Senior Director, Risk Management

Job not on LinkedIn

🔥 4 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟠 Senior

🔒 Insurance

👻 Ghost score 10%

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Curana Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

🤝 B2B

⚕️ Healthcare Insurance

Healthcare • B2B • Healthcare Insurance

Curana Health is a healthcare provider focused on senior primary care and on-site clinical services in skilled nursing and senior living communities. The company partners with operators, payors, and Medicare Advantage plans to implement value-based care models, offering physician-led care teams, medical director services, care coordination (including RPM and APCM), behavioral health, and palliative care. Curana emphasizes reducing hospital readmissions, falls, and polypharmacy while improving resident satisfaction through integrated, community-based care supported by technology and payor partnerships.

📋 Description

• 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