Senior Director, Risk Management

This is a fully remote position, open to applicants in United States.

📋 Description

• Develop and oversee the Company's risk management function.

• Manage the insurance claims process from initial notification to final resolution.

• Handle complex medical professional liability claims, which includes investigation, reviewing medical records, assessing liability and damages, setting reserves, supervising legal counsel, mediation, settlement negotiations, and trial preparation.

• Create and implement a clinical risk management program that utilizes claims, complaints, adverse events, and near-misses to identify patterns and mitigate risk.

• Establish governance for claims, including triage, escalation, documentation, authority protocols, metrics, and total-cost-of-risk reporting.

• Assess and implement AI and analytics tools for claims intake, medical record evaluation, exposure analysis, trend identification, and defense-budget assessment.

• Oversee the insurance portfolio strategy, including broker relationships, renewals, coverage, pricing, limits, retentions, and risk financing.

• Formulate recommendations regarding self-insurance, third-party administrators (TPAs), fronted programs, and captive insurance formation.

• Own the risk management AI strategy and provide guidance to leadership on AI-related risks.

• Develop the risk management roadmap, budget, risk register, and risk management information system.

• Supervise insurance and claims due diligence for acquisitions, joint ventures, and entry into new markets.

• Report to and offer counsel to the Chief Legal Officer, Chief Financial Officer, and executive leadership.

⛳️ Requirements

• A Bachelor's degree is mandatory.

• An advanced degree is preferred, such as a Juris Doctor, Master of Health Administration, Master of Business Administration, Master of Science in Nursing, or a similar qualification.

• Professional credentials are preferred, including CPHRM, AIC, ARM, CPCU, or RPLU.

• Extensive knowledge in managing medical professional liability claims at both the individual-case and portfolio levels.

• Practical understanding of AI tools and the ability to assess value, risk, and the need for human review.

• Capability to establish trust with physicians and advanced practice providers and influence their behavior without direct authority.

• Familiarity with healthcare risk frameworks, including peer review and quality protections, HCQIA, PSQIA, National Practitioner Data Bank reporting, and protected investigations.

• Strong executive presence and the ability to translate complex claims, insurance, and clinical risk issues into clear recommendations.

• A minimum of ten years of progressively responsible experience in risk management.

• At least seven years of significant direct experience managing healthcare professional liability claims.

• Required experience in building or significantly expanding a claims, risk management, or clinical risk program.

• Proven experience leading professional staff is required.

• Clinical training or active clinical licensure is preferred but not mandatory.

• Must not require visa sponsorship; the company is unable to provide sponsorship for a visa.

🏝️ Benefits

• Commitment to Equal Employment Opportunity and a nondiscrimination policy.

• No visa sponsorship is available at this time.