About the role
Job Description
Salary Range: $110,000 - $115,000/year
Incident Review and Investigations
* Review incident reports for completeness, accuracy, severity, and liability exposure; obtain missing information and assist communities with accident investigations and reporting. * Conduct and coordinate factual investigations, including interviews, timelines, records, and witness identification; work with clinical and operations leaders to assess contributing factors and immediate follow-up needs. * Escalate matters under established criteria to the General Counsel, clinical and operations leadership, or carriers; maintain organized investigation files and track open items to completion. * Preserve records, communications, video, and other evidence under established protocols and counsel’s direction.
Claims Management and Litigation Support
* Review claims in online systems daily; identify reportable incidents, claims, and circumstances, assist General Counsel with submission of timely and accurate insurance notices and supporting materials, and track acknowledgments and follow-up requests. * Maintain a claims register with status, key dates, assigned adjusters and counsel, and action items. * Monitor claims activity and deadlines, obtain updates, escalate significant developments or delays, and assist in counsel’s preparation of factual summaries for evaluation, mediation, and resolution. * Under counsel’s direction, coordinate discovery records, factual information and identification of witnesses and custodians. * Protect sensitive information and follow counsel’s instructions on confidentiality, privilege, and document preservation.
Risk Prevention and Process Improvement
* Analyze incident and claims trends, frequency, and severity by region and community; identify recurring causes and reporting gaps, and report significant matters, trends, and corrective actions to the General Counsel. * Partner with clinical and operations leaders to develop and track corrective actions and initiatives that reduce claim frequency and severity; improve policies, reporting, investigations, escalation criteria, and claims workflows. * Train and guide community teams on reporting, documentation, and investigation expectations; perform other duties as assigned.
Qualifications
Level of Formal Education: Bachelor’s Degree from a four-year college preferred; or equivalent combination of education and training
Area of Study: N/A
Years of Experience: Minimum five years of experience.
Type of Experience: Risk and claims management with at least two years of insurance experience (e.g. Carrier, Broker, or Third Party Administrator). Relevant backgrounds may include corporate or regional risk management for a senior living operator; professional liability claims work for a carrier, broker, or third-party administrator; or healthcare risk consulting. Experienced litigation paralegals with demonstrated insurance reporting and incident investigation experience will also be considered. A nursing background is a plus but is not required.
Special Certifications: N/A
Language Skills: N/A
Technical Competencies: Experience with MS office (Word, Excel, Powerpoint, Access)
Skills and Ability:
* Effective verbal and written communication skills, with the ability to effectively interact with all internal and external business partners. * Strong analytical and problem-solving skills. * Excellent organizational skills including ability to prioritize and coordinate multiple tasks and projects. * Ability to make independent decisions and solve problems based on precedents and established guidelines. Know when to refer issues to supervisor and when to handle them personally. * Ability to work in a team environment and independently. * Ability to maintain confidentiality.
Personal Attributes: Interact professionally and effectively with all levels of the organization
Other/Preferred:
* Excellent knowledge of claims management, HR practices, principles, and workers compensation laws/regulations. * Travel to communities required.
Additional Information
Senior Lifestyle offers a comprehensive benefits plan to eligible team members including health, dental, vision, retirement benefits, short-term disability, long-term disability, and paid time off. All Senior Lifestyle positions are eligible to use DailyPay, an application that allows you to access your earned but unpaid wages before your next payday.