Vice President Claims and Risk Financing - Claims and Insurance

Health First Careers•Rockledge, FL

About The Position

The Vice President, Claims and Risk Financing manages medical, professional, and general liability claims and structures the enterprise insurance program to finance and mitigate risk, including a wholly owned captive for Health First and its subsidiaries. The role manages outside defense counsel, collaborates with underwriting leadership on claims advisories and coverage issues, and advises risk managers, general counsel, C-suite executives, and senior leadership on claims strategy and insurance coverage. In coordination with the Chief Legal Officer (CLO/CRO), the position also advises the Board of Directors on these matters. The Vice President leads the Company's claims management program and directs its insurance program, including annual renewals, insurance coverage and policy structuring, actuarial reserve planning, captive utilization, and cost-effective risk financing. The role oversees claims operations, litigation management, reserving, regulatory compliance, outside counsel, the wholly owned captive insurance company, and performance reporting. It also leads loss control, risk prevention, and risk identification strategies using data analytics and trend analysis to reduce liability exposure and support patient safety, high-reliability practices, and organizational performance. The position provides technical leadership and guidance to claims staff, risk managers, executives, boards, and company management on significant claims, coverage matters, and insurance strategy. It establishes standards, metrics, and best practices across claims and insurance operations, and serves as an objective enterprise resource for risk-related matters affecting strategic objectives, operating performance, financial results, and the organization's risk profile. Leadership responsibilities include setting a clear team vision, coaching and developing staff, leading change, fostering inclusion and collaboration, recruiting and retaining a diverse workforce, and applying strategic and financial acumen. The position requires a bachelor's degree in a relevant field and seven years of progressive claims and risk management experience with an insurance carrier or large, complex healthcare system. The work schedule is full-time, 8:00 a.m. to 5:00 p.m. The role may require travel to facilities within and beyond the county perimeter, potentially using a personal vehicle.

Requirements

Bachelor's degree in a relevant field.
Seven years of progressive claims and risk management experience with an insurance carrier or large, complex healthcare system.
Demonstrated experience managing people, budgets, and vendor relationships.
Experience handling one or more of the following service lines: general liability, professional/medical liability, or management liability.
Expertise interpreting insurance policy language and analyzing complex coverage issues.
Ability to independently evaluate claims and formulate sound, well-reasoned coverage recommendations.
Exceptional analytical, organizational, and critical-thinking skills.
Outstanding writing skills, including the ability to develop persuasive, technically sound coverage analysis and advocacy positions.
Excellent verbal communication and presentation skills.
Strong client relationship skills and a commitment to exceptional service.
Majority of work time involves sitting or standing, with occasional walking, bending, and stooping; long periods of computer or workstation use.
Light work that may include lifting or moving objects up to 20 pounds, with or without assistance.
Ability to communicate with others to exchange information; visual acuity and hand-eye coordination to perform tasks.
May require travel to facilities within and beyond the county perimeter and may require use of a personal vehicle.

Nice To Haves

Juris Doctor (JD), Master of Business Administration (MBA), or related degree.
CPCU (Chartered Property Casualty Underwriter), ARM (Associate in Risk Management), or RPLU (Registered Professional Liability Underwriter) certification.
Ability to lead, coordinate, and motivate a team to reduce the organization's total cost of risk.
Executive demeanor and ability to interact effectively with internal and external stakeholders, including boards of directors and senior leadership.
Ability to devise and implement organization-wide risk management policies.
Ability to identify emerging risks and threats and recommend strategies and measures to reduce overall enterprise risk.
Strong proficiency in strategic planning and understanding the inputs into long-term organizational objectives.

Responsibilities

Lead the Company's claims management program, including operations, budget and fiscal oversight, risk parameters, regulatory compliance, reserving practices, litigation management, claims-guideline adherence, and settlement and reserve authority under the Delegation of Authority Policy.
Lead enterprise loss control, risk prevention, and risk identification strategies using data analytics and trend analysis to mitigate liability exposure, improve patient safety, strengthen high-reliability practices, and optimize operations.
Direct and administer the Company's insurance program, including coverage, insurance guidelines, event reporting, policy structure, renewals, and cost-effective risk financing strategies.
Provide technical leadership and guidance on significant claims, coverage issues, claims strategy, and insurance matters to claims staff, risk managers, executive leadership, boards, and company management; coordinate Board-level discussions with the CLO/CRO.
Maintain technical oversight of medical, professional, and general liability claims, including claim management, documentation, reserve adequacy, and compliance with claims-handling standards and Delegation of Authority requirements.
Direct annual insurance renewals with leadership, brokers, underwriters, and Finance, including actuarial reserve planning, policy layering, retentions, captive utilization, and coverage optimization.
Establish and monitor key performance indicators, reporting, and analytics for claims and insurance operations to support informed decisions, continuous improvement, cost reduction, and service delivery.
Manage the wholly owned captive insurance company, including strategic utilization, cost-reduction initiatives, regulatory and board reporting, annual board meeting preparation, and performance oversight.
Oversee outside defense counsel and attorney defense panels, including selection, budget management, performance evaluation, and compliance with litigation management and claims-handling standards.
Collaborate with underwriting leadership, brokers, carriers, and other stakeholders on claims advisories, coverage issues, and insurance program matters.
Serve as an objective enterprise resource on risk-related matters that may affect strategic objectives, operating performance, financial results, and the overall risk profile, in coordination with the CLO/CRO.
Establish standards, metrics, and best practices across claims and insurance operations to meet loss-cost objectives, improve quality outcomes, enhance customer service, and strengthen program performance.
Define and communicate a compelling team vision aligned with Health First's mission and vision, and inspire the team to achieve it.
Lead, motivate, coach, and support team members to promote growth and development and build an effective, high-performing team.
Lead change through effective communication, explain organizational value and impact, build buy-in and urgency, and obtain team commitment.
Encourage diverse ideas, inclusion, and collaboration across teams to help meet team and organizational goals.
Recruit, select, develop, and retain highly engaged, high-performing, diverse, and inclusive associates.
Apply strategic and financial acumen in areas of responsibility in alignment with organizational objectives.