Director-Risk Management & Claims

About the role

Provides leadership oversight for Baptist Memorial Health Care Corporation’s system-wide claims program, including professional liability and general liability matters, working in close coordination with the Senior Associate General Counsel – Claims Oversight and General Health Law or designee.

Responsibilities

• Manages the daily operations of the claims function for professional liability and general liability claims across designated Baptist markets, to include hospital entities, affiliates, employed provider settings, ambulatory locations, and other applicable sites of care or business operations.
• Coordinates timely claim intake, assignment, documentation, investigation, and follow-up to support accurate claim evaluation, regulatory compliance, and appropriate resolution.
• Partners with legal counsel, risk management, operational leaders, clinical leaders, human resources, employee health, and safety personnel to gather information, evaluate exposure, and support effective claim strategy.
• Serves as an operational contact for third-party administrators, insurers, brokers, outside counsel, adjusters, and other vendors involved in claims administration and litigation management for areas of responsibility.
• Monitors claim activity, reserves, expenses, litigation status, settlement recommendations, recovery opportunities, and closure plans to support effective financial stewardship and risk mitigation.
• Maintains accurate claim files, databases, dashboards, correspondence, and reports to support timely communication, audit readiness, insurance program administration, and leadership decision-making.
• Uses claims analytics and trend data to evaluate claim frequency, severity, cost, status, and emerging patterns; identifies actionable insights, communicates key findings to appropriate stakeholders, and supports data-informed recommendations for operational improvement and risk reduction in conjunction with Risk Management.
• Assists with insurance renewals, actuarial reviews, reserve analyses, self-insured retention monitoring, captive or excess coverage reporting, and other insurance program activities as requested.
• Promotes consistent claims processes across the health care system and supports the development, review, and implementation of policies, procedures, workflows, templates, and training materials related to claims management.
• Ensures confidentiality and appropriate handling of privileged, protected, personnel, medical, and sensitive claim information in accordance with applicable laws, policies