Senior Legal Medical Malpractice Examiner
Senior Legal Medical Malpractice Examiner
Primary Location Oakland, California
Job Number 1021737
Date posted 03/10/2022
Description:
Responsible for managing legal reserves, which are included as a separate line item on the company's financial statements, as well as any professional and general liability claims that may arise throughout the course of conducting business across the corporation. The total amount of claims settled, as affected by this job function, directly affects KP's bottom line. Both KP's reputation and potential regulatory participation may be affected by how these accusations are resolved. Make that claims are managed properly within the National Claims Guidelines and are successfully settled, including by hiring outside defense counsel, resolving disputes internally, and keeping an eye on legal fees, charges, and settlement costs.
Significant Duties:
complete help for cases and lawsuits against Kaiser Permanente including medical malpractice and related issues. Manages the defense and resolution of professional liability claims and litigation in collaboration with the accountable lawyer in the public and professional liability practice group.
Claims Management: Ensures that management, handling, and reporting of moderately difficult to complex claims are done in accordance with internal PPL policies.
investigates pre-suit claims involving medical malpractice, professional liability, general liability, coverage/benefit, and some business practices and disposes of them, as necessary. This includes choosing and keeping on board medical experts and engaging in negotiations with claimants and/or their attorneys.
updates maintain and inserts data into national databases that are relevant to claims.
analyzes discovery requests and creates responses to them (including interrogatories and responses to requests for the production of documents).
attends important hearings, settlement meetings, trials, and depositions.
In the event that an early disposition is neither suitable nor feasible, retains and directs defense counsel. monitors the status of the lawsuits and the outside counsel's adherence to the rules of litigation. participates in the creation of a strategic case management plan and action measures with outside counsel.
Updates KP Lead Claims Counsel on all significant issues or legal advancements that occur within the claims roster of the incumbent.
Financial Management: Establishes reserves based on the potential total loss exposure and the likelihood of various claim resolution outcomes. creates and executes a quarterly examination of reserve data.
Insurance Policy Management: Ensures that the necessary reports about potential excess insurer involvement are completed and submitted to Risk Finance.
Compiles requested data for management reporting; updates and maintains the claims calendar; keeps track of the claim files.
Read also employees expected conduct for this job
- Minimum five (5) years of related experience with a commercial professional liability insurer is required. The commercial professional liability insurer experience may be substituted for related experience with a self-insured trust, captive insurer, or physician indemnification program, handled either by an internal corporate legal dept, or outside law firm, or equivalent experience.
- Bachelor's degree in a related field, OR four (4) years directly related experience required.
- High School Diploma or General Education Development (GED) required.
- N/A
- Similar experiences with an equivalent self-insured trust, captive insurer, or physician indemnification program will also be considered.
- Medical and/ior legal experience.
- Effective knowledge and understanding of professional liability claims handling protocols and processes.
- Experience working and communicating with senior leadership and ability to present and discuss claims in a formal setting.
- Strong computer skills with proficiency in Microsoft Office software.
- Must be able to work in a Labor/Management Partnership environment.
- Seven (7) years of related experience with a commercial professional liability insurer. The commercial professional liability insurer experience may be substituted for related experience with a self-insured trust, captive insurer, or physician indemnification program, handled either by an internal corporate legal dept, or outside law firm, or equivalent experience.
- JD Preferred
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