Description

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advance technology. Capital Health is a five-time Magnet-Recognized health system for nursing excellence and is comprised of 2 hospitals. Capital Health Medical Group is made up of more than 250 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Position Overview:

Capital Health Job Descriptions

VERSION:

1

JOB TITLE:

Captive & Risk Retention Group Program Manager

COST CENTER:

000000

JOB CODE:

25417

FLSA Exemption Status:

Exempt

Telecommuting Eligible:

SUMMARY (Basic Purpose of the Job)

Provides operational and strategic direction for Capital Health’s insurance program including internal management of our two captive insurance companies (CRIC and BSR) as well as management of various private lines of insurance, domestic and London-based reinsurance and manages the relationship with our insurance broker as well as outside counsel, accountants and actuaries. Works with Strategic Risk Strategies, finance, actuaries, auditors, underwriters, legal counsel and accountants in management of the insurance program which supports all employed practitioners and the healthcare system related to professional and general liability as well as various other lines of insurance.

MINIMUM REQUIREMENTS

Education:

Bachelor’s Degree in related field..

Experience:

Five years recent experience in an acute care facility, risk management, safety, quality, law firm and/or insurance environment.

Other Credentials:

Knowledge and Skills:

Effective organizational, interpersonal and verbal and written communication skills. Knowledge of statistics, data analysis and experience with claims or litigation management.

Special Training:

Advanced knowledge of software applications such as Microsoft Office, Outlook, Word and Excel applications or similar products with good presentation skills.

Mental, Behavioral and Emotional Abilities:

Team player with ability to interact with all levels of staff often in sensitive and highly stressful situations. Ability to influence change without direct authority and strong negotiation skills. Ability to work flexible hours as situations demand including on call responsibilities.

Usual Work Day:

8 Hours  

Reporting Relationships

Does this position formally supervise employees? No

ESSENTIAL FUNCTIONS

• Manages and leads the relationship between Capital Health (CH) and our Insurance Captives (CRIC and BSR) and Reinsurers. Responsible for daily transactions involving CRIC and BSR.
• Works with External Captive Manager to plan topics and agenda for CRIC and BSR Board Meetings and coordinates with Board to address substantive issues. Works with external Captive Manager on yearly CRIC and BSR Audits and work with Reinsurers on yearly audits. Prepares financial reports for Board Finance Committee for CRIC and BSR.
• Responsible for all financial transactions related to CRIC and BSR and Risk Management, including review, approval and payment of all invoices for all litigation matters involving HPL/GL, EPL and D&O Claims/Cases.
• Works with Deputy General Counsel for Litigation and Risk on setting appropriate ultimate reserves on all HPL/GL and EPL claims.
• Works with DGC on regulatory reporting of litigation claims (MMSEA and NPDB). Assists DGC on Special Projects/Risk Assessments. Prepares and submits reports to MMSEA Section 111 and NPDB per regulation on a timely basis.
• Manages Converge safety reporting system for Claims, troubleshoots and resolves issues. Provides reporting and data analytical services for quality, safety and improvement activities. Produces ad-hoc reports to manage and monitor patient care risk, quality and efficiency. Prepares quarterly loss run reports for CRIC, BSR and D&O/EPL claims.
• Tracks, enters, and monitors over 350 incidents/claims for HPL/GL.
• Reports all incidents/claims to all reinsurer levels, including updating reinsurers in a timely manner and on a regular basis.
• Performs Risk Assessment for newly hired employed practitioners and repeat risk assessment during reappointment.
• Tracks all Insured Practitioners. Stores and sends Certificates of Insurance on an annual basis. Maintains list of PA Physicians with Separate Commercial Insurance Policies. Provides claim histories for all employed practitioners for credentialing. Maintains data base for all insured physicians and advanced practice professionals.
• Manages annual insurance renewal process. Maintain accurate roster of insurance renewals. Process certificates of insurance, maintain e- files and distribute as required. Conduct surveys with other hospitals on practice and industry standards and presents findings in written reports.
• Participates in various committees as Risk Management Representative. Provides committee support, record minutes, and track pending issues for resolution.
• Conducts research and analysis to identify and report on evidence-based standards. Conducts research on the internet as needed. Designs, formats, and prepares documents and presentations as needed as demonstrated skills with intermediate and advanced computer applications.
• Fields requests from attorneys and/or actuaries to ensure compliance.
• Reviews various reports and assists in identifying and determining educational needs for Capital Health employees including physicians. Designs and plans special education events and publication of newsletters.
  
  

PHYSICAL DEMANDS AND WORK ENVIRONMENT

Frequent physical demands include: Keyboard use/repetitive motion

Occasional physical demands include: Standing , Walking , Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Wrist position deviation , Pinching/fine motor activities

Continuous physical demands include: Sitting , Talk or Hear

Lifting Floor to Waist 15 lbs. Lifting Waist Level and Above 10 lbs.

Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Color Discrimination, Minimal Depth Perception, Accurate Hearing

Anticipated Occupational Exposure Risks Include the following: N/A IND123


Offers are contingent upon successful completion of our onboarding process and pre-employment physical.  Capital Health will require all applicants to have an annual flu vaccine prior to start date, with the exception of individuals with medical and religious exemptions.


"Company will never ask candidates for social security numbers or date of birth during application phase. If you are asked for this information online, you may be a target for identity theft."