Senior Claims Administrator

To perform professional, technical and analytical functions in a variety of liability claims areas including, but not limited to personal property, personal injury, auto and general liability to ensure SMUDs requirements are met within all applicable laws, rules, regulations, and policies.

Serves as an senior/subject matter expert level resource in a relevant professional discipline; works independently on projects of moderate complexity; exercises independent judgment and discretion; may serve in a Lead role and assist in planning, coordinating, prioritizing, monitoring and evaluating the work results in assigned area and in selecting, training, motivating, evaluating and developing lower-level personnel.

• Leads in analysis of claims and supporting documentation filed against SMUD to determine the appropriate response within the time frame and in the manner prescribed by the California Government Code and recommends the appropriate response to the General Counsel
• Manages and oversees the activities of third-party liability claims administrator firm (TPA) to ensure timely and effective claim investigations, appropriate loss and expense reserving, and claim handling actions based on evaluations of legal liability and damages.
• Gives direction and leads settlement negotiations or deny claims based upon the liability and damage analysis. In disputed claims where litigation may result, assign and assist defense counsel in case defense, as well as evaluate the performance of defense counsel through the progression of the case to conclusion.
• Responsible for budget forecast recommendations annually for auto liability and general liability claim and expense payments.
• Directs the managing of the claim trust account to ensure adequate funding through monthly replenishment deposits and special deposits to cover larger than normal expenditures. Reconcile the claim trust account check register monthly to verify accuracy and resolve any discrepancies before forwarding the trust deposit requests to SMUD Accounting.
• On an ongoing basis, review small claims resolutions by SMUD Field Services to ensure payouts are limited to $5,000 and made only when SMUD is liable.
• Oversight for the validity and accuracy of the Attorney-Client Privilege log is completed on claims referred to the TPA and is provided to the Office of the General Counsel.
• Oversee the notification of the excess liability insurance carrier of catastrophic injury or fatality incidents, employment liability claims, or any claims valued at 50% of SMUD's self-insured retention. Provide an initial analysis of SMUD's liability exposure. After notification, ensure the insurance carrier is apprised of case developments. During litigation, ensure assigned defense counsel copies the insurance carrier on status reports, pleadings and settlement strategy.
• Plans, coordinates, prioritizes, monitors, guides, reviews and conducts work activities associated with department internal/external projects in accordance with established task objectives.
• Performs related duties as required.

BA/BS degree from an accredited college or university majoring in Business or Public Administration, Insurance and Risk Management, Finance or related field or equivalent experience. If no degree, at least nine (9 ) years of relevant experience is required.

Five (5 ) or more years of progressively responsible work experience as a paralegal, insurance claims adjuster/manager, or equivalent. Experience to include analyzing legal causes of action, investigating factual backgrounds of claims and preparing claims evaluations.

Procedures and practices for monitoring and managing projects; procedures and practices for overseeing contractor's/consultant's work activities; procedures and practices for litigation budget management; federal, state and local laws, codes and regulations governing the utility industry; policies, claim handling practices and procedures related to the utility industry; trends and best-practices related to liability claim program analyses and treatment of 3rd party claim risk; methods and techniques related to claim reserve financing; 3rd party property damage and personal injury claim risks of a nuclear utility; claim mitigation through loss control; tort and contract law; principles and practices of economic analyses of liability claim exposure of projects and programs; methods and techniques for planning, organizing, directing and controlling work activities; methods and techniques for training staff; principles and practices for budget administration; techniques and concepts related to team management; English composition and business writing and vocabulary standards; methods and techniques for report preparation and writing; characteristics and operational needs of various organizational units; interrelationships between SMUD's operations and relevant external entities.

Assess liability claim risks and identify appropriate methods of mitigation; identify alternative courses of action and determine which is best; reconcile significant and/or controversial differences to bring interested parties to consensus; develop and implement new and revised policies and procedures to provide for the effective operation of the area of responsibility; direct on-the-job training activities; initiate, maintain and oversee adherence to safety policies and procedures; interact with others to influence and motivate; interpret and apply SMUD policies procedures, applicable MOU and/or other special agreements; explain complex and/or controversial policies, regulations, procedures and/or activities internally/externally; express ideas/facts clearly and concisely to individuals or groups, taking into account the audience and nature of information; monitor and manage projects; analyze relevant legislation and develop related policies and procedures; identify and implement effective programs geared to SMUD needs; conduct complex claim risk analysis; achieve results through the efforts of other people; establish and maintain effective working relationships internally/externally; plan, organize, direct, and review the work of others; prepare performance plans and evaluations for employees; develop performance standards and accountability; utilize English grammar, punctuation and vocabulary standards; systems and software relevant to the job; communicate effectively orally and in writing internally/externally; establish and maintain effective working relationships internally/externally.