Director of Claims in Nashville, Tennessee, United States
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HCA Healthcare

Director of Claims

Nashville, TN, United States
Full-time • No Weekends
Directors and Managers   Job ID: 692927
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Description

Introduction

Do you want to join an organization that invests in you as a Director of Claims? At HCA Healthcare, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.

Benefits

HCA Healthcare, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

  • Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as telemedicine services and free AirMed medical transportation.
  • Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
  • Fertility and family building benefits through Progyny
  • Free counseling services and resources for emotional, physical and financial wellbeing
  • Family support, including adoption assistance, child and elder care resources and consumer discounts
  • 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
  • Employee Stock Purchase Plan
  • Retirement readiness and rollover services and preferred banking partnerships
  • Education assistance (tuition, student loan, certification support, dependent scholarships)
  • Colleague recognition program
  • Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

You contribute to our success. Every role has an impact on our patients’ lives and you have the opportunity to make a difference. We are looking for a dedicated Director of Claims like you to be a part of our team.

Job Summary and Qualifications

This Director of Claims position resides within our Healthcare Indemnity (HCI) claims team, which is part of the larger HCA Risk & Insurance (R&I) team. Together, the R&I teams work to protect the interests and risk of HCA, it’s associates, affiliates, partners, and supports HCA’s overall goal of providing outstanding patient care. The Director of Claims must hold exceptional experience, skill and expertise in the proactive management of professional medical liability claims. This individual has leadership, development and coaching responsibility of their associates, typically between 4 – 10 people. Expectations of the Director of Claims role is to provide proactive oversight, management, evaluation and strategy for all claims handled by their team. They are also expected to collaborate with and support other Director of Claims leaders, all claims staff, business intelligence and clinical quality initiatives. The Director of Claims is expected to be a thoughtful leader, proactive in case investigation, exposure assessment, reserving and resolution strategy. The Director of Claims is expected to manage staffing, associate development, engagement, workloads and workflows. They must be willing to take on additional assignments, such as special projects, departmental or organizational support roles, and other responsibilities as they may arise.

What you will do in this role:

Quality

  • Handle high severity cases as well as a designated caseload. This includes strategic thinking towards resolution, as well as collaborating, directing and managing outside counsel.
  • Assist with development and implementation of department policy, guidelines and operations for better claims management, with an overall goal to add value to the department and organization as a whole.
  • Serve as a resource to corporate departments for policy development and operations issues.
  • Enforce the department and company strategy and philosophy of proactive, efficient and effective claims management.
  • Assure accountability among the department for appropriate documentation within, and maintenance of, the electronic claims system.
  • Ensure a regular diary process is maintained within the teams and department.
  • Utilize monthly loss runs and/or auditing of claims to maintain performance accountability against established metrics.
  • Evaluate the efficiency of outside defense counsel based on audits and metrics provided by HCI and firms.

Service

  • Manage a segment of the Company’s liability claims to achieve fair, efficient, timely exposure assessment, strategy development and ultimate resolution of matters.
  • Maintain current licensure needed to perform duties as required in territory assigned.
  • Oversight and administration of special projects as assigned by the HCI President and VP of Claims and perform other duties as assigned by the VP of Claims.
  • Have strong experience in coverage evaluation process and coverage issues pertinent to medical professional liability claims.
  • Have a strong understanding of risk transfer strategies, to include additional insured standing, contractual indemnity and collateral sources.
  • Maintain current knowledge of relevant industry trends, changes in laws and rules affecting liability claims management decisions.

People

  • Directly or indirectly supervise a team of 4-10 claims professionals that collectively account for a segment of the Company’s professional liability claims whom have responsibility and accountability for millions in case reserves.
  • Assist in evaluation and management of outside defense counsel and claim investigators within established guidelines.
  • Effectively lead associates in the proactive management of claims, reserving, case evaluation, strategies, settlement negotiations, mediations, arbitrations and trials.
  • Develop associates on an individual basis to ensure optimized performance, results, achievement of future goals and career potential.
  • Develop and maintain effective, efficient and respectful working relationships with the organization’s Risk Managers, Patient Safety Directors, C-suite colleagues and Division leaders.
  • Build and maintain strategic alliances and collaborative partnerships with the HCI Risk Management team, HCA Legal Department, Clinical and Physician’s Services Group and other corporate departments that will mutually benefit the Claims Department and the organization.
  • Lead and/or participate in committees or task forces as assigned.

Finance

  • Assist in the development of meaningful metrics to measure performance of each claims professional and the department overall. Maintain regular and accurate collection of the metrics, and appropriate monitoring, analysis and reporting within the organization.
  • Implement a program for successful monitoring, analysis and enforcement of inventory management.
  • Responsibly utilize case reserving and settlement authority within established levels individually and for his/her team, and ensure appropriate documentation of the same.
  • Assure ongoing monitoring and accountability among the Claims Department expenses and litigation fees.
  • Identify appropriate cases and prepare those for presentation to the AVP, VP and Claims Committee for settlement authority and to excess and reinsurers as needed.
  • Responsible for efficient, effective and accurate loss adjustment expenses and indemnity payments.

Education & Experience:

  • Bachelor's degree required
  • 5+ years of experience in claims’ management, preferably in healthcare and preferably in a multi-state environment; knowledge of hospital and healthcare operations required
  • Juris Doctorate preferred
  • Defense and trial experience preferred
  • The position may require up to 10% travel to meet with business associates, attend claims settlement meetings, seminars, mediations, trials and participate in committees, task forces, etc. Physical demands of travel include extended periods of standing and walking.

HCA Healthcare (Corporate), based in Nashville, Tennessee, supports a variety of corporate roles from business operations to administrative positions. Like our colleagues in any HCA Healthcare hospital, our corporate campus employees enjoy unparalleled resources and opportunities to reach their potential as healthcare leaders and innovators. From market rate compensation to continuing education and career advancement opportunities, every person has a solid foundation for success. Nashville is also home to our Executive Development Program, where exceptional employees are groomed to take on CNO- and COO-level roles in our hospitals. This selective program focuses on ethics, leadership and the financial and clinical knowledge required of professionals at this level of the industry.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"Good people beget good people."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder

We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Director of Claims opening. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring!

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

This position is incentive eligible.

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Details

Directors and Managers
Full-time • No Weekends

COVID-19 Vaccination

In compliance with the emergency regulation issued by the Centers for Medicare & Medicaid Services (CMS) dated November 4, 2021, and company policy, this role MAY require you to be fully vaccinated for COVID-19 based on local, state and /or federal law or regulations, or to have applied for a medical or religious exemption (including booster for California). (For further clarification, please ask your recruiter.)

About HCA Healthcare

What matters most to our diverse and talented colleagues is giving people the absolute best healthcare in the most compassionate way possible.

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