal risk retention group, and operates an insurance brokerage providing insurance products and services to healthcare entities and providers nationwide. AEIX members pool their risks, and a majority of the members have internal claim management operations. Premier Insurance works with the member claims teams to manage complex, catastrophic, high value claims that are covered by the AEIX policies of insurance.

The purpose of this position is to operationalize and execute the mission of AEIX, to partner with forward-thinking healthcare leaders to safeguard assets, enhance patient safety, and inspire innovation, through collaborative and strategic claim management. This position will directly evaluate, monitor, and negotiate predominantly medical liability matters from notification to resolution. This position will manage the litigation process with broad authority requiring a high degree of technical complexity and be accountable for business results through cost-effective and timely resolution of multi-million-dollar claims. This position will provide guidance and leadership regarding deployment of AEIX assets.

The Senior Director, Claims & Legal, must be a sophisticated, self-possessed individual who can balance working with different members and different personalities. This individual must be able to display a high degree of experience with an aptitude for complex, high value litigation. Diplomacy, sincerity, and a passion for vigorously defending claims must always be present. In addition to working directly with the AEIX membership, this position will work cooperatively with other Premier Insurance departments. This individual will be required to prepare and present reports internally, to members and their representatives, such as TPA, defense counsel, and consultants. This position will be responsible for staying abreast of current industry trends and best practices and will provide updates to members and governance, as needed. In addition, this position will assist the Chief Legal Officer with legal review and editing and maintenance of contracts.

Key Responsibilities

Claim Management- 80%

• Evaluating and monitoring liability matters, predominantly medical liability matters, from notification to completion;
• Demonstrating proactive intellectual curiosity regarding claim trajectory to provide solution-oriented ideas
• Review and assess member and attorney reports, expert opinions, medical records, and life care plan to develop strategies for resolution
• Identifying, retaining, and directing appropriate attorneys, experts, and consultants as necessitated by the facts of a particular claim;
• Working with member claims teams and their agents during the life of a claim to educate, strategize, and optimize best outcomes and drive down claims values;
• Understanding insurance policies and coverage determinations on a case-by-case basis;
• Understanding and following the litigation process in a way that allows for proactive decision making;
• Maintaining a caseload of high complexity and high severity claims, documenting files accurately and timely
• Monitoring business costs with a critical eye towards expense spend, mindfully directing the resolution of claims in a cost effective and timely manner;
• Making recommendations regarding appropriate indemnity reserves, settlement recommendations, and allocation of resources;
• Conducting annual claim reviews of AEIX member claim files and preparing summary reports of findings with recommendations for improvement opportunities, correcting deficiencies, and best practices;
• Identifying and coordinating web based and live educational sessions for AEIX members to encourage subject matter expertise and identification of valuable resources available to AEIX membership;
• Keeping abreast of developments in the hospital/medical liability sector including availing oneself of educational opportunities;
• Providing industry overviews and claim updates to clients as needed but including governance meetings.

Legal - 20%

• Substantive legal review of contracts, insurance policies, rules, regulations, and other legal documents
• Assist with legal governance and regulatory matters

• Maintain and supervise contract repository of all legal agreements for Premier Insurance and AEIX

Required Qualifications

Work Experience:

Education:

Required Certifications/Licensing

Skills & Experience:

• Medical liability litigation

• Medical liability claim management

• Accountable for claim outcomes

Education:

• JD

Preferred Qualifications

Relevant Experience to include:

• Medical liability strategic negotiation

• 5+ years multi-jurisdictional claim management

• Excess insurance claim management

• Insurance policy analysis

• Captive insurance

• Claims adjuster licenses

Additional Job Requirements:

• Remain in a stationary position for prolonged periods of time

• Be adaptive and change priorities quickly; meet deadlines

• Attention to detail

• Operate computer programs and software

• Ability to communicate effectively with audiences in person and in electronic formats.

• Day-to-day contact with others (co-workers and/or the public)

• Making independent decisions

• Ability to work in a collaborative business environment in close quarters with peers and varying interruptions

Employees also receive access to the following benefits:

* Health, dental, vision, life and disability insurance

* 401k retirement program

* Paid time off

* Participation in Premier's employee incentive plans

* Tuition reimbursement and professional development opportunities

Premier at a glance:

• Ranked #1 on Charlotte's Healthiest Employers list for 2019, 2020, 2022, and 2023 and 21st Healthiest Employer in America (2023)

• Named one of the World's Most Ethical Companies by Ethisphere Institute for the 16th year in a row

• Modern Healthcare Best in Business Awards: Consultant - Healthcare Management (2024)

• The only company to be recognized by KLAS twice for Overall Healthcare Management Consulting

For a listing of all of our awards, please visit the Awards and Recognition section on our company website.

Employees receive:

• Perks and discounts

• Access to on-site and online exercise classes

Premier is looking for smart, agile individuals like you to help us transform the healthcare industry. Here you will find critical thinkers who have the freedom to make an impact. Colleagues who share your thirst to learn more and do things better. Teammates committed to improving the health of a nation. See why incredible challenges require incredible people.

Premier is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to unlawful discrimination because of their age, race, color, religion, national origin, ancestry, citizenship status, sex, sexual orientation, gender identity, gender expression, marital status, familial status, pregnancy status, genetic information, status as a victim of domestic violence, covered military or protected veteran status (e.g., status as a Vietnam Era veteran, disabled veteran, special disabled veteran, Armed Forces Serviced Medal veteran, recently separated veteran, or other protected veteran) disability, or any other applicable federal, state or local protected class, trait or status or that of persons with whom an applicant associates. We also consider qualified applicants with criminal histories, consistent with applicable federal, state and local law. In addition, as a federal contractor, Premier complies with government regulations, including affirmative action responsibilities, where they apply. EEO / AA / Disabled / Protected Veteran Employer.

Premier also provides reasonable accommodations to qualified individuals with a disability or those who have a sincerely held religious belief. If you need assistance in the application process, please reply to diversity_and_accommodations@premierinc.com or contact Premier Recruiting at 704.816.5200.

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