Leads and directs a group Medical Malpractice Claims Managers in the Program business and is accountable for delivering superior business results through efficient and proper claim file execution. In conjunction with senior leadership, works within authority limits on assignments requiring a high degree of technical knowledge and expertise. May have multiple product line scope of responsibility.
Essential Duties & Responsibilities:
1. Leads and directs the work activities and has full management responsibility for the performance and development of subordinate staff in accordance with corporate strategic direction.
2. Contributes to organizational profitability by ensuring that claims are effectively managed in accordance with external regulatory and company guidelines and standards. Effectively manages loss costs and claim expenses.
3. Collaborates with internal business partners to ensure optimal implementation of business strategies; regularly communicating with senior management and internal business partners regarding progress and status updates on applicable claim files, claim trends and legal changes that may impact total claim outcome and other relevant business results.
4. Manages expenses and adequately controls resources to ensure successful operations within established budget, productivity and efficiency standards. Leverages systems capabilities, data and metrics/reports to analyze trends and improve organizational and process performance.
5. Reviews and directs the application of claims policies, guidelines, insurance laws and regulations by direct reports and team members.
6. Participates with senior leadership in the development and implementation of claim policies, business strategies and goals, regularly evaluating performance against goals; and holding self and team accountable for achieving desired results.
7. Remains current of state/territory regulations and issues, industry activity and trends. May represent company in industry trade groups.
Skills, Knowledge & Abilities:
1. Ability to identify, lead, coach, develop and retain talented claim professionals.
2. Ability to effectively interact and collaborate with all levels of CNA's internal and external business partners, possessing excellent communication, negotiation and presentation skills.
3. Advanced technical and business management acumen, investigation and claims resolution skills, knowledge of insurance and claims principles, practices and procedures.
4. Excellent analytical and problem solving skills, with the ability to prioritize and manage multiple projects and teams.
5. Ability to solve issues with a sense of urgency; utilizes and manages all available resources to make informed decisions and achieve superior total claim outcome.
6. Ability to creativity and effectively manage through ambiguous and challenging business problems, lead through change and take appropriate levels of risks.
7. Demonstrates the knowledge and understanding of when and how to use metrics to make informed business decisions.
8. Knowledge of Microsoft Office Suite and other business-related software.
Education & Experience:
1. Bachelor’s degree with Master’s preferred or equivalent experience. Professional designations preferred.
2. Typically minimum of ten years of Professional Liability claims related experience.
3. Management experience is required.
CLAIM USSPL-Health Pro (H PRO)