Director, Claims
Great Place To Work
full-time
Posted on:
Location Type: Hybrid
Location: United States
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Salary
💰 $131,102 - $172,072 per year
Job Level
About the role
- Manage a portfolio of high‑severity and complex medical professional liability claims from intake through resolution.
- Conduct detailed liability, causation, and damages analyses and set and adjust reserves in accordance with company/client guidelines.
- Direct and oversee litigation strategy, including selection, instruction, and ongoing evaluation of defense counsel.
- Participate in mediations, settlement conferences, and negotiations; recommend settlement authority consistent with exposure and company strategy.
- Ensure compliance with internal quality standards, regulatory requirements, and applicable insurance laws.
- Build, supervise, and mentor a team of claim professionals as unbundled claim services scale.
- Create performance metrics, operational workflows, and service-level expectations for a hybrid team supporting multiple client arrangements.
- Provide regular coaching, training, and technical development aimed at ensuring consistent, high-quality claims practices.
- Contribute to the design, implementation, and ongoing refinement of TDC’s unbundled claim services model.
- Collaborate with underwriting, account management, and operational leaders to align claims handling protocols with client expectations and contractual requirements.
- Develop customized reporting frameworks, communication channels, and performance dashboards for unbundled accounts.
- Serve as claims liaison for partner organizations, addressing escalations, presenting claim trends, and supporting risk‑mitigation efforts.
- Act as a subject‑matter expert across the enterprise on complex claims issues, emerging liability trends, and risk‑management opportunities.
- Provide input on product development, coverage analysis, and underwriting considerations related to unbundled programs.
- Support continuous process improvement, including digital workflow enhancements, audit practices, and quality‑assurance initiatives.
- Represent the Claims Department in cross‑functional committees, leadership meetings, and external stakeholder presentations.
Requirements
- Bachelor’s degree or equivalent professional experience.
- Minimum 10 years of medical professional liability claims experience, including litigation management.
- Demonstrated expertise handling high-exposure, complex clinical matters.
- Strong analytical skills with the ability to interpret medical records, expert opinions, and legal strategies.
- Excellent communication, negotiation, and presentation skills.
- Ability to build relationships with physicians, attorneys, executives, and partner organizations.
- Prior leadership or supervisory experience (formal or informal) preferred.
- Experience within a national medical malpractice carrier or healthcare‑focused insurance organization preferred.
- Familiarity with unbundled claims models, TPA structures, or captive programs preferred.
Benefits
- Health, dental, and vision insurance
- Health care tax-free spending accounts with a company match
- 401(k) and Roth IRA with company match, as well as catch-up plans for both
- Vacation days, sick days, and paid personal days each calendar year (with vacation increases based on length of service)
- Paid holidays each calendar year
- Life and travel insurance
- Tax-free commuter benefits
- In-person and online learning opportunities
- Cross-function career opportunities
- Business casual work environment
- Time off to volunteer
- Matching donations to qualifying nonprofit organizations
- Company-sponsored participation at non-profit events
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
medical professional liability claimslitigation managementliability analysiscausation analysisdamages analysisreserve settingclaims handling protocolsperformance metricsoperational workflowsrisk management
Soft Skills
analytical skillscommunication skillsnegotiation skillspresentation skillsrelationship buildingleadershipmentoringcoachingteam supervisionprocess improvement
Certifications
Bachelor's degree