Job Description
Director of Risk & Claims Management
New York, NY, United States of America
Overview
Job Skills / Requirements
General Duties/Requirements
Risk and Insurance Management
- Assess the company’s exposures and design appropriate program structures to mitigate risk while minimizing cost.
- Develop and manage insurance risk strategies and processes to support corporate strategic objectives for all related companies and ownership.
- Manage the procurement and renewal process for all lines of coverage including negotiations, delivery and payment.
- Manage the overall renewal process for all lines of insurance, working with consultants and brokers network to structure comprehensive and competitively priced insurance programs, bidding the business out to insurers, as required.
- Develop, manage, document and implement standardized systems, policies and procedures for the identification, collection and analysis of insurance risk management related data.
- Develop and manage risk management-related performance metrics and benchmarks.
- Work with brokers or directly with insurance companies to negotiate all new policies and renewals and to ensure they are received timely.
- Ensure companies take advantage of all possible premium discounts, credits and other cost savings programs.
- Audit all invoices for accuracy and timely payment.
- Proactively seek competitive bids and pricing for all insurance products used by the company.
Claims Management
- Day to day management of all insurance claims (workers’ comp, DBL, GL, PFL, health etc.) and monitor compliance with insurance procedures; document activities relating to same.
- Analyze insurance claims to determine the extent of the insurance Carrier/Company’s liability & exposure and recommend solutions.
- Manage and monitor WC, GL, DBL, PFL, health/medical related matters to provide cost effective means for handling.
- Communicate clear and concise action plans to present next steps for moving a claim to closure.
- Manage all third-party service providers including consultants, brokers, insurers, IME doctors, investigators, insurance defense counsel, TPAs, etc.
- Prepares loss analyses and budgets.
Workers’ Comp Claims Management
- Proactively and aggressively monitor and manage all workers’ comp claims from initial loss to closure.
- Monitor and communicate with all-third parties related to claims handling: investigators, attorneys, carrier, brokers, consultants, IME doctors etc.; document all action.
- Communicate daily with insurance adjusters to obtain updates on each claim and to regularly press for Return to Work, Settlement and/or Lower Reserves; document all efforts.
- Regularly obtain and review WC loss runs to ensure data accuracy and opportunities to close cases, reduce costs etc.
- Have frequent and regular communications directly with injured employees to determine status and possible RTW; create and maintain documentation.
- Create and update Open Case and RTW tracking report; meet weekly regarding same.
- Take lead role at quarterly WC claim review meetings.
- Attend WC hearings and depositions, as appropriate.
- Create and enforce all policies and procedures necessary for proper workplace incident/accident reporting and claims management; document efforts regarding same.
- Coordinate claims through Local 32BJ network providers, as applicable.
Workers’ Comp Case Management Program (CMP)
- Ensure that the company is actively engaged in and is following the Case Management Program (CMP) model for workers compensation claims.
- Conduct post-accident investigations, witness interviews, documentation, etc.
- Create and enforce all policies and procedures necessary to enforce CMP; document efforts regarding same
Workers’ Comp Return to Work (RTW) Program
- Oversee and Administer WC Return to Work (RTW) Program.
- Proactively identify and push for opportunities to return employees to work as soon as possible; track and document efforts.
- Deal with all parties involved re RTW programs – employee, IME doctor, claims adjuster, QBS Operations; document and follow-up regarding same.
- Arrange for and place returning employees into modified duty jobs as soon as possible upon notice of IME that might allow a RTW.
- Draft, send and document written offer letters for all offers of RTW modified duty; create and send all related docs; create and maintain records documenting same.
- Meet with all returning employees before they RTW to review restrictions, modified duties, etc.
- Meet with all supervisors of returning employees, regarding the RTW restrictions and modified duties applicable to the returning employees.
- Ensure timely follow-up to move employees from modified to full duty as soon as possible.
- Create and enforce all policies and procedures necessary to enforce RTW program; document efforts regarding same.
Training Activities
- Train Supervisors and Area Managers in workplace injury procedures, including proper preparation of reports.
- Help supervisors to prepare reports, go over reports, submit report after each accident to the insurance company.
- Attend weekly Supervisors Meetings to review updates, forms, communications and enforcement of policies and procedures with QBS supervisors and managers.
- Train personnel to perform back-up for Risk & Claims Manager
Safety Program Activities
- Develop, implement and oversee Safety & Health Program.
- Supervise and Manage Safety Manager(s).
- Develop and oversee policies and procedures for Safety Managers.
- OSHA compliance/reporting – maintain Injury Log, report fatalities, hospitalizations, etc.; document same.
Other Insurance Programs
- Oversee and manage GL and Excess coverage programs, including oversight of defense counsel in personal injury actions, facilitate discovery, settlement, etc.
Other Insurance, Claims and/or Risk-Related Activities
- Review commercial/services contracts for risk, insurance and indemnification issues; refer to brokers or carriers for COIs, coverage assessments, etc.
- Ensure on-going compliance with all insurance contracts.
- Other tasks and functions as requested.
Additional Information / Benefits
This is a Full-Time position
Number of Openings for this position: 1