Director, Claims Management - 140738

UC San Diego · United States

Reassignment Applicants : Eligible Reassignment clients should contact their Disability Counselor for assistance.

The Director, Claims Management is a key leader within the Risk Management Department responsible for the operational oversight and strategic coordination of the organizations claims liability programs. This position directs and manages professional liability, general liability, and employment practices liability claims across UC San Diego Healths clinical and administrative operations.

The Director, Claims Management serves as the primary operational leader responsible for coordinating claim investigation, litigation management, financial exposure evaluation, and resolution strategies in collaboration with internal stakeholders, defense counsel, and third-party administrators.

This role provides experts guidance on complex liability matters, evaluates litigation risk and settlement strategies, ensures consistent and effective management of claims in alignment with the organizations risk tolerance and operational priorities. The Directors also collaborates closely with clinical leadership, Human Resources, Patient Experience, Compliance, and the Office of Campus Counsel to address claims exposure, support organizational responses to adverse events, and identify opportunities to mitigate future risk.

The position requires strong analytical and strategic judgment in managing complex claims matters that may carry significant legal, financial, operational, and reputational implications for the organization.

KEY RESPONSIBILITIES

Claims Program Leadership

Provides operational leadership and oversight for the organizations liability claims programs, including professional liability, general liability, and employment practices liability claims.
Directs claims investigations, evaluation, and resolution activities in collaboration with internal stakeholders, third-party administrators, and/or defense counsel.
Establishes priorities and workflows to ensure timely and effective claims management and reporting.
Provides leadership and guidance to claims staff responsible for claims coordination and administrative support.

Litigation Strategy and Case Management

Collaborates with defense counsel and third-party administrators to develop litigation strategies aligned with organizational objectives and risk tolerance.
Reviews case evaluations, litigation plans, discovery, and settlement recommendations for complex claims matters.
Monitors case progress including discovery, mediation, and trial preparation.
Participates in settlement discussions, mediations, and strategic case review meetings as appropriate.

Organizational Collaboration

Works closely with clinical leadership, Human Resources, Patient Experience, Compliance, and the Office of Campus Counsel to address claims-related matters and support coordinated responses to adverse events and other liability-creating events.
Participates in case review meetings, disclosure discussions, and multidisciplinary forums when claims exposure is present.
Provides subject matter expertise to inform organizational risk mitigation initiatives.
Assists in the coordination and implementation of corrective action with the appropriate organizational stakeholders.

Claims Reporting and Program Development

Maintains oversight of claims tracking systems, documentation, and reporting processes.
Prepares reports and presentations related to claims activity, litigation trends, emerging liability risks, and financial exposure.
Supports development and implementation of policies and procedures related to claims management.
Identifies opportunities to improve claims processes and reduce organizational liability exposure.

• Bachelors degree in healthcare administration, business administration, risk management, or related field.

• Seven or more years or progressively responsible experience in claims management, litigation management, or risk management OR a Juris Doctor and four years of experience.

• Demonstrated experience managing or coordinating claims within a healthcare environment.

• Experience working with third-party administrators and outside legal counsel in the management of liability claims.

• Strong analytical and problem-solving skills with the ability to evaluate complex claims and litigation matters.

• Demonstrated ability to manage competing priorities in a fast-paced environment.

• Excellent communication and interpersonal skills and ability to coordinate with clinical leaders, attorneys, and administrative stakeholders.

• Juris Doctorate

• Certified Professional in Healthcare Risk Management (CPHRM) or similar professional certification.

• Experience in civil litigation within California.

• Experience within an academic medical center or large integrated healthcare system.

• Experience managing multiple liability claim lines including professional liability, general liability, and employment practices liability.

• Experience analyzing claims data to identify risk trends and mitigation opportunities.

• Current UC San Diego employee.

• Must be able to work various hours and locations based on business needs.

• Employment is subject to a criminal background check and pre-employment physical.

Pay Transparency Act

Annual Full Pay Range: $123,000 - $237,800 (will be prorated if the appointment percentage is less than 100%)

Hourly Equivalent: $58.91 - $113.89

Factors in determining the appropriate compensation for a role include experience, skills, knowledge, abilities, education, licensure and certifications, and other business and organizational needs. The Hiring Pay Scale referenced in the job posting is the budgeted salary or hourly range that the University reasonably expects to pay for this position. The Annual Full Pay Range may be broader than what the University anticipates to pay for this position, based on internal equity, budget, and collective bargaining agreements (when applicable).

If employed by the University of California, you will be required to comply with our Policy on Vaccination Programs, which may be amended or revised from time to time. Federal, state, or local public health directives may impose additional requirements.

UC San Diego Health is the only academic health system in the San Diego region, providing leading-edge care in patient care, biomedical research, education, and community service. Our facilities include two university hospitals, a National Cancer Institute-designated Comprehensive Cancer Center, Shiley Eye Institute, Sulpizio Cardiovascular Center, the only Burn Center in the county, and dozens of outpatient clinics. We invite you to join our team!

Applications/Resumes are accepted for current job openings only. For full consideration on any job, applications must be received prior to the initial closing date. If a job has an extended deadline, applications/resumes will be considered during the extension period; however, a job may be filled before the extended date is reached.

To foster the best possible working and learning environment, UC San Diego strives to cultivate a rich and diverse environment, inclusive and supportive of all students, faculty, staff and visitors. For more information, please visit UC San Diego Principles of Community .

The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected status under state or federal law.

For the University of Californias Anti-Discrimination Policy, please visit:

UC San Diego is a smoke and tobacco free environment. Please visit smokefree.ucsd.edu for more information.

UC San Diego Health maintains a marijuana and drug free environment. Employees may be subject to drug screening.

Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer.

a. "Misconduct" means any violation of the policies governing employee conduct at the applicants previous place of employment, including, but not limited to, violations of policies prohibiting sexual harassment, sexual assault, or other forms of harassment, or discrimination, as defined by the employer. For reference, below are UCs policies addressing some forms of misconduct:

• UC Sexual Violence and Sexual Harassment Policy
• UC Anti-Discrimination Policy
• Abusive Conduct in the Workplace