Director of Complex Claims & Counsel
Banner Health, Phoenix, AZ, United States
Primary City/State
Phoenix, Arizona
Department Name Litigation & Claims Mgmt
Work Shift Day
Job Category Legal
Position Summary This position is a high impact role responsible for cost‑effective and successful management of complex, potentially high exposure claims while providing legal counsel on risk management, claims and litigation matters across Banner Health (BH). The role combines advanced litigation and claims management expertise with legal acumen to manage complex professional liability claims, multi‑party litigation, and other liability exposure. The position directs the claims investigation process, evaluates liability, oversees outside counsel, and develops equitable resolution strategies for claims and lawsuits, primarily focusing on Hospital and Physician Professional Liability (HPL) claims. The role may also co‑manage General Liability, Employment Practices, Management Liability or other claims as assigned.
Core Functions
Knows, incorporates, and demonstrates the mission, vision, values, brand, strategic initiatives, core measures and core behaviors into leadership behaviors, practices and decisions, performing all functions according to established policies and regulatory requirements.
Implements best‑in‑class claims and litigation management strategies, responsible for the investigation, evaluation and management (or co‑management) of complex, potentially high exposure claims through resolution, including insurance coverage evaluation, carrier notifications, negotiations with claimants and attorneys, and direct interaction with senior management and external stakeholders.
Drives resolution of claims by formulating and implementing thorough investigation plans and defense strategies for each claim, including preservation holds, witness credibility assessment, reserve setting and ongoing communication with the Sr. Director, Claims & Litigation Counsel.
Manages data entry, monitoring, and compliance with Medicare, Medicaid, and MMSEA reporting requirements, as well as secondary payer regulations.
Serves as a trusted advisor to internal clients, providing legal advice on risk management, settlement, and litigation strategies, and directing privileged investigations.
Participates in attorney selection and re‑evaluation processes, retains defense counsel, supervises outside counsel per litigation protocol, approves fees and expenses, and establishes claim resolution strategies with counsel.
Presents comprehensive information at internal claim reviews and prepares case review material, providing status reports for open and closed claims as requested, and updates policies and procedures for senior leadership.
Identifies risk management issues, documents risk modification strategies, collaborates with risk managers, and provides education and training on risk and litigation mitigation.
Directs and supervises Litigation Management Specialists/Paralegals and Information Analysts, provides performance feedback, participates in hiring and orientation, and evaluates progress to plan.
Minimum Qualifications • 4‑year undergraduate degree or equivalent related experience. • Juris Doctorate (J.D.) and admission to at least one state bar, plus a minimum of eight to ten years of medical professional liability management experience, either in‑house or as outside counsel. • Admission to the AZ bar through reciprocity or in‑house counsel provision. • Strong negotiating skills, working knowledge of medical terminology, analytical skills, ability to organize and communicate information both orally and in writing. • Initiative, independence, conflict‑resolution ability, and handling sensitive situations calmly. • Ability to meet deadlines, respond to shifting priorities, collaborate in a shared leadership environment, adapt to changing priorities, and work under pressure. • Ability to travel to various BH sites or other locations for litigation management purposes up to 50% of the time.
Preferred Qualifications • Nursing degree or other clinical background. • Advanced knowledge of healthcare claims, risk management, insurance, quality management, and performance improvement. • Knowledge of in‑house liability claims management processes and procedures, and related healthcare regulatory and/or litigation experience. • Prior managerial experience within a healthcare system setting or other large multi‑operational, complex corporate environment.
EEO Statement EEO/Disabled/Veterans
Workplace Policy Our organization supports a drug‑free work environment.
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Department Name Litigation & Claims Mgmt
Work Shift Day
Job Category Legal
Position Summary This position is a high impact role responsible for cost‑effective and successful management of complex, potentially high exposure claims while providing legal counsel on risk management, claims and litigation matters across Banner Health (BH). The role combines advanced litigation and claims management expertise with legal acumen to manage complex professional liability claims, multi‑party litigation, and other liability exposure. The position directs the claims investigation process, evaluates liability, oversees outside counsel, and develops equitable resolution strategies for claims and lawsuits, primarily focusing on Hospital and Physician Professional Liability (HPL) claims. The role may also co‑manage General Liability, Employment Practices, Management Liability or other claims as assigned.
Core Functions
Knows, incorporates, and demonstrates the mission, vision, values, brand, strategic initiatives, core measures and core behaviors into leadership behaviors, practices and decisions, performing all functions according to established policies and regulatory requirements.
Implements best‑in‑class claims and litigation management strategies, responsible for the investigation, evaluation and management (or co‑management) of complex, potentially high exposure claims through resolution, including insurance coverage evaluation, carrier notifications, negotiations with claimants and attorneys, and direct interaction with senior management and external stakeholders.
Drives resolution of claims by formulating and implementing thorough investigation plans and defense strategies for each claim, including preservation holds, witness credibility assessment, reserve setting and ongoing communication with the Sr. Director, Claims & Litigation Counsel.
Manages data entry, monitoring, and compliance with Medicare, Medicaid, and MMSEA reporting requirements, as well as secondary payer regulations.
Serves as a trusted advisor to internal clients, providing legal advice on risk management, settlement, and litigation strategies, and directing privileged investigations.
Participates in attorney selection and re‑evaluation processes, retains defense counsel, supervises outside counsel per litigation protocol, approves fees and expenses, and establishes claim resolution strategies with counsel.
Presents comprehensive information at internal claim reviews and prepares case review material, providing status reports for open and closed claims as requested, and updates policies and procedures for senior leadership.
Identifies risk management issues, documents risk modification strategies, collaborates with risk managers, and provides education and training on risk and litigation mitigation.
Directs and supervises Litigation Management Specialists/Paralegals and Information Analysts, provides performance feedback, participates in hiring and orientation, and evaluates progress to plan.
Minimum Qualifications • 4‑year undergraduate degree or equivalent related experience. • Juris Doctorate (J.D.) and admission to at least one state bar, plus a minimum of eight to ten years of medical professional liability management experience, either in‑house or as outside counsel. • Admission to the AZ bar through reciprocity or in‑house counsel provision. • Strong negotiating skills, working knowledge of medical terminology, analytical skills, ability to organize and communicate information both orally and in writing. • Initiative, independence, conflict‑resolution ability, and handling sensitive situations calmly. • Ability to meet deadlines, respond to shifting priorities, collaborate in a shared leadership environment, adapt to changing priorities, and work under pressure. • Ability to travel to various BH sites or other locations for litigation management purposes up to 50% of the time.
Preferred Qualifications • Nursing degree or other clinical background. • Advanced knowledge of healthcare claims, risk management, insurance, quality management, and performance improvement. • Knowledge of in‑house liability claims management processes and procedures, and related healthcare regulatory and/or litigation experience. • Prior managerial experience within a healthcare system setting or other large multi‑operational, complex corporate environment.
EEO Statement EEO/Disabled/Veterans
Workplace Policy Our organization supports a drug‑free work environment.
#J-18808-Ljbffr