Senior Claims Counsel

InterMed Cost Containment Services; Fully; Sur place; CHF 107 000 - 124 000; Plein temps

Avantages offerts par ce poste

Medical, dental, and vision benefits

HSA/FSA contributions

Employer-paid life and disability

401(k) with company match

PTO and company holidays

Wellbeing resources

Résumé du poste

AvonRisk seeks a Senior Medical Malpractice Claims Counsel to lead a high-impact portfolio of medical malpractice and general liability claims, driving coverage analysis, strategy, and resolution with insureds, defense counsel, and clinical stakeholders.

The role requires a JD and 7+ years of experience in a TPA, carrier, or healthcare risk setting; strong policy interpretation, litigation management, and client communication skills; travel required.

Qualifications

• JD required; RN, NP, or other clinical licensure strongly valued.
• Minimum 7+ years of medical malpractice claims experience, with significant litigation management and coverage expertise.
• Strong proficiency in interpreting policies, statutes, legal opinions, and medical records.
• Demonstrated ability to manage high-severity, complex claims requiring strategic judgment and legal/clinical analysis.
• Experience working in a TPA, carrier, risk management, or healthcare liability environment.
• Excellent written and verbal communication skills; ability to translate complex legal and medical concepts for clients.
• Must hold (or obtain) all required adjuster licenses.
• Proficiency in MS Office, RMIS platforms, and remote collaboration tools (Teams, Zoom, WebEx, etc.).

Responsabilités

• Lead the end-to-end management of complex medical malpractice and general liability claims, including high-severity, catastrophic, and legally intricate matters.
• Conduct comprehensive and timely coverage analysis, identify issues, and draft detailed coverage position letters.
• Direct and oversee litigation strategy for assigned cases, including evaluation of exposure, negotiation strategy, settlement recommendations, and trial readiness.
• Manage outside counsel performance, litigation budgets, and expert/consultant engagement.
• Maintain an active 30–45-day diary and implement action plans designed to drive timely, defensible outcomes.
• Evaluate potential liability, damages, indemnity exposure, and risk transfer opportunities (including contribution and apportionment).
• Ensure all claim activity complies with statutes, service contracts, and client reporting requirements.
• Apply advanced knowledge of medical terminology, clinical procedures, and standards of care to assess liability and causation.
• Engage medical experts early to evaluate clinical issues and strengthen case strategy.
• Translate complex medical information into clear risk evaluations for clients and stakeholders.
• Serve as a trusted advisor to clients, building strong, collaborative relationships.
• Provide timely, clear, and professional communication—including written reports, presentations, and case evaluations.
• Participate in client meetings, mediations, trials, and industry conferences as needed.
• Model Intercare’s core values and contribute to a supportive, account-able culture.
• Mentor colleagues and contribute to team development, collaboration, and continuous improvement initiatives.
• Promote a solutions-driven mindset, encouraging innovation, service excellence, and operational discipline.

Connaissances

JD

Medical malpractice claims

Litigation management

Coverage analysis

Policy interpretation

TPA / carrier experience

Communication skills

Travel readiness

MS Office

RMIS platforms

Remote collaboration tools

Formation

Juris Doctor (JD)

Outils

MS Office

RMIS platforms

Teams/Zoom/WebEx

Description du poste

Job Type

Full-time

Description

The Senior Medical Malpractice Claims Counsel is a high-impact legal and claims leadership role responsible for managing a complex portfolio of medical professional and general liability claims through resolution. This position involves sophisticated coverage analysis, litigation strategy, and direct engagement with insureds, defense counsel, and clinical stakeholders.

This role requires a JD and extensive experience handling high-severity, medically complex claims within a TPA, carrier, or healthcare risk environment.

This position operates in alignment with Intercare’s Core Values—Integrity, Collaboration, Accountability, Respect, and Excellence—and plays a central role in maintaining our culture, representing our clients, and advancing our mission to deliver proactive, technically superior claims and risk solutions.

Claims & Legal Management

• Lead the end-to-end management of complex medical malpractice and general liability claims, including high-severity, catastrophic, and legally intricate matters.
• Conduct comprehensive and timely coverage analysis, identify issues, and draft detailed coverage position letters.
• Direct and oversee litigation strategy for assigned cases, including evaluation of exposure, negotiation strategy, settlement recommendations, and trial readiness.
• Manage outside counsel performance, litigation budgets, and expert/consultant engagement.
• Maintain an active 30–45-day diary and implement action plans designed to drive timely, defensible outcomes.
• Evaluate potential liability, damages, indemnity exposure, and risk transfer opportunities (including contribution and apportionment).
• Ensure all claim activity complies with statutes, service contracts, and client reporting requirements.

Clinical and Medical Analysis

• Apply advanced knowledge of medical terminology, clinical procedures, and standards of care to assess liability and causation.
• Engage medical experts early to evaluate clinical issues and strengthen case strategy.
• Translate complex medical information into clear risk evaluations for clients and stakeholders.

Client Engagement & Communication

• Serve as a trusted advisor to clients, building strong, collaborative, and enduring relationships.
• Provide timely, clear, and professional communication—including written reports, presentations, and case evaluations.
• Participate in client meetings, mediations, trials, and industry conferences as needed.

Leadership & Culture

• Model Intercare’s core values and contribute to a supportive, accountable, and excellence-driven culture.
• Mentor colleagues and contribute to team development, collaboration, and continuous improvement initiatives.
• Promote a solutions-driven mindset, encouraging innovation, service excellence, and operational discipline.

Requirements

Required Qualifications

• JD required; RN, NP, or other clinical licensure strongly valued.
• Minimum 7+ years of medical malpractice claims experience, with significant litigation management and coverage expertise.
• Strong proficiency in interpreting policies, statutes, legal opinions, and medical records.
• Demonstrated ability to manage high-severity, complex claims requiring strategic judgment and legal/clinical analysis.
• Experience working in a TPA, carrier, risk management, or healthcare liability environment.
• Excellent written and verbal communication skills; ability to translate complex legal and medical concepts for clients.
• Must hold (or obtain) all required NY adjuster licenses.
• Proficiency in MS Office, RMIS platforms, and remote collaboration tools (Teams, Zoom, WebEx, etc.).
• Ability to travel for mediations, trials, client meetings, and conferences.

Competencies

• Legal and analytical excellence
• Clinical literacy and strong investigative skills
• Strategic litigation and negotiation expertise
• High emotional intelligence, professionalism, and client service orientation
• Leadership presence with the ability to influence and collaborate
• Strong judgment, accountability, and execution discipline
• Adaptability and ability to manage competing priorities

Physical & Work Environment Requirements

• Primarily sedentary work with periods of standing, walking, and light lifting (up to 10 lbs)
• Travel by car, train, or air required; may involve overnight stays.

Compensation

Salary Range: $130,000-$150,000 annually

The salary range listed is an estimate. Actual compensation will be determined based on several factors such as a candidate’s experience, qualifications, skill set, and work location. Position is eligible for AvonRisk’s full benefits package.

Benefits

• Comprehensive medical, dental, and vision benefits
• Company contributions to HSA and FSA plans
• Employer-paid life and disability insurance
• 401(k) with company match
• Paid time off (PTO) and company-paid holidays
• Employee assistance resources and a supportive culture that values balance and wellbeing

Equal Opportunity Employer

AvonRisk is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

Pursuant to the Los Angeles and San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest or conviction records.