Claims Director Jobs in Riverside, CA (NOW HIRING)

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CNA is a market leader in insuring Healthcare providers and entities including Allied Healthcare Facilities, Aging Services and Allied Healthcare Providers, including nurses, nurse practitioners, physical therapists, counselors, pharmacists, massage therapists, and more than 100 other categories of medical service providers. In this position, you will direct handle and serve as a lead strategist on complex and high-exposure Allied Healthcare Provider professional liability claims. This role is responsible for analyzing complex coverage matters, driving claim resolution, managing complex litigation including risk transfer opportunities, advising leadership on legal and claim risks, and partnering with Underwriting and other business units on emerging trends and portfolio management. The individual must be capable of stepping into a claim at any point in its lifecycle, independently evaluating exposure, and proactively advancing matters toward optimal resolution.
The Healthcare Claims Severity & Excess Team manages the most severe of our Healthcare claims across all segments. While this role will be focused on Allied Health Providers, there may be opportunities to expand into other segments as the business grows and evolves

JOB DESCRIPTION:

Claims & Litigation Strategy

• Handle and oversee the most complex and severe Allied Healthcare Provider claims.
• Evaluate coverage, liability, causation, damages, and settlement opportunities.
• Support and mentor AHP claim professionals with complex coverage analysis and communication.
• Identify and assist with risk transfer opportunities, including evaluating potential tenders, contractual indemnity, additional insured status, and other avenues to shift or share exposure where appropriate.
• Develop and direct litigation management strategies.
• Lead negotiations in high-value claims and alternative dispute resolution efforts.
• Ensure appropriate reserving and exposure management.
• Provide strategic guidance during trials, mediations, and critical litigation events.
• Other duties as assigned

Skills & Competencies

• Advanced Healthcare claims, coverage, and litigation expertise.
• Strategic thinking and executive-level decision-making.
• Excellent negotiation, verbal and written communication, and presentation skills.
• Ability to influence stakeholders across multiple functions.
• Strong analytical and problem-solving capabilities.
• Ability to thrive in ambiguous, high-pressure situations.

Leadership & Consultation

• Serve as the subject matter expert and strategic resource for Allied Healthcare Provider matters.
• Counsel claim leadership regarding legal risks, litigation strategy, and emerging claim trends.
• Mentor claim professionals and provide technical training on complex healthcare exposures.
• Participate in large-loss reviews, escalation discussions, and portfolio strategy initiatives.
• Create and present financials, claim trends, loss drivers, and other key portfolio insights for business partners, claim reviews, and association meetings.

Business Partnership

• Partner closely with Underwriting, Actuarial, Risk Control, and Operations to identify claim trends and severity drivers.
• Communicate significant claim developments and emerging legal issues impacting the healthcare portfolio.
• Support underwriting strategy through claim trend analysis and lessons learned from large-loss matters.

Regulatory & Industry Expertise

• Monitor legal, regulatory, and healthcare industry developments.
• Provide guidance on evolving exposures involving allied healthcare providers, hospitals, aging services, physicians, allied facilities, and other healthcare providers.
• Assist in the development of claim handling best practices and operational initiatives.

Qualifications

Required Experience

• Minimum 10 years of healthcare professional liability, medical malpractice, insurance claims, or litigation experience.
• Demonstrated expertise handling high-severity and high-exposure claims.
• Strong background in litigation management and settlement negotiations.
• Proven ability to analyze complex coverage, liability, damages, and business issues.

Education and Experience

• Bachelor's degree; Juris Doctor (J.D.) preferred.
• Prior medical malpractice defense, healthcare litigation, or complex coverage claims experience strongly preferred.
• Demonstrate leadership and mentoring skills.
• Innovative and adaptive to the evolving Claims environment, including incorporating the use of AI as appropriate.
• Insurance designations a plus (AIC, CPCU)

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In certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia, California, Colorado, Connecticut, Illinois, Maryland, Massachusetts, New York and Washington, the national base pay range for this job level is $97,000 to $189,000 annually.Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visitcnabenefits.com.

CNAutilizesAI-enabled technology during the recruiting process. For more information, please visitourcareers page.

CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contactleaveadministration@cna.com