Department Overview: Function/Duties of Position:

Assist VP/Chief Risk Officer (CRO)

• Assist by leading and oversight of Risk Management Department administrative/organizational tasks and positions including supplies/equipment, systems and office wide meetings/projects. Lead team of Risk Analyst/Executive Assistant(s) with management of CS Stars/Riskonnect (RMIS) and OnBase.
• Provide leadership and guidance for the INSCO claim payment process including approval of transfer of funds in absence of VP/CRO, processing of stop payments, voids, etc… Provide approval of payments for non-INSCO claim payments.
• Responsible for oversight of personnel matters including attendance policy and work schedules. Assist with onboarding and offboarding staff. Provide tools and recommendations for personal and professional development of staff.
• Provide updates on key matters/issues to VP/CRO. Act as key contact person for risk management issues in their absence.
• As directed by and in collaboration with the VP/CRO, partner on strategic planning and developing reports/data to support needs and recommendations.
• Collaborate with other RM management staff to provide support and assistance in developing Enterprise Risk Management tools, practices and policies to analyze and manage risks according to an enterprise risk management framework, ensuring alignment with organizational objectives.

Insurance Services Oversight:

• Provides, within authority granted by VP/CRO: the purchase and implementation of specified components of the OHSU Risk Financing Program including technical management of the multiple lines of insurance, renewal processes, and risk financing strategy recommendations and recesses.
• Assist in broker, third party administrators (TPA) and insurer selections for various risk management product. Ensure development and management of risk financing and multiple lines of coverage renewal timelines, application process, coverage questions and contractual requirements.
• Gather and analyze underwriting data, including loss data; assist in making underwriting recommendations; assist in developing underwriting guidelines; review and analyze loss control reports.
• Accountable for achieving strategic objectives ensuring effective risk management processes are in place for insurance programs. Identify measure and provide technical management losses affecting the multiple lines of insurance coverages. Maintain appropriate internal controls and processes for identifying insurable exposures, coverage documentation, and authorized extensions of insurance/self-insurance coverage within authority granted by VP/CRO.
• Direct and supervise development and distribution of insurer submissions as required by OHSU contracts, law, and policy or as requested by VP/CRO.
• Provide oversight of the management of the Off-Campus Authorization process to ensure extension of professional liability insurance coverage to all OHSU employed clinicians. Also, in collaboration with the VP/CRO, review and analysis emerging risk exposures. Explore and strategize risk transfer options for these emerging risks (i.e. international travel, employees outside OR and WA, patients outside OR and WA).

Claim Management/Claims Information:

• Provide technical oversite of the claims administration for multiple lines of coverage including program design and strategy, implementation and day-to-day operational management within authority granted by VP/CRO.
• Act as liaison with insurers to ensure reporting and compliance with claims handling instruction of EPL/D & O claims in collaboration with OHSU Legal. Including participation in monthly EPLI Review Meetings and providing timely handling and litigation management including provision of loss advice forms to carriers and other claims related functions.
• As requested by the VP/CRO, assist with budgetary projections, multiple lines of coverage mitigations and strategies and related activities.
• Implement programs consistent with organizational program standards; Manages accountabilities in the administration of first- and third-party claims. Oversight and direction of TPA or insurer services.
• Builds, maintains and manages relationships with claims insurers, TPA’s, outside legal counsel, vocational rehabilitation case managers, medical case managers, and other claims related parties.
• Manage day to day performance of WC program, return to work and medical management processes. Oversight and direction of OHSU’s return to work program/light duty work assignments; assurance of appropriate management of WC claim management including, but not limited to, compensation payments, notices, regulatory compliance, etc. Manages litigated and complex cases and has significant settlement authority to include employment related matters when deemed appropriate.
• Collaborate with internal stakeholders in investigating potential claims, claims/lawsuits resulting in developing risk avoidance techniques by collaborating on development and implementations of risk mitigation measures. This includes partnerships with internal stakeholders including, but not limited to Human Resources, Affirmative Action/Equal Opportunity, Legal, Environmental Health, Occupational Health, and facilities.

Other Insurance Risk Program Performance:

• Establish performance, customer service and quality measurement standards for the risk finance and insurance services team. Provide direction to departments and internal Risk Management staff with regard to evaluating, measuring, reporting and data related to those programs.
• Identify, direct, consult and interact in risk mitigation activities necessary to reduce work injuries and other exposures that could result in a claim. Interact with Environmental Health, AAEO, Legal, HR, Facilities, Department Directors and outside resources necessary to achieve a reduction in exposures.
• Ensure team members maintain membership on various OHSU Safety committees and other committees that may impact reductions in risk exposures.

• Develop, implement and deliver appropriate education and information resources for the OHSU community related to WC, employee/general public safety, and related insurance/risk financing including, but not limited to, new employee orientation, website content, departmental needs and other projects as assigned.

Required Qualifications:

• BA or BS from an accredited college or University
• Over 10 years of professional experience in insurance/claims/risk management field, preferably with a combination of experience related to claims management and work in healthcare field.
• At least 5 years of insurance program development experience

• Proficient in using Microsoft office products
• Knowledge and Skills: Working knowledge of and experience with insurance, risk management, risk financing, workers’ compensation, regulatory requirements related to financing issues.
• Program design & implementation skills; Program and personnel management skills;
• Analytical skills; ability to manage multiple priorities; regulatory & compliance knowledge;
• Computer skills sufficient to utilize database, spreadsheet, web technology, statistical programs and other related materials; Writing, Editing and Presentation skills;
• Financial/Accounting skills pertinent to budget recommendations, financial tracking, and performance evaluation of risk financing and insurance programs;
• Familiarity with claims management processes; reporting, investigations, litigation, medical and vocational case management, delivery of claims information;
• Team management skills;
• Quality Management & Process Improvement skills;
• Ability to be accountable to deadlines & to drive projects to completion;
• Ability to interact with a wide variety of departments, internal and external customers to achieve positive working solutions;
• Creative problem-solving and dispute resolution skills;
• Project management skills; Program management skills;
• Must be able to perform the essential functions of the position with or without accommodation

Preferred Qualifications:

• Diploma or certification in Risk Management desired.
• At least 10 years of Workers’ Compensation management experience and/or other lines of coverage claims adjusting experience

All are welcome: Oregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request reasonable accommodation contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or aaeo@ohsu.edu.

As an organization devoted to the health and well-being of people in Oregon and beyond, OHSU requires its employees to be fully vaccinated against COVID-19.