出海雷达

医疗专业责任法律顾问

Claim Counsel - Healthcare Professional Liability

其他限定地区(需当地身份)
公司Davies North America
薪资$110,000 - $135,000/年
工作地点United States
地域资格限定地区(需当地身份)
时区要求日间重叠约 9 小时,基本正常作息
用工类型Full Time
发布时间8 天前
数据来源Himalayas
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注意地域限制:该职位明确限定在 United States 招聘。如果你是位于中国大陆的求职者,通常需要当地工作身份才能投递,或需与雇主确认是否接受独立合同(Contractor)形式合作。
关于本页中文:职位描述由本机离线模型翻译,属机器翻译,供快速判断用;正式沟通与投递请以英文原文为准。官方翻译通道恢复后会自动重译升级。

我们的故事想象是作为一个团队的一部分,不仅塑造未来,而且积极推动它。在戴维斯北美,我们处于创新和卓越领域的前沿,将尖端技术与顶级专业服务结合在一起。作为全球戴维斯集团的一个重要组成部分,我们帮助企业导航风险,优化运营以及保险和监管部门的头转型。戴维斯 北美正在寻找负责管理和解决高严重性复杂的保险索赔的人员,重点放在覆盖分析,政策解释和战略索赔解决方面。该职位主要集中在医疗不实践和医疗保健专业责任索赔,特别是在护理院,辅助住宿设施和相关的医疗保健计划中。其中许多都是以包括职业责任和一般责任覆盖的套餐政策编写的。该角色作为卫生责任覆盖问题的关键主题专家,为内部团队和运营商提供咨询,涉及临床护理,设施运营和监管暴露的复杂索赔。获得成功的候选人将管理复杂医疗责任索赔组合,可能涉及七位数暴露,灾难性伤害,错误死亡,复杂因果问题,专家争端,过度影响以及重要的调解或和解活动。此职能需要强大的技术索赔专业知识,健全的诉讼判断,覆盖能力分析,并能够有效地与运营商,保险人员,辩护律师,覆盖顾问,医学专家和内部利益相关者合作。这一职位是适合具有医疗责任,医疗不良实践,保险和诉讼经验的律师或具有经验证明管理高暴露健康责任索赔的高级复杂索赔专业人士。通过调查,诉讼,调解,和解和审判准备来进行了检查,调解和解决。关键责任 综合卫生责任索赔管理 ·自主管理从分配到解决过程中对高严重的医疗保健专业责任索赔组合。·处理涉及重大金融风险的问题,包括有七位数储备的索赔,要求,结算或潜在判决等。·评估责任,损害,因果关系,护理标准,医疗文档,场所风险;c

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Our Story
Imagine being part of a team that’s not just shaping the future but actively driving it. At Davies North America, we’re at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors.

Davies North America is looking for a candidate responsible for managing and resolving high-severity, complex insurance claims with a strong emphasis on coverage analysis, policy interpretation, and strategic claim resolution. The position focuses on Medical Malpractice and Healthcare Professional Liability claims, particularly within nursing homes, assisted living facilities, and allied healthcare programs, many of which are written as package policies that include both professional liability and general liability coverages.

This role serves as a key subject matter expert for healthcare liability coverage issues, advising internal teams and carriers on complex claims involving clinical care, facility operations, and regulatory exposures.

The successful candidate will manage a portfolio of complex healthcare liability claims that may involve seven-figure exposures, catastrophic injuries, wrongful death, complex causation issues, expert disputes, excess implications, and significant mediation or settlement activity. This role requires strong technical claims expertise, sound litigation judgment, coverage analysis capability, and the ability to partner effectively with carriers, insureds, defense counsel, coverage counsel, medical experts, and internal stakeholders.

This position is well-suited for either an attorney with healthcare liability, medical malpractice, insurance coverage, and litigation experience, or a senior complex claims professional with demonstrated experience managing high-exposure healthcare liability claims through investigation, litigation, mediation, settlement, and trial preparation.

Key Responsibilities

Complex Healthcare Liability Claims Management

  • Independently manage a portfolio of high-severity healthcare professional liability claims from assignment through resolution.
  • Handle matters involving significant financial exposure, including claims with seven-figure reserves, demands, settlements, or potential judgments.
  • Evaluate liability, damages, causation, standard of care, medical documentation, venue risk, comparative fault, and potential excess exposure.
  • Analyze medical records, expert reports, deposition testimony, defense assessments, and damages evaluations.
  • Develop and execute claim resolution strategies based on investigation, legal exposure, coverage obligations, litigation posture, and business objectives.
  • Provide clear, independent evaluations and recommendations to carriers and internal stakeholders.
  • Maintain accurate and thorough documentation of claim strategy, liability evaluation, damages analysis, reserves, coverage issues, and resolution activity.

Litigation Management & Strategy

  • Oversee complex litigated healthcare liability claims, including medical malpractice, hospital liability, physician liability, nursing liability, long-term care, and other healthcare-related professional liability matters.
  • Direct and partner with defense counsel on litigation strategy, discovery, expert retention, dispositive motions, mediation preparation, and trial planning.
  • Review and analyze pleadings, discovery responses, medical records, deposition summaries, expert reports, life care plans, economic loss evaluations, mediation briefs, and trial assessments.
  • Establish litigation plans, budgets, and key milestones in partnership with counsel and carriers.
  • Attend and actively participate in mediations, settlement conferences, strategy meetings, and significant litigation events.
  • Provide strategic recommendations regarding settlement, continued defense, alternative dispute resolution, or trial preparation.

Coverage Analysis & Policy Interpretation

  • Review and interpret healthcare professional liability policies, endorsements, exclusions, conditions, claims-made provisions, consent-to-settle provisions, and applicable statutes.
  • Analyze coverage issues and provide recommendations regarding defense obligations, indemnity exposure, reservation of rights, and potential coverage defenses.
  • Draft, review, or provide input on reservation of rights letters, coverage position letters, disclaimers, and denial letters, as appropriate.
  • Partner with coverage counsel, in-house legal teams, carriers, and internal stakeholders on complex coverage matters.
  • Identify and escalate coverage disputes, bad faith concerns, excess exposure, regulatory issues, and other high-risk claim developments.

Settlement, Negotiation & Resolution

  • Evaluate settlement demands and develop negotiation strategies based on liability, damages, standard of care, causation, venue, coverage, and verdict exposure.
  • Negotiate settlements within authority and make recommendations for matters requiring additional approval.
  • Manage reserves in accordance with carrier guidelines and claim exposure.
  • Participate in mediations and settlement conferences involving high-value healthcare liability disputes.
  • Balance legal risk, financial exposure, policy obligations, and business objectives when recommending claim resolution.

Regulatory Compliance & Quality

  • Ensure claims are handled in accordance with applicable Department of Insurance regulations, statutory requirements, carrier guidelines, and internal protocols.
  • Maintain strong file documentation supporting liability analysis, damages evaluation, coverage positions, reserves, settlement strategy, and litigation direction.
  • Monitor claims for compliance risks, including timeliness, communication standards, fair claims handling practices, and escalation requirements.
  • Support audit readiness and quality claim handling expectations across assigned matters.

Skills, knowledge & expertise

Required (one of the following)

  • Juris Doctor (JD) with active bar membership in good standing, or
  • 7–10+ years of senior-level experience handling medical malpractice, healthcare liability, or complex professional liability claims.
  • Demonstrated experience handling claims with significant financial exposure, including seven-figure settlements, reserves, demands, or potential judgments.
  • Strong litigation management experience, including directing outside counsel and developing litigation strategy.
  • Experience evaluating liability, medical causation, damages, coverage, reserves, settlement value, and trial risk.
  • Demonstrated expertise in insurance coverage analysis and policy interpretation.
  • Experience issuing, drafting, reviewing, or advising on coverage positions, including reservation of rights letters, disclaimers, or denial letters.
  • Active adjuster licenses in applicable jurisdictions, or ability to obtain additional licenses as required.
  • Strong negotiation, analytical, documentation, and communication skills.
  • Ability to independently manage multiple high-severity, complex claims in a fast-paced environment.

Preferred Experience

  • Healthcare professional liability, medical malpractice, hospital liability, physician liability, nursing liability, allied health, or long-term care claims experience.
  • Experience working in a Major Case Unit, Complex Claims Unit, Specialty Claims Unit, or Excess Claims environment.
  • Prior experience as Claims Counsel, Coverage Counsel, National General Adjuster, Executive General Adjuster, Senior Claims Examiner, Complex Claims Specialist, or Senior Complex Claims Consultant.
  • Experience managing matters through mediation, settlement conference, arbitration, trial preparation, or trial monitoring.
  • Strong understanding of bad faith risk, excess exposure, coverage litigation, healthcare liability evaluation, and medical damages analysis.

Equal Employment Opportunity & Legal Notices

Benefits

At Davies North America, we are dedicated to supporting the well‑being and future of our qualifying employees. Our comprehensive benefits package includes:

  • Medical, dental, and vision plans to support your health and that of your family
  • A 401(k) plan with employer matching
  • Time‑off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non‑exempt employees
  • Paid holidays
  • Life insurance and short‑term and long‑term disability coverage

Benefit offerings, eligibility, and required employer contributions may vary based on role, classification, and applicable federal, state, and local laws, including those tied to an employee’s primary work location.Where required by law, the Company provides paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements.Diversity and Inclusion

Davies is dedicated to fostering a diverse and inclusive workplace that embraces a wide range of perspectives and experiences. We believe that diversity of thought is essential for innovation and creativity, and we actively promote an environment where all voices are valued and heard.

Compensation Transparency:
The salary range listed reflects the full compensation band for this role across all locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may impact the final offer. We share ranges to remain transparent and consistent with pay equity practices.

Background Check & Fair Chance Compliance

Any background check or review of criminal history, if applicable to the role, will be conducted only after a conditional offer of employment and in compliance with applicable federal, state, and local laws, including fair‑chance hiring requirements.

Massachusetts NoticeIt is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

We do not use sites like Facebook, Craigslist, or Telegram to recruit or interview potential employees or contractors. If you have been asked to provide any information through any method other than our career portal, please email us at

Originally posted on Himalayas

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