Directs and manages the Risk, Claims & Insurance Department. The Risk, Claims & Insurance Department includes direct management of five (5) co-workers -- (four (4) Directors and one (1) Senior Data analyst) -- and indirect supervision for fifteen (15.5) Risk/Claims Managers and Claim Coordinators. The responsibilities include managing:
the purchase of all commercial insurance policies across the Ministry
the handling of all claims made against the Ministry and co-workers
setting and meeting financial goals for Risk Claims & Insurance including the financial performance of the Pooled Liability Programs and purchased insurance policies
relationships with retained actuaries and Ministry Finance to ensure adequate funding of the Pooled Liability Programs
determining equitable cost allocation to Mercy entities and co-workers for the applicable Pooled Liability Programs and purchased insurance coverages
communication with senior leadership as needed regarding goals, significant risks and claims
Responsibilities and Qualifications
Establish the goals, strategies, operational processes, internal controls and monitoring reports for the Risk Claims & Insurance team for the Ministry including all Communities, hospitals and foundations (see attached document).
Direct supervision of five (5) co-workers – four (4) Director, Regional Risk/Claims positions (all remote) and one (1) Senior Data Analyst position – and indirect supervision of fifteen (15) Risk/Claims Managers and Claim Coordinators (all remote).
Establish and monitor liability coverage for the Ministry through the use of Pooled Liability Programs, purchased insurance, risk transfer through contract provisions, and assumption of risk.
Establish and meet financial goals for Risk Claims & Insurance including claim recognition and handling, claim reserving, loss and expense payments, departmental budget, Pooled Liability Programs reserving and balance sheet asset allocations in consultation with retained actuaries and Ministry Finance.
Create and maintain a culture of fairness and accountability for the Risk Claims & Insurance team which includes a commitment to pay claims that are owed and to ensure workloads that are achievable.
Draft and revise Pooled Liability Program documents as needed in compliance with all applicable laws, regulations and court decisions.
Provide legal review of contractual terms regarding insurance and indemnification as requested by the Legal Department.
Participate in legal review for all acquisitions and new ventures to ensure all appropriate insurance coverage terms and conditions through Pooled Liability Programs and/or purchased insurance for the acquired or new entity and for Mercy Health.
Act as the sole source in consultation with the Ministry Insurance Manager and the Credentialing and Data Center for confirmation of coverage for liability and first party exposures for Mercy entities and co-workers.
Serve as the principal liaison with Ministry Patient Safety leadership, the Data & Credentialing Center and Legal team members
Manage the operation of relevant systems including Riskmaster, Datix, and Business Objects to ensure data integrity and completeness for financial reporting requirements.
Education: Law Degree. Preferred membership in CPCU and CLM.
Licensure: Eligible to join Missouri State Bar.
Experience: Ten (10) years of claim management experience including direct management of remote staff and familiarity with medical malpractice claims
Excellent oral and written communication skills.
Ability to work collaboratively with diverse groups to impact and influence change.
Ability to travel up to 25% of the time.
Proficient with Office including Excel, Word, PowerPoint.
Demonstrated understanding of actuarial reports and techniques.
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