Senior Director, Risk Management

We need to output HTML fragment with sections for headings: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections that have real specific content. The posting includes a lot of description: summary about company, then reporting line, responsibilities (claims management, clinical risk management program development, insurance portfolio and risk financing, program leadership and other risk management responsibilities). Also qualifications: need to infer from text? It mentions "The successful candidate will remain personally engaged..." but not explicit qualifications like education, years experience. It mentions "Candidates with experience supporting the feasibility analysis, formation, or operation of a captive insurance company are particularly competitive". Also mentions need to be capable with AI tools. So we can extract qualifications: experience in risk management, claims, clinical risk, insurance portfolio, AI, etc. But we must not invent details; we can only include what is explicitly stated. The posting includes many duties; we can put those under Responsibilities. For Requirements/Qualifications/Skills, we need to see if there is explicit list. The text includes: "The Senior Director establishes the processes, technology, governance, and measures required..." That's duty. "The Senior Director is also expected to be capable with artificial intelligence tools and to assess where and how AI can be deployed..." That's a requirement/skill. Also "Candidates with experience supporting the feasibility analysis, formation, or operation of a captive insurance company are particularly competitive for this role." That's a qualification/skill. Also maybe "Reporting to the Chief Legal Officer" is not a requirement. There's no explicit education or years. So we might create a Requirements section with bullet points like: Experience in claims management, clinical risk management, insurance portfolio oversight; Ability to use AI tools; Experience with captive insurance formation/operation (preferred). But we must not invent; we can paraphrase but must preserve substance. It's okay to rephrase as long as we don't add new info. We'll extract from text. Also Benefits, Pay, Schedule: none mentioned. So we should not include those sections. Thus we will have sections: About the role (maybe we can include company overview? The instruction: Use

for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule). The "About the role" could be the summary paragraph about mission etc. But they said do NOT repeat the job title as a heading (the page already shows it) and do NOT put Job ID / requisition numbers as headings — fold minor metadata into a short

or drop it. So we can have About the role containing the introductory paragraph about Curana Health mission etc. That seems appropriate. Responsibilities: all the duties listed. Requirements: maybe combine qualifications and skills? But we have separate headings possible. We could have Requirements (mandatory) and Skills (preferred). However we need to only include sections when posting has real specific content. The posting does mention capabilities: "capable with artificial intelligence tools", "experience supporting feasibility analysis, formation, or operation of a captive insurance company". Those could be skills/qualifications. We'll put them under Requirements (or Skills). Let's decide: Requirements: Experience in claims management, clinical risk management, insurance portfolio oversight; Ability to assess AI deployment; Experience with captive insurance (preferred). Skills: maybe AI tools, analytics, risk finance, leadership. But we might just have one Requirements section covering both. We must not create sections with filler like "not specified". So only include sections we have content for. Thus output:

About the role

At Curana Health, we're on a mission to radically improve the health, happiness, and dignity of older adults—and we're looking for passionate people to help us do it. As a national leader in value-based care, we offer senior living communities and skilled nursing facilities a wide range of solutions (including on-site primary care services, Accountable Care Organizations, and Medicare Advantage Special Needs Plans) proven to enhance health outcomes, streamline operations, and create new financial opportunities. Founded in 2021, we've grown quickly—now serving 200,000+ seniors in 1,500+ communities across 32 states. Our team includes more than 1,000 clinicians alongside care coordinators, analysts, operators, and professionals from all backgrounds, all working together to deliver high-quality, proactive solutions for senior living operators and those they care for. Ranked #147 on the Inc. 5000 list of America's fastest-growing private companies, we're just getting started. If you're looking to make a meaningful impact on the senior healthcare landscape, you're in the right place—and we look forward to working with you.

Responsibilities

• Serve as the Company's senior claims leader and design a claims management function capable of supporting progressively higher levels of retained risk.
• Lead the Company's strategy and active participation in complex medical professional liability claims from first notice through final resolution, including fact development, medical-record review, witness identification, and preservation of evidence.
• Evaluate liability, causation, damages, venue and verdict risk, and potential exposure; develop documented strategy and resolution recommendations with the carrier and panel counsel.
• Support litigated matters through discovery, witness and deposition preparation, expert selection, and trial preparation.
• Develop and maintain independent per-claim reserve positions that account for the Company’s retained exposure separately from carrier reserves, including documented liability, damages, and venue analysis on each significant file.
• Present material reserve movements and aggregate retained loss forecasts to the CFO on a defined cadence, and support accrual and audit positions in coordination with Finance and the CLO.
• Develop settlement recommendations and obtain internal authority; lead the Company's mediation and settlement planning and participate actively with the carrier and panel counsel in negotiations and resolution decisions, subject to policy terms and carrier authority.
• Participate in selection of defense counsel from carrier-approved panels where permitted; work closely with panel counsel; evaluate performance; recommend litigation plans and budgets; and escalate concerns to the carrier and Legal department.
• Design the operating model for claims administration, including appropriate use of internal personnel, carriers, third-party administrators, consultants, and technology.
• Establish claims triage, escalation, file documentation, and authority protocols aligned with carrier requirements and with practices designed with the Legal department to preserve attorney-client privilege and work-product protection.
• Identify, evaluate, and deploy artificial intelligence and analytics tools to strengthen claims work, including intake and triage, medical-record review and summarization, exposure analysis, loss-trend detection, and review of defense counsel budgets, with appropriate human review and controls for privilege and protected health information.
• Oversee carrier and excess-carrier notice and reporting, loss-run reconciliation, and coverage analysis; escalate disputed coverage positions to the Legal department.
• Administer consent-to-settle requirements and coordinate National Practitioner Data Bank and state licensing-board reporting with the Legal, credentialing, and clinical functions.
• Manage employment and other insured claims in coordination with Human Resources, employment counsel, carriers, and other internal stakeholders.
• Establish claim review cadence and metrics addressing frequency, severity, loss development, defense spend, cycle time, resolution outcomes, and recurring causes of loss.
• Establish and track total cost of risk metrics including retained loss ratios, defense spend as a percentage of indemnity, and year-over-year program cost movement, and present performance against external benchmarks to the CFO and CLO on a quarterly basis.
• Coordinate actuarial loss forecasting and incurred-but-not-reported analyses and partner with Finance on accrual methodology, retained-loss forecasting, collateral, and audit support.
• Design, build, and lead the Company's clinical risk management program including its operating model, staffing, workflows, escalation criteria, and measures, in partnership with clinical, quality, credentialing, operational, legal, and finance leaders.
• Aggregate and analyze claims, complaint, adverse-event, and near-miss information to identify trends by specialty, care setting, site, region, clinician cohort, allegation, and contributing factor.
• Apply AI and analytics to event, complaint, and claims narratives to surface contributing factors and emerging trends at a scale that manual review cannot achieve, and validate outputs before they inform clinical risk conclusions.
• Define and report key measures, including claim frequency and severity, loss development, defense spend, total cost of risk, resolution cycle time, and education completion.
• Translate trends into targeted risk-reduction initiatives and clinician and staff education, including documentation, informed consent, communication, goals-of-care discussions, and transitions of care.
• Develop practical event and near-miss reporting capabilities for clinicians practicing in facilities controlled by third parties, including interfaces or parallel reporting channels.
• Provide risk management consultation regarding adverse events, unanticipated outcomes, disclosure conversations, escalated complaints, and other high-risk clinical situations.
• Support the Legal department's evaluation and implementation of a patient safety organization strategy and patient safety evaluation system.
• Partner with the Chief Medical Officer and other clinical leaders to establish and mature peer review and clinical risk review governance; recommend committee charters, referral criteria, decision rights, escalation paths, and documentation standards.
• Support separate processes for review of individual practitioner performance and for systems and aggregate risk trends, with distinct charters and documentation protocols.
• Serve on the Credentialing Committee and coordinate the flow of claims, event, and loss information among claims, clinical risk, peer review, and credentialing.
• Provide strategic oversight of the Company's insurance portfolio, including professional and general liability, managed care errors and omissions, property, automobile, employment practices, management and fiduciary liability, cyber, and workers' compensation.
• Oversee the national insurance broker relationship and direct renewal strategy, marketing, submissions, coverage comparison, and negotiation of terms, pricing, limits, and retentions.
• Negotiate and administer the program terms that determine the Company’s ability to influence claim outcomes, including claims-handling protocols, panel counsel approval rights, insured consent-to-settle provisions, a dedicated adjuster with defined escalation, scheduled claim reviews, participation in reserve and mediation discussions, and claim-level data access.
• Delegate broker relationship management, insurance administration, and portfolio management to the Senior Manager, Risk Management while retaining accountability for overall strategy and performance.
• Advise the Chief Legal Officer, Chief Financial Officer, and other executive leaders regarding limits, retentions, coverage gaps, program structure, and total cost of risk.
• Develop a multi-year risk financing roadmap that evaluates the economic case for increased self-insurance, TPA engagement, fronted programs, and captive formation, and present recommendations with financial modeling to the CFO and CLO.
• Lead evaluation, selection, and ongoing performance management of TPA, including RFP development, fee and authority structure negotiation, claims-handling protocol design, adjuster accountability frameworks, and periodic performance audits against defined metrics.
• Evaluate proposed increases in the Company’s self-insured retention and develop a multi-year recommendation on movement toward a structure in which the Company controls defense and settlement, including a fronted program or a captive.
• Own the AI roadmap for the risk management function, including use case identification, tool evaluation and selection, standards for human review and data governance, measurement of results, and coordination with Legal, Compliance, and Information Technology on vendor diligence and data handling.
• Develop a multi-year roadmap for claims management capability, clinical risk management, insurance oversight, staffing, technology, governance, and performance measurement.
• Develop and manage the Risk Management budget, including staffing, insurance premium spend, retained losses, and claims-related outside counsel expense.
• Advise leadership on risk and insurance implications of the Company’s own use of artificial intelligence, including in clinical documentation and decision support.