Director of Claims

  • HCA
  • Nashville, TN, USA
  • Feb 02, 2018

Job Description

Job Code: 10201-23213


No Weekends

HCA, a Fortune 100 company with more than 200,000 employees, is one of the nation's leading providers of healthcare services, operating over 170 locally managed hospitals and over 100 freestanding surgery centers in 20 states and the United Kingdom. With its founding in 1968, HCA created a new model for hospital care in the United States, using combined resources to strengthen hospitals, deliver patient-focused care and improve the practice of medicine. HCA is a learning healthcare system that uses more than 27 million annual patient encounters to advance science, improve patient care and save lives. HCA has been named one of the world's most ethical companies for eight years in a row. At HCA, we are driven by a single goal: the care and improvement of human life.


This position is one of the leadership roles in the HCI Claims Department and in the larger Risk & Insurance Department. The Director of Claims is responsible for the overall management of a segment of the Company's professional and general liability claims. This includes directly or indirectly supervising 4-10 claims professionals, conformance to department standards and performance against established metrics. This individual has solid experience managing healthcare liability claims, is familiar with hospital operations and has demonstrated management and leadership ability.


  • Manage a segment of the Company's liability claims through a team of claims professionals to achieve fair and efficient resolution of all matters.
  • Supervise one of four teams of 4-10 claims professionals that collectively account for approximately 700* claims per team and responsibility and accountability for more than $200 million in cash reserves.
  • Responsibly utilize case reserving and settlement authority within established levels individually and for his/her team and ensure appropriate documentation of the same.
  • Assure accountability among the team for approval of claims expenses and litigation fees.
  • Assure accountability among the team for appropriate documentation within and maintenance of the electronic claims system.
  • Hire and supervise directly, and via the team, outside defense counsel and claim investigators within established guidelines.
  • Effectively participate and counsel team members as appropriate, in settlement negotiations, mediations, arbitrations and trials as required for optimal outcomes.
  • Identify appropriate cases and prepare those for presentation to the AVP, VP and Claims Committee for settlement authority and to excess and reinsurers as needed.
  • Enforce the department and company strategy and philosophy for effective claims management.
  • Ensure a regular diary process is maintained within the team.
  • Utilize monthly loss runs and/or auditing of claims assigned to team members to maintain performance accountability against established metrics.
  • Maintain current knowledge of laws and rules affecting liability claims management decisions; educate and train staff.
  • Develop and maintain effective, efficient and respectful working relationships with local Risk Managers, Patient Safety Directors, CEOs and Division leaders.
  • Build and maintain strategic alliances and collaborative partnerships with the HCI Risk Management team, HCA Law Department, Clinical and Physician's Services Group and other corporate departments that will mutually benefit the Claims Department and the organization.
  • Serve as chairperson and/or participate in committees or task forces as assigned.
  • Integrate and counsel team members on newly developed projects affecting claims and overall company operations ( e.g. DCCP, PSO).
  • Assume a personal caseload of pending claims as assigned by AVP.
  • Maintain current licensure needed to perform duties as required in territory assigned.
  • Perform other duties as assigned by the AVP of Claims

*Caseload may vary based on overall volume of department and territories managed.


College Graduate Required Undergrad

Certification in risk management or insurance is a plus, e.g. CPHRM, ARM, CPCU, etc.

Adjuster's license in states in which HCI operates, especially Florida, is a plus.


6-8 years of claims management experience, preferably in healthcare and preferably in a multi-state environment; knowledge of hospital and healthcare operations.


Must be eligible to apply for and obtain adjusters license(s) in assigned jurisdictions.

Proficient computer skills with word processing and database competency.

Effective oral and written communication skills.
Critical thinking, analytical and problem solving skills.




Last Edited: 02/01/2018