Executive Director of Claims & Insurance

Executive Director of Claims & Insurance page is loaded## Executive Director of Claims & Insurancelocations:
Kansas City, KStime type:
Full time posted on:
Posted Todayjob requisition :
R-47932# Position Title Executive Director of Claims & Insurance Bell Hospital## Position Summary / Career Interest:

The Executive Director of Claims & Insurance has broad responsibility, in collaboration with the UKHA General Counsel, for the identification, prevention and mitigation of real and potential risk to the University of Kansas Physicians (UKP), its employed practitioners, and affiliates and for the University of Kansas Hospital Authority overall. This position supports building and evolving of the enterprise risk management program - designing frameworks, influencing decisions, and ensuring UKP's risk posture aligns with the strategic goals of the University of Kansas Health Authority (UKHA) and UKP.

The position will collaborate with senior and executive leadership, risk owners, and external partners to develop, implement, and continuously improve the overall risk financing positioning of the health system. The Executive Director of Claims & Insurance provides leadership and direction to a team of insurance and claims professionals and has a dual reporting relationship to UKHA General Counsel and UKP senior leadership.
** Responsibilities and Essential Job Functions
*** Lead and evolve the health system's enterprise risk management program with a focus on continuous improvement and patient safety.
* Act as point of contact for captive manager in the day-to-day captive and RRG operations.
* Manage health system property and casualty insurance portfolio in conjunction with the General Counsel and Director of Insurance.
* Present risks and appropriate mitigation strategies to senior leadership, influencing prioritization and resource allocation.
* Facilitate early claims resolution process for serious unanticipated outcomes.
* Provide claims leadership, including serving as co-chair for the Claims Committee.
* Actively participate in root cause analysis meetings as appropriate to review adverse/sentinel event occurrences and near misses that affect, or may affect or involve, any UKP practitioner.
* Monitor external threats, macroeconomic trends, and regulatory shifts. Collaborate with appropriate partners to develop necessary response.
* Collaborate with University of Kansas Health System (“UKHS”) medical staff and medical staff leadership to facilitate investigations, assuring all relevant privileges and protections are triggered and preserved.
* Provide independent, unbiased and discrete assistance to UKP practitioners regarding potential claims at the pre-claim stage. Investigate cases identified as potential risk issues, with a goal of avoiding or minimizing the UKP practitioner’s professional liability and harm to professional reputation.
* Collaborate with UKP Human Resources to ensure that HR-related issues and findings are effectively documented and necessary corrective actions are taken.
* Champion risk awareness and continuous improvement. Participate in compliance oversight, monitor accreditation and regulatory inspections, surveys and visits. Participate as member of facility or enterprise crisis management teams pursuant to applicable policies.
* Notify the Health Care Stabilization Fund ("HCSF") of any claims, demands, or lawsuits or issues likely to result in a claim. Review and investigate patient/family complaints, patient demand letters, and incident reports. In collaboration with UKHS and UKP, make recommendations to HCSF if requested regarding disposition of complaints and demands.
* Assist physicians with response to patient complaints in coordination with Risk Management and Patient Relations. Collaborate with Regulatory, Clinical Risk Management and other relevant departments to facilitate compliance with Medicaid/Medicare and other federal and state regulations.
* When necessary or prudent, request counsel for practitioner. As requested by the HCSF, serve as the liaison to attorneys for requests to interview UKP practitioners, obtain depositions for subsequent treating practitioners, and…