ROLE PROFILE

Job Title: Head of Costs Unit/Costs Lawyer / Current Job Holder(s):
Department: Claims Policy & Technical Department –Professional Services Division / Date Created/By:
DEPARTMENTDESCRIPTION
The MPS claims handling process is designed to ensure efficient and timely claims handling, providing excellent service to members. All new claims and pre-claims undergo assessment and evaluation within the Claims Assessment Team (CAT) prior to allocation for handling by the appropriate Medical or Dental Pathway Teams.
The Claims Policy and Technical department is part of the Professional Services Division. The department delivers a claims management function in all Regional claims, all England and Wales claims valued in excess of £500,000 and provides technical advice, resource and governance to enable and support the delivery of a world class claims management service to MPS members.
Following referral from the Pathway Teams the Costs Unit provides an in-house costs resolution and advisory service
JOB PURPOSE
The purpose of this role is twofold –
As a Technical Unit Leader:
To provide leadership for and undertake line management responsibility of the Costs Unit whilst ensuing costs data is collected, maintained and reported in order to identify trends and to enable the Unit to provide costs advice to the claims teams.
As a Costs Solicitor:
To provide an in-house specialist servicefor the claims team. To analyseclaims for costs; to draft and serve relevant procedural documentation. To negotiate and settle costs with Claimant firms and where necessary advocate at hearings on behalf of MPS. To minimise reliance on external input and enhance the speed and efficiency in which costs claims are concluded. To review claimant and defence costs submittedby external panel to ensure excellent value. Claims are largely UK based yet input into other jurisdictions may be required.
RESOURCES MANAGEMENT
Management responsibility for: Direct reports – 8CostsNegotiators
Reports to: Director of Claims Policy and Technical
Budgetary/financialframework: Role involves authority to settle costs up to a specified amount, as applicable from time to time.Responsible for an annual operational budget of c. £350k. Role involves approving strategy and settlements on costs claims. Responsibility for people, resources and equipment.
KEY RESPONSIBILITIES
Internal Liaison
  • Lead and performance manage the roles that are agreed with theDirector of Claims Policy and Technical, ensuring that performance reviews and relevant training/development activities are identified and undertaken
  • Assist the Director of Claims Policy and Technical in preparing claims reports and information for brokers and actuaries at annual insurance renewal
  • Assist the Director of Claims Policy and Technical in preparing responses to Consultations
  • Ensure agreed Operational MI is reported to Director of Claims Policy and Technical
  • Work collaboratively with the Claims Policy and Technical function, Medical Services Department and Dental Protection to ensure that all agreed policies are observed and quality standards are delivered to be reviewed on a regular basis.
  • Liaise with all Leads to ensure clear and consistent quality standards and communication, consistent member service and the removal of any barriers impeding claims service delivery
  • Liaison with the pathway Leads providing regular feedback on the Litigation Solicitorsperformance.
Management of the team to ensure prompt and consistent:
  • Team allocation of new referrals/cases
  • Advice to CAT and the Claims team on appropriate costs estimates when requested
  • Direct managementof claims for costs from receipt/service of a schedule or bill through to payment/recovery; liaising on costs apportionment and obtaining contribution where necessary.
  • Reduction of overall costs by minimising the use of external counsel and costs advisors
  • Development of team and individual targets ensuring they are met and exceeded in accordance with MPS Delivering Exceptional Staff (DES) and reported to the Director of Claims Policy and Technical
  • Team communication and development sessions
  • Review and update of team resource scheduling models and that any resource issues are escalated to the Director of Claims Delivery
Management of and liaison with Third Parties
  • Work with a procurement specialist to establish and thereafter maintain a cost efficient framework with third party costs service providers.
  • Undertake regular audits of any externally instructed Costs Advisors providing reports to the Quality Assurance Lead, Director of Claims Delivery and Director of Claims Policy and Technical
  • Ensure that MPS is a point of contact for consultation on legislative, rule or protocol changes which may impact upon overall Costs and that it has a presence and is represented on any key consultative committees eg Civil Justice Committee
  • Develop and maintain a high profile for the MPS Costs Unit in the Legal market place.
Compliance, training & legal knowledge
  • Act as a knowledgeable and effective technical expert for the costs negotiators and wider claims management team
  • Develop and maintain high levels of technical MPS operating knowledge by building team knowledge
  • Be responsible for the provision of regular updates and training on legal changes relevant to costs as they impact upon clinical negligence litigation, to include but not limited to face to face updates, a regular bulletin of key changes and guidance on implementation issues.
  • Continually develop personal skills by attending all required training courses and maintaining an up to date knowledge of the relevant legislation and case law, services, systems and work processes
  • Monitor proposals for changes to legislation and procedural rules, and any external factors which might impact on MPS claims philosophy and processes and ensure these are brought to the attention of the Director of Claims Policy and Technical and the Director of Claims implementation
  • Comply with applicable professional ethical guidance and all relevant internal and external rules, policy and procedures, including those relating to Health and Safety, Data Protection, IT Security and all those contained within the issued Staff Handbook. Adheres to the business rules relevant to the role, which are subject to change from time to time.
  • Review and act upon internal and external audit recommendations
Data
  • Collate and maintain a database of settled quantum and costs claims with particular reference to claimant firms to facilitate estimating, trends and to advise on costs
  • Ensure the reports for the reinsurers are completed and submitted as and when requested by the risk team
Other
  • Undertake other duties and tasks that from time to time may be required and that are appropriate to the role.

MAIN JOB REQUIREMENTS AND PERSON SPECIFICATION
Education, Experience, Skills, Knowledge and Abilities:
  • Certified costs Lawyer with current practising certificate
  • Member of the Association of Costs Lawyers
  • Substantial experience of dealing with clinical negligence costs claims
  • The competence and the ability to critically review information and take a proactive and strategic approach tocosts negotiation
  • Understanding the importance of and having the ability to accurately estimate costs
  • Experience of leading through change
  • Experience of leading a comparable claims operation / service delivery team in a legal or insurance environment
  • Proven track record of delivering excellent internal customer and external member service
  • An understanding of how and why proactive claims management is essential to the success of the organisation
  • An awareness of how internal and external changes can and do have an impact on MPS
  • Leadership skills demonstrated in a high performance environment
  • Excellent analytical, communication, interpersonal and negotiation skills
  • The ability to identify potential issues and solve problems as and when they arise
  • Ability to remain calm and professional in the face of challenge and assertion
  • Ability to resolve conflict in an effective and professional manner
  • Strong commitment to a collaborative working environment.
  • Ability to adapt and be flexible in order to meet the needs of the members and the team
  • Integrity and respect for people of all roles and backgrounds with the ability to gain the trust and respect of colleagues and external contacts

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