At Triple-S, we are committed to providing meaningful job experiences for Valuable People (Gente Valiosa). We strive for excellence in everything we do, from the way we work together to the way we serve our customers.
When you join Triple-S, you will be key to our efforts on delivering high-quality and affordable healthcare as well as contribute to our purpose to enable healthier lives. We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid, Commercial, Life and Property & Casualty Businesses.
Let's build healthier communities together, join now!
JOB SUMMARY
In charge of leading our litigation and claims management efforts, overseeing all aspects of litigation, from selecting external counsel to developing and implementing litigation strategies. Responsible for managing high-risk litigations, ensuring compliance with billing policies, and supervising internal and external personnel. As Secretary to the Claims Committee, the Claims Legal Manager will have a strong understanding of insurance litigation, claims handling, and risk management, with the ability to collaborate with cross-functional teams and make strategic decisions that minimize reputational risk and financial exposure. Provides strategic direction to drive tactical plans of the company, in addition to administrative responsibilities and development of its employees.
ESSENTIAL FUNCTIONS
- Oversee all litigation matters, including selection and referral of claims to internal or external counsel, and approval of key litigation strategies and documents (e.g., motions, briefs).
- Receive and respond to legal inquiries from claims staff, referring matters to internal or external counsel as needed.
- Receive and manage complaints and investigations from regulatory bodies (e.g., OCS), referring matters to internal or external counsel as needed.
Identify and escalate high-risk litigations to TSM/GW, reporting on litigations with potential reputational risk or exposure over $1M. - As secretary of the Claims Committee, in charge of identifying and notifying the cases to be presented, develop their presentation to the committee in close collaboration with the adjusters and/or lawyers as required, and prepare and notify the meeting minutes as defined in the charter.
- Collaborate with the Casualty Claims Manager to develop and implement litigation strategies, including adjustments, expert resources, and budgeting.
- Evaluate the performance of external counsel and internal staff on an annual basis.
- Supervise and manage internal counsel, ensuring effective and efficient delivery of legal services.
- Oversee and ensure compliance with billing policies and procedures.
EDUCATION
- Juris Doctor
EXPERIENCE
- Juris Doctor from an accredited institution, admitted to the bar in Puerto Rico and licensed to practice law in local and federal courts, with 10 years of experience and extensive knowledge of Property and Casualty Policies and Regulations.
- Puerto Rico All Lines Insurance Adjuster License, preferable.
LICENSES AND CERTIFICATIONS
COMPETENCIES
- Customer Delight
- Data Driven Insights
- Develops Talent
- Financial & Business Acumen
- One Company Mindset
- Practical Knowledge in Tech
It is company policy to seek for the qualified applicants for positions throughout the company without distinction of race, color, national origin, religion, sex, gender identity, real or perceived sexual orientation, civil status, social condition, political ideologies, age, physical or mental disability, veteran status or any other characteristic protected by law. Drug-free company.
Equality Employment Opportunity/Affirmative Action for People with Disabilities/Veterans. Employer with E-Verify to verify the eligibility of employment of all the new employees.
We encourage Veterans and Disabled to Apply.