Sr. Director, Claims and Clients Services - Medical Malpractice - Intercare Insurance

Sr. Director, Claims & Client Services - Medical Malpractice 

Description

This is a dynamic leadership position that reports directly to an Associate Vice President of the Liability Division. This position is multifaceted and includes the following primary areas of focus:

Culture – every member of the Intercare team is responsible for nurturing and promoting a healthy culture. Our culture is the most important element of our success. Intercare’s culture is defined by our Core Values:

INTEGRITY: Reinforces our commitment to Transparency

COLLABORATION: Strengthens our passion for Customer Service

ACCOUNTABILITY: Supports our actions

RESPECT: Inspires us to do the right thing

EXCELLENCE: Drives our outcomes

We are a positive and supportive team that works closely together to ensure succeed for all. Our common goal is to provide a healthy work environment for our colleagues and exceptional service and work product for our clients.

Management – this leader is responsible for growth, development and productivity of a team of 3-6 as well as the success of the various programs managed by the team. Expectations regarding team leadership and account management are best described by our mission:

Mission: To be the leading third party administrator offering professional and technological resources through pro-active and aggressive claims and managed care solutions in support of our clients’ objectives. Innovative processes and state-of-the-art technology support our people. Exceptional individuals provide the human element needed to deliver excellent service and drive excellent outcomes.

This leader is responsible for manage the Claim Representatives/Adjusters as well as developing and maintaining strong relationships with our clients. This leader is responsible and accountable for the client service, work quality and work efficiency of the claims team. The nature of the work involves coaching and counseling the claims team including training, mentoring, monitoring work product to assure compliance with client and industry requirements as well as company rules and regulations, conducting performance evaluations, and instituting corrective action when appropriate. This leader will prepare and present data and stewardship reports to each client. This leader may also carry a caseload.

Operations – the leader works closely with the other managers, supervisors and the EVP of Claims to run the Liability Division. This includes the responsibilities of day-to-day operations such as education, training, internal and external meetings, contract renewals, internal and external audits, ensuring compliance with national statutory and regulatory requirements for claims management, strategic planning, and drafting or revising policies, procedures, best practices, forms and client instruction guidelines. We are also looking for ways to be better for each other and our clients.

Marketing & Growth – the leader works closely with every member of the Intercare team to carry out our vision to promote growth:

Vision: To be recognized as the most trusted and innovative partner in providing Claims and Managed Care solutions that are tailored to the specific needs of our clients.

Every contact and interaction that this leader makes has the potential to develop additional business with current clients as well as develop new business for the Intercare team. This leader must be relationship focused and growth oriented.

• Monitor productivity and compliance trends of the division for implementing procedural adjustments, as necessary, to enhance or improve productivity and results.
• Revise and develop division policies, procedures and forms to ensure compliance with industry best practices.
• Develop and present training and educational programs for colleagues and clients.
• Assist with contract renewal and negotiations.

Marketing & Growth

• Maintain the mindset that everyone is a potential client.
• Actively and consistently network with colleagues, clients, risk managers, carriers, brokers, captive managers, co-defendants and other service providers to cultivate new business.
• Attend national conferences and network on behalf of Intercare to cultivate new business.
• Prepare and participate in submissions for national speaking opportunities.
• Participate in national speaking engagements.
• Participate in oral presentations in response to RFPs.

Requirements

Competency:

To perform the job successfully, an individual should demonstrate the following competencies:

• An open mind, an eagerness to learn, a positive attitude and healthy curiosity.
• Strong communication skills including being open and respectful of everyone, regardless of their position or role in the world.
• Flexibility and the ability to adapt to change quickly. This includes the ability to switch gears efficiently between various program needs and client and colleague personalities numerous times throughout the day.
• Problem solving, change and conflict management including being able to develop workable implementation plans and recommendations, communicating changes effectively, building commitment and overcoming resistance, and preparing and supporting those affected by change and conflict.
• Leadership by example and service, including instilling and exhibiting confidence in yourself and others, inspiring and motivating others to perform well, ethically and positively influencing the actions and opinions of others, inspiring respect and trust, accepting and growing from the feedback from others, providing vision and inspiration to all colleagues, providing appropriate recognition to others, displaying passion and optimism, mobilizing others to fulfill the vision, accepts responsibility and accountability.
• Management skills such as including staff in planning, decision-making, facilitating and process improvement; taking responsibility for direct reports’ activities, being available to all colleagues, providing regular performance feedback, developing and applying performance improvement plans as necessary, and developing direct reports’ skills and encourages growth.
• Exceptional customer service including always going above and beyond for clients, searching for ways to expand our services for each client, soliciting client feedback to improve service, promptly responding to all client needs and requests and ensuring compliance with client contracts and service instructions. Responds to requests for service and assistance. Meets commitments.
• Strong business acumen including being well spoken, displaying poise, presenting yourself and Intercare with a measured balance of confidence and humility, taking initiative, sparking innovation, understanding the business implications of decisions, displaying orientation to profitability, demonstrating knowledge of the market and competition, and aligning work with strategic goals.
• Discipline in all aspects of the position with a focus on accuracy, thoroughness and constant desire for improvement.
• Project management skills, including developing project plans, coordinating projects, staying/keeping on task, communicating changes and progress, and completing projects on time and budget.

Qualification Requirements:

To perform this job successfully, an individual must, at a minimum, be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience:

Juris Doctorate (JD) or Bachelor’s Degree is preferred.

Minimum of five years’ experience managing liability claims and/or defending medical professional and general liability lawsuits is required. Specific experience and knowledge of national claims management rules and regulations for liability claims management is essential.

Language Skills:

Ability to read, analyze, and interpret insurance policies, statutes, legal opinions, general business periodicals, professional journals, technical procedures, and governmental regulations. Ability to write complex coverage letters, reports, business correspondence, procedure manuals, and correspondence to clients, colleagues and industry peers. Ability to effectively present information, both verbally and written, and respond to questions from groups of managers, clients, customers, and the general public. Fluent spoken and written English is required.

Math Skills:

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

Reasoning Ability:

This position requires strong problem solving and analytical skills. It requires the ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. It requires the ability to deal with problems involving several concrete variables in standardized situations.

Computer Skills:

To perform this job successfully, an individual must be proficient with Word, Excel, Outlook, PowerPoint, RMIS software, Zoom, TEAMS, WebEx, GoToMeeting and other tele-video conferencing software and apps.

Certificates and Licenses:

Home state adjuster and/or law licensure are strongly preferred.

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