Position Title:

Senior Associate Counsel and Director of Insurance Services

Department:

Legal

Job Description:

This position serves as the primary attorney responsible for managing all professional liability claims and will work with other attorneys in the Office of the Chief Legal Officer for the management of all other claims, including but not limited to general liability,  automobile and property claims and to act as lead counsel for the Patient Safety and Experience Departments. This position currently reports to the Chief Legal Officer; reporting relationship may change from time to time in the sole discretion of the health system.

Essential Responsibilities:

• Manage internal claims and reserve committees and obtain appropriate approval for the settlement of litigated claims
• Select and maintain claims/incidents/reserves data base (versus Gallagher Bassett data base)
• Assisting with reporting and responding to state and federal licensure boards
• Oversee selection of captive and commercial insurance programs
• Oversee the issuance of COI and Claims History Letters
• Lead annual insurance renewals
• Select and manage insurance brokers and litigation counsel. Ensure outside counsel's compliance with litigation management guidelines and billing practices
• Determine and recommend appropriate reserve levels for all claims and; ensure adequate financial coverage to support resolution of claims
• Acceptance of subpoenas and oversee production of documents for litigation
• Create SOPs for Claims and Insurance Coordinator and/or other direct reports
• Act as lead counsel for Patient Safety and Patient Experience Departments
• Collaborate as requested with hospital medical staff offices and medical staff leadership to facilitate investigations, assuring all relevant privileges and protections are triggered/preserved
• Participate with Senior Leadership and legal counsel in formulating defense strategies
• Maintain strong relationships with various stakeholders, including, but not limited to, incumbent broker(s), captive manager, third party claim administrators,), excess carriers and reinsurers, and defense law firms
• Assist practitioners with answering questions on licensure and credentialing applications which includes obtaining necessary documents to accompany the application
• Notify the insurance carriers (captive and commercial) of potentially compensable events, claims, or lawsuits.
• Provide independent, unbiased, and discrete assistance to  practitioners regarding potential claims at the pre-claim stage; and investigate cases identified as potential risk issues, with a goal of mitigating professional liability exposure and harm to professional reputation
• Attend mediations and trials on behalf of health system providers
• Assist, when called upon, to assure compliance with various codes, laws, rules, and regulations concerning patient care (including those mandated by state and federal agencies), incident reporting and investigation activities in support of Legal, Compliance, and Patient Safety and Experience departments
• Request bill holds, make recommendations for waiver of bills, and attend bill-hold meetings.
• Review proposed OUH policies, programs, agreements, and relationships to identify and minimize risk where appropriate
• Review collected data to identify trends regarding accidents, incidents, claims and/or occurrences, preparing analysis and reports, and recommending corrective action to leadership and Board of Directors (when requested)
• Conduct legal analyses; advise business units on potential legal solutions; and exercise independent judgment
• Protect the health system by minimizing its exposure to legal risk and keeping legal expenses to a minimum
• Keep abreast of national trends in determining institutional priorities
• Determine fiscal requirements and prepare budgetary recommendations; monitor, verify and verify expenditures of budgeted funds
• Manage various personnel functions including, but not limited to, hiring, performance appraisal, promotions, transfers and vacation schedules

General Responsibilities:

• Performs other duties as assigned.

Minimum Qualifications:

Education

• Master's degree in Business Administration, Hospital Administration, Law or a closely related field preferred.
• J.D. degree from an ABA-accredited institution required.

Experience:

• 10+ years of professional  experience managing claims for hospitals, health systems and/or providers, in house or in a law firm setting.  
• Experience budgeting, staffing and supervision of personnel.  
• Prior experience must include negotiation of settlements and projection of insurance reserves required. 
• Experience working with captives, commercial insurers and securing insurance is preferred.  
• Experience working cross-functionally with patients relations/patient experience departments and litigation experience is preferred.

Certifications/Registrations Required

• Must hold an active license to practice law in the United States. Current licensed attorney and bar affiliation in the State of Oklahoma or the ability to get licensed within 12x months.

Knowledge, Skills and Abilities:  

• Experience with professional liability claims, litigation and litigation management. 
• Experience in professional licensure issues and related reporting obligations is a plus.
• Knowledge of regulatory codes, legal requirements and health care law issues impacting enterprise and practitioner risk.
• HIPAA knowledge and expertise.
• Must have strong organizational skills and time management skills with the ability to manage multiple projects and meet tight deadlines.
• Must have strong written and verbal communication skills, excellent negotiation skills with the ability to influence others. Interpersonal communication skills to effectively interact, negotiate and exercise discretion while utilizing diplomacy when dealing with internal and external customers and executive management. Excellent analytical skills.
• Demonstrate ability to persuade, market and sell new ideas and the ability to work effectively in a diverse group.
• Ability to demonstrate emotional intelligence within a high-pressure environment, often in a crisis situation, to render good decisions to resolve problems.
• Capable of developing a vision of continuous improvement through the application of best practices.
• This position requires someone who is self-motivated, flexible, and works with little supervision
• Strong personal and professional integrity, principles and knowledge, earning respect and support when making difficult decisions and choices.
• Strong customer service orientation, be self-motivated, organized, a team player and work well in high-energy, fast-paced environment.
• Excellent project management skills, the ability to execute on plan, deliver results and manage external legal costs. 
• Strong interpersonal and communication skills with the ability to interact with individuals at all levels of the company, including top executives, managers, and outside counsel.
• As this position will involve handling confidential matters, good judgment and discretion are necessary, as well as a working knowledge of applicable privileges to protect confidentiality.
• Ability to multi-task and be extremely responsive to a high volume of diverse requests.
• Strong legal analytical research, drafting, negotiation and communication skills required to: a) identify and manage complex legal issues; b) develop and implement creative solutions; and c) regularly advise on matters of strategic importance.
• Proficiency in MS Office (Outlook, Excel, Word, PowerPoint) or similar software is required.

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OU Health is an equal opportunity employer. We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, create peace of mind for you and your family.