Senior Director, Risk Management
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Job Description
Senior Director leading claims, clinical risk, insurance, and AI strategy for Curana Health’s value-based senior healthcare organization. Supporting risk financing and measurable reductions in total cost of risk.
Responsibilities:
- Build and lead the Company's risk management function
- Lead insurance claims management from first notice through final resolution
- Manage complex medical professional liability claims, including investigation, medical-record review, liability and damages evaluation, reserves, counsel oversight, mediation, settlement, and trial preparation
- Design and implement a clinical risk management program using claims, complaints, adverse events, and near-misses to identify trends and reduce risk
- Establish claims governance, triage, escalation, documentation, authority protocols, metrics, and total-cost-of-risk reporting
- Evaluate and deploy AI and analytics tools for claims intake, medical-record review, exposure analysis, trend detection, and defense-budget review
- Oversee insurance portfolio strategy, broker relationships, renewals, coverage, pricing, limits, retentions, and risk financing
- Develop recommendations regarding self-insurance, TPAs, fronted programs, and captive formation
- Own the risk management AI roadmap and advise leadership on AI-related risk
- Develop the risk management roadmap, budget, risk register, and risk management information system
- Oversee insurance and claims diligence for acquisitions, joint ventures, and new market entry
- Report to and advise the Chief Legal Officer, Chief Financial Officer, and executive leadership
Requirements:
- Bachelor's degree required
- Advanced degree preferred, including Juris Doctor, Master of Health Administration, Master of Business Administration, Master of Science in Nursing, or comparable degree
- Professional credential preferred, such as CPHRM, AIC, ARM, CPCU, or RPLU
- Deep expertise in medical professional liability claims management at individual-case and portfolio levels
- Practical fluency with AI tools and judgment regarding value, risk, and human review
- Ability to establish credibility with physicians and advanced practice providers and influence behavior without direct authority
- Working knowledge of health care risk frameworks, including peer review and quality protections, HCQIA, PSQIA, National Practitioner Data Bank reporting, and protected investigations
- Executive presence and ability to translate technical claims, insurance, and clinical risk matters into concise recommendations
- Ten or more years of progressively responsible experience in risk management
- At least seven years of substantial direct experience managing health care professional liability claims
- Experience building or substantially expanding a claims, risk management, or clinical risk program required
- Experience leading professional staff required
- Clinical training or active clinical licensure is valued but not required
- Must not require visa sponsorship; the company is unable to provide sponsorship for a visa
Benefits:
- Equal Employment Opportunity commitment and nondiscrimination policy
- No visa sponsorship is provided at this time
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