Director, Insurance/Risk Management

Purpose:

Responsible to effectively manage the corporation's Cost of Risk. Has system-wide responsibilities directing risk financing of Property/Casualty risks, evaluating operational opportunities to reduce expense using alternative risk financing options, claim management, clinical risk control, and database management functions to support insurance company accounting and internal audit and financial controls.

Responsibilities:

Develop and design the financial framework to protect the health system's assets and revenue from risks associated with property/ casualty loss. This may involve Insurance/Reinsurance Program, Self-Insurance, and Captive Insurance Companies. Coordinate and organize Risk Management departmental operations to effectively serve operational and corporate goals and objectives. Negotiate and direct insurance brokerage services to most effectively reduce the corporation's Cost of Risk. Oversee claim management services provided through outside legal counsel. Work with claim adjusters to negotiate prudent disposition of property and liability claims. Coordinate claim settlement negotiations among Mcare representatives, legal counsels, and insurance adjusters when determined to be in the best interest of the corporation. Influence Senior Management on operational matters that impacts Cost of Risk. Maintain insurance, accounting, serious incident reports and claim data in an effective time managed data system. Coordinate administrative servicing of the corporation's Self-Insurance Workers' Compensation with the Bureau of Labor and Industry. Identify system-wide exposures for loss and develop most prudent method of handling. Arrange and evaluate actuarial reports to evaluate loss exposures, satisfy Trust Regulators, and establish adequacy of liability reserves. Investigate Adverse Medical Events (AME) for liability exposure and root cause analysis. Develop department goals and objectives that support cost of risk management and improve patient safety. Design and maintain an effective database management reporting system that captures relevant data and enables critical information to be maintained and trended to serve various operational and corporate initiatives. Work on the Workers' Compensation Task Force to monitor effectiveness of the program and to recommend and implement changes that reduce Cost of Risk. Participate in the Environment of Care Committee. Support a strong operational linkage with Performance Improvement. Provide semi-annual Risk Management reports to Medical Executive Committee. Provide regular Risk Management reports to Corporate Management Group. Member of the Safety & Risk Management Hospital Board Committee. Maintain awareness of legislative and insurance industry activities that impact the corporation's Cost of Risk and strategic planning. Performs in accordance with system-wide competencies/behaviors. Performs other duties as assigned. A graduate degree in Business Administration with specialized focus on finance and/or risk management and insurance specialties is required. Additional specialized education with Associate in Risk Management (ARM) or Certified Property/Casualty Underwriter (CPCU) certification is required. Training in CQI or TQM is required. Ten or more years of progressively responsible experience in risk management in a multi-site organization which includes for-profit and not-for-profit business units. Well developed knowledge of accounting and financial skill to evaluate financial alternatives and manage insurance operations of captive insurance companies. Well understood and experienced background of Insurance broker relationships and the Insurance market delivery system.

Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran