Claims & Litigation Associate (Remote)

Stanford Health Care; United States; Remoto; USD 214.000 - 284.000; Tempo pieno

Descrizione del lavoro

Stanford Health Care is seeking a senior claims professional to manage, investigate, and resolve professional and general liability claims for the Stanford Medicine enterprise. You will coordinate with internal stakeholders, oversee panel counsel, and analyze complex medical claims to evaluate exposure and liability.

You will develop litigation strategies, retain outside counsel, monitor costs, manage cyber/privacy, construction, and property claims, and ensure accurate reserves and timely case

Competenze

• Juris Doctor (JD) required; California license preferred.
• Five (5) years of progressively responsible claim management experience.
• Strong writing, negotiation, and communication skills.
• Ability to analyze complex legal problems and review medical records.

Mansioni

• Develop action plans for managing litigated claims and oversee defense strategies.
• Retain outside counsel, coordinate support for investigations, and monitor counsel compliance.
• Investigate pre-suit claims, review medical records, interview providers, and negotiate settlements when warranted.
• Prepare claims reports and settlement evaluations; present high-exposure cases to leadership and stakeholders.

Conoscenze

Strong writing

Negotiation skills

Analytical problem solving

Team leadership

Formazione

Juris Doctor (JD)

Descrizione del lavoro

If you’re ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered.

Day - 08 Hour (United States of America)

This is a Stanford Health Care job.

A Brief Overview

Primary responsibility for managing, investigating, and resolving professional and general liability claims for the Stanford Medicine enterprise. Requires coordination with internal stakeholders and staff, as well as oversight and management of panel counsel. Analyzes complex medical claims and evaluates exposure and liability. Assists in handling other types of exposures as warranted, including cyber/privacy, construction, and property claims.

Locations

Stanford Health Care

What you will do

• Develops action plan for managing litigated claims, evaluates insurance coverage, attends mediation and trial, monitors litigation costs, handles discovery, and provides recommendations for ultimate resolution.
• Oversees legal defense strategy, retains outside counsel, coordinates support for investigation, reviews attorney invoices, and monitors counsel’s compliance with litigation management guidelines.
• Investigates pre-suit claims, reviews medical records, interviews providers, retains consultants when necessary, communicates with patients and/or families, and directly negotiates settlements when warranted.
• Prepares claims reports and settlement evaluations. Presents high-exposure cases to leadership and stakeholders, including reinsurance partners.
• Maintains accurate defense and indemnity reserves.
• Manages claims files in internal database. Inputs all work product to ensure case information is accurate and entered in a timely manner.
• Investigates cyber and privacy claims. Pursues recovery in construction and property claims. Manages associated insurance reporting and communication requirements.
• Assists in other matters as assigned. Handles Medical Board and NPDB reporting. Prepares and conducts Risk Management educational presentations.

Education Qualifications

• Juris Doctor (JD) required. California license preferred.

Experience Qualifications

• Five (5) years of progressively responsible and directly-related claim management experience.

Required Knowledge, Skills and Abilities

• Strong writing, communication, and presentation skills.
• Effective negotiation skills.
• Ability to analyze complex legal problems and develop solutions.
• Ability to review and evaluate medical records and literature.
• Knowledge of laws pertaining to professional and general liability litigation.
• Ability to work effectively both as a team player and leader.

Licenses and Certifications

• None

These principles apply to ALL employees:

SHC Commitment to Providing an Exceptional Patient & Family Experience

Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanford’s patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery.

You will do this by executing against our three experience pillars, from the patient and family’s perspective:_

• Know Me: Anticipate my needs and status to deliver effective care
• Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health
• Coordinate for Me: Own the complexity of my care through coordination

**Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in****all of **its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.

Base Pay Scale: Generally starting at $103.03 - $136.49 per hour

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.