At the strategic direction of and in concert with the SVPT, the HCRM is responsible for supervising and managing the functional work outlined above. The HCRM will be supported by internal department staff and external contracted services. The HCRM must also work closely with leaders across the Program and external insurer, reinsurer, claim and service provider executives. The HCRM is responsible for developing appropriate infrastructure, staffing, policies, procedures, metrics and relationships to support a focused, cohesive approach to risk management across the Program. At the strategic direction of and in concert with the SVPT, HCRM has direct responsibility for recommending and arranging risk financing program structures which are coherent with Kaiser-s risk tolerance and appetite and Tresuary-s capital policies. The risk financing structures will include elements of self insurance, Kaiser captive insurance subsidiaries as well as excess commercial insurance, reinsurance and capital market arrangements. The HCRM is responsible for managing broker, consultant, insurer and reinsurer relationships and for overseeing the administration and execution of contracts and services which will be required in order to achieve the desired outcomes. The HCRM is responsible for managing Kaiser-s three captive subsidiaries which in the aggregate have combined assets of nearly $3 billion and form the foundation of Kaisers self insurance programs and risk financing structures. With the assistance of CRM staff and contracted captive managers, legal, actuarial and audit providers the HCRM assures that risk programs are prudently managed, and all financial statements, tax and regulatory filings are accurate and timely. The HCRM is accountable for managing a SOX compliant process to assure that self retained liabilities for long term workers compensation and PPL claims are prudently reserved on Kaiser-s balance sheet. In this capacity the HCRM directs the work of internal and external staff to prepare reserve valuations, assuring that analytic methodologies, key assumptions, claim and other data feeding actuarial analyses are appropriate and accurate. The individual provides advice and guidance to internal customers on risk related matters involving operational issues and legal contracts. This HCRM fully adopts and supports the Principles of Responsibility (Company's Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to the applicable federal, state and local laws and regulations, accreditation and licenser requirements (if applicable), and Company's policies and procedures.
- Development and implementation of Program-level strategies for managing Company-s financial exposures to various forms of risks, including PPL (professional liability), workers compensation, earthquake, directors and officers liability, terrorism and pandemic events, cyber attacks and other property and casualty risks.
- Direction of workers compensation claim administration efforts through an internal CRM claim oversight team and contracted 60+staff third party claim administrator team. Assure that (1) injured worker benefits are delivered promptly and fairly in full compliance with state regulations, (2) cost containment and quality improvement programs are effective and (3) KP operation management and other stakeholders are appropriately engaged and informed about performance trends and outcomes.
- Development of infrastructure (metrics, stochastic models, frameworks, processes, data standards, and interpersonal relationships) to support Program-level financing/insurance management and other risk management strategies.
- Work cooperatively with legal and clinical risk management leaders, and IT staff in creating an integrated vision and functional design requirements for a new risk information system to improve data capture and analytics to reduce clinical errors and patient injuries.
- Act as liaison with Medical Groups and Health Plan and Hospital leaders at the Regional and Program levels to promote improvements in quality, reductions in incidents, effective management of claims, and effective management of the costs of financing risk. Promote an understanding of the financial linkages.
- M&A activity - Manage efforts to analyze operational exposures, financial liability, insurance and self insurance programs of potential M&A counter parties; advise on adequacy of incumbent insurance structures and valuation of self insured balance sheet reserves.
- Provide feedback on Regional and local risk management programs.
- Monitor regulatory changes, identify impacts and participate in developing appropriate responses.
- Monitor financial markets to identify trends, opportunities, and necessary changes in financing strategies.
- Oversee the execution and delivery of third party insurance and reinsurance brokerage services.
- Oversee the negotiation, placement and delivery of third party actuarial contracts, reserve analysis and analytic services. Assure the accuracy and timeliness of both internal and external actuary work product and accurate reflection in Kaiser published financial statements and management reports.
- Manage Kaiser-s three captive subsidiaries through internal CRM team members and externally contracted captive managers.
- Direct the tracking and analysis of risks, management reporting and support to Regions.
- Network outside of the organization to learn and leverage best practices.
- Minimum ten (10) years of experience in insurance brokerage, actuarial finance, risk management and/ or corporate finance at a senior level within a large company.
- Bachelor-s degree in business administration, finance or other related field
License, Certification, Registration
- Exhibits efficiency, candor, results orientation, diplomatic assertiveness, attention to detail and teamwork.
- Word Processing: Inputs and edits standard text for routine correspondence and reports.
- Spreadsheets: Possess knowledge and ability to design complex spreadsheets, with multiple-functions involving statistical formulas or construction of look-up tables,complex macros, create graphs and charts, link, import or export to data or word processing files.
- Database: Direct reports are more likely to manage databases and reports, but familiarity with databases will be important.
- Master-s degree preferred