Risk Insurance Examiner 2 at Oregon Health & Science University

, , United States -

Full Time

Start Date

Immediate

Expiry Date

02 Mar, 26

Salary

0.0

Posted On

02 Dec, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Insurance Program Management, Claims Management, Contract Review, Risk Analysis, Underwriting, Negotiation, Data Analysis, Attention to Detail, Leadership, Communication, Organizational Skills, Process Improvement, Customer Service, Compliance, Problem Solving, Teamwork

Industry

Higher Education

Description

Department Overview The mission of Risk Management is to provide a comprehensive risk management program that contributes to health, safety and protection of patients, employees, faculty, students and visitors, while also protecting the University's physical and financial resources. OHSU uses a combination of self-insurance and commercial insurance to fund risk of loss. Risk manages over 30 lines of insurance as well as a captive insurance company. Claims are managed internally by experienced claims managers. Function/Duties of Position Insurance Program Management Ensure insurance policies and all supporting documents are maintained; analyze existing policies for coverage and exclusions; anticipate and prepare for policy expirations. Plan timelines for completion of Property/Casualty and other applications. Work with insurance team to prepare specs for submission to markets. Participate in negotiating policy provisions with insurance carriers and brokers. Gather and analyze underwriting data, including loss data; assist in making underwriting recommendations; assist in developing underwriting guidelines; review and analyze loss control reports, prepares statistical data to support the continuation or reduction of premiums paid and reserves. Recommends process and procedures to enhance the current risk financing, including captive program. Ensure timely review and completion of insurer applications and submissions as required by OHSU contracts, law or policy. Identify opportunities to streamline existing processes. Handles requests from customers for internal & external insurance certificate production, verification of coverage processes and assists in compliance with state insurance reporting requirements. Maintain insurance policies in accordance with records retention policy. Claims Manage claims for property, general liability, cyber, auto and all other coverages as assigned. Claims management includes: reporting to carriers and internal partners, system maintenance, detailed claims investigations, establishing and evaluating reserves regularly, selecting and monitoring defense counsel, conferring directly with claimants, attorneys, physicians, employees, brokers, carriers and consultants; settling claims with merit. Ensure that all regulatory reporting and insurer/reinsurer reporting is completed accurately, appropriately, and in compliance with standards. Establish, maintain and review reserves for each claim throughout the life of the claim file based upon thorough investigation, evaluation and insurance industry standards. Devise, develop, implement and maintain claims management and reporting processes that minimize risk of loss to the organization and promote effective and systematic resolution of claims against OHSU and its employees. Monitor claims to disposition. Explain OHSU policies, claims processes and procedures to OHSU employees staff, external counsel, and insurers. Contracts Review OHSU contracts for insurance and indemnification compliance and adherence to current insurance policies and risk to the organization. Consult with OHSU departments or other external roles with regard to contract language, documentation, or other issues pertaining to insurance coverage, evidence of coverage, loss prevention processes, risk reduction strategies, cost allocation strategies or other programs aimed at reducing the cost of and risk of losses to the organization. Provide risk analysis related to contract terms for escalation to leadership for business decisions. Support contracting units on training and process improvement initiatives. Describe OHSU insurance policies and coverage related matters to contracting parties. Other duties as assigned. Required Qualifications Bachelors’ degree in related specialty or equivalent work experience. 5 or more years of insurance, contracting and claims management experience with a higher education and/or healthcare institution. CPCU, ARM or Oregon Insurance Producer License. Knowledge, Skills, and Abilities General knowledge of all lines of insurance coverage for a university health system, including but not limited to, casualty, general liability, directors and officers, employment practices, property, and workers compensation. Knowledge of deductibles, risk retention, and coinsurance practices. Ability to interpret and analyze actuarial studies. Experience evaluating indemnification contract provisions. Familiarity with claims investigation & management processes. Ability to be accountable to deadlines & to drive projects to completion. Demonstrate effective leadership and diplomacy skills. Demonstrated proficiency of Microsoft Office applications and underwriting software. Must be able to communicate effectively and professionally with company personnel and customers. Ability to work independently and as a team. Demonstrates strong attention to detail, organizational skills, and timeliness. Demonstrates the ability to work in a fast-paced environment meeting aggressive business deadlines. Preferred Qualifications 4 or more years of commercial line insurance experience. Experience with self–insured or high SIR programs, and/or captive programs JD, CPCU, ARM, Oregon Insurance Producer License. Additional Details Must be able to respond to 24/7 pages one week per month. Benefits Healthcare for full-time employees covered 100% and 88% for dependents. $50K of term life insurance provided at no cost to the employee. Two separate above market pension plans to choose from. Paid time off - 208 hours per year, prorated for part-time. Extended illness bank - 64 hours per year, prorated for part-time. 9 paid holidays per year. Substantial Tri-Met and C-Tran discounts. Employee Assistance Program. Childcare service discounts. Tuition reimbursement. Employee discounts to local and major businesses. All are welcome Oregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request reasonable accommodation contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or aaeo@ohsu.edu.

Responsibilities

The Risk Insurance Examiner 2 is responsible for managing insurance policies, claims, and contracts to ensure compliance and minimize risk. This role involves analyzing underwriting data, negotiating with insurance carriers, and maintaining accurate claims management processes.