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Director of Claims - Risk Management #1455

Dallas, Texas · Legal
Director of Claims – Risk Management
Full Time - Exempt
Location:
Dallas, TX (Hybrid)


We have been retained by our highly respected client to aid in a search for a Director of Claims in their Risk Management Department. This is a coveted opportunity with incredible benefits, excellent growth and advancement within the legal and compliance team. The Director of Claims will be asked to focus on all areas of workers’ compensation, auto, general, professional liability, cyber, property and all other insured matters relating to risk for the organization.

Qualifications/Requirements:
  • Bachelor’s Degree in Business, Legal Studies, or an insurance related field
  • Master’s Degree is highly preferred or equivalent tenured experience
  • 10+ years of experience of experience in risk management with at least 3 years in claims management
  • 4+ years of management/supervisory experience
  • Certified Professional in Healthcare Risk Management (CPHRM) and/or similar Risk Management designations (ARM or CPCU) preferred
  • Thorough understanding of Workers’ Compensation, with a focus in Texas healthcare governmental agencies
  • Working understanding of investigations, subrogation, insurance claims reporting, negotiations and the closure process is crucial for this role
  • Ability to efficiently manage Third Party Administrators (TPAs)
  • Good understanding of corporate insurance and risk financing programs

Duties/Responsibilities:
  • Develop, implement and monitor an effective and efficient Claims Management process
  • Develop and control an annual budget for Workers’ Compensation, Risk Claims and office needs
  • Work with third-party actuaries in the annual determination of reserve changes and forecasting
  • Manage Vendors/Third Party Administrators (TPA) to ensure contractual expectations are being met
  • Ensure compliance with local, state and federal guidelines, with an emphasis on Workers’ Compensation, and  compliance with the Division of Workers’ Compensation/Texas Department of Insurance as well as any state agency overseeing workers’ compensation in connection with of out-of-state/remote employees
  • Expected to be strong liaison and active member of a variety of committees, workgroups encompassing workers’ compensation, injury metrics, personnel safety, auto/general and professional liability
  • Provide accurate and clear reporting to the Legal Affairs and Risk Management groups
  • Serve as a continuous support to staff in the education of the injury on duty process
  • Establish and monitor policies and procedures related to injury on duty, patient/visitor property, safe driving and incident reporting
  • Support safety and control initiatives to reduce the likelihood and severity of claims
  • Attend a variety of ongoing seminars/workshops and participate in professional organizations
  • Develop effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans
  • Develop and monitor annual budgets ensuring the department has the necessary funds to carry out the goals and objectives that have been established for the department
  • Manage team of individuals including goal setting, performance reviews, mentoring and supporting professional growth

Genius Road, LLC is proud to be a Certified Women’s Business Enterprise, an Equal Opportunity Employer and values diversity. All employment is decided on the basis of qualifications, merit and business need.
 

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