Director Insurance and Business Operations

SUMMARY :

Under the general supervision of the Vice President, Risk Management (RM) / President Brown University Health Risk Services (BUHRS), responsible for the procurement, design and administration of Brown University Health’s property and casualty insurance program in coordination with Brown University Health’s self-insurance captive insurance company, R.I. Sound Enterprises Insurance Co. LLC (RISE). Provide insurance oversight for Brown University Health system-wide business contracts. Responsible for BUHRS’ general and self-insurance and underwriting operations within the corporation, including the marketing and underwriting of BUHRS’ multi-million-dollar book of affiliated physician business and the accounting and underwriting systems that support this business. Responsible for preparing and presenting Risk Management’s operational budget and actual vs. budget variance analysis. Supervise staff in support of BUHRS’ accounting, customer services and underwriting operations.

PRINCIPAL DUTIES AND RESPONSIBILITIES :

Consistently apply Brown University Health values of respect, honesty and fairness, and the constant pursuit of excellence in all aspects of work.

Responsible for the entire underwriting process for all hospitals and affiliated physician groups. Responsible for both the development of language to be used in insurance policies, the underwriting of those policies, issuing of policies to hospitals and physicians and the rate development process.

Oversee the process of reviewing physician applications for indemnification coverage, applying eligibility criteria to applications to ensure the physicians are properly rated, and developing a contribution schedule for both hospitals and physicians, in cooperation with the actuaries. Ensure that contributions are appropriately collected and provide oversight of intercompany accounts and transfers on behalf of BUHRS.

Utilize Risk Management’s claims database, Riskonnect, to ensure the monitoring of risk and coverage issues. Prepare summaries, spreadsheets and reports showing loss ratios for the Brown University Health facilities and covered physician groups. Work in conjunction with the Directors of Claims Management, Loss Prevention, Loss Prevention and Risk Management to communicate performance statistics and loss ratios to hospitals and physician leadership. Serve as the principal Brown Health Malpractice Plan (BHMP) customer service representative for BUHRS. Provide written and verbal communication to various BHMP participants and ensure that everyone understands both the benefits and the responsibilities associated with the BHMP program. Prepare and present various financial and budget reports to management and work cooperatively with the Finance Department and Internal Audit Department to ensure that all intercompany transfers are timely and accurate. Ensure that all financial policies and procedures within BUHRS are adhered to and are in conformance with Brown University Health protocols. Oversee periodic financial audits of practices in BUHRS. Work with the President of BUHRS in organizing annual meetings of both BUHRS and RISE.

Oversee all BUHRS accounting records and operating accounts. Ensure that all account receivables and payables that relate both to BUHRS and BHMP are appropriately managed and reconciled as well as ensure the timely and accurate production of all financial reports required by the Brown University Health Finance Department and RISE (captive). Ensure the prompt communication of all intercompany charges and other accounting / administrative matters concerning either RISE or BUHRS. Ensure that all journal vouchers are promptly and accurately prepared and that all general ledger postings are consistent with Brown University Health protocols. Monitor the BUHRS budget and prepare budget analysis for consideration by the President of BUHRS.

Under the guidance of the Vice President RM / President of BUHRS, maintain and update – at a minimum of every 3-years - policies and procedures, and audit protocols. Perform other duties as required. The Director of Insurance and Business Operations, must act independently and oversee the following activities :

Accounting / Financial operations :

Prepare the RM, BUHRS and RISE operational budgets.

Prepare the Brown Health Medical Group (BHMG) malpractice and indirect cost budget allocation by cost center.

Supervise accounting staff.

Manage BUHRS’ operating accounts, including the reconciliations of the BUHRS’s bank accounts.

Manage BUHRS’ general-ledger, including the reporting and posting of operating transactions.

Manage BUHRS’ accounts payable.

Manage BUHRS’ billing and accounts receivable.

Prepare budget variance and analyses' information, of the BUHRS, RISE, and other Brown University Health Risk Management centers.

Prepare RISE inter-company statement of charges (invoices).

Report Brown Health Medical Group and Indemnified Physician Practices’ Revenue to RISE.

Supervise the BHMP indemnified billing and collection process.

Coordinate internal and external BUHRS and RISE audits, including CMS Medicare audit.

Underwriting operations :

Responsible for all aspects of maintaining and updating the underwriting system.

Upon request, provide malpractice cost estimates to Brown University Health management and to indemnified physician practices.

Supervise the Brown Health Malpractice Plan application process.

Refine rate classes vis-à-vis standard professional practices per BHMP experience and industry trends.

Supervise periodic physician practice specialty rate class reviews.

Activate BHMP coverage for eligible medical professionals.

Supervise the issuance and tracking of invoices to indemnified individuals concerning their BHMP coverage.

Provide oversight of all RISE captive policies and BHMP forms and documents.

Supervise the preparation and distribution of the BHMP indemnification agreements and other BHMP coverage documentation to direct and indirect customers.

Maintain files concerning the underwriting activity, correspondence, and financial records concerning each indemnified individual and medical-practice group of the BHMP.

Communicate to the finance department and to RISE the underwriting activity for financial-reporting purposes.

Budget for and procurement of all Property & Casualty Insurance :

Coordinate the services of brokers and insurance consultants.

Utilize Brown University Health’s captive to leverage optimum pricing strategies.

Facilitate communication between facilities and Brown University Health’s property carrier to implement property loss prevention initiatives.

Provide oversight of Fleet and Personal Vehicle driving policies and loss prevention initiatives.

Activate the renewal process for Brown University Health’s commercial insurance coverages, through working with insurance brokers and other consultants.

Prepare and maintain files for all insurance coverages.

Notify our commercial insurers, via the insurance broker, of any interim changes that would affect the coverages provided by the insurance, which could warrant coverage endorsement.

Prepare files for all insurance programs for each of the affiliates of Brown University Health.

Prepare and maintain cost-analyses’ and cost-savings' reports and documentation concerning the affiliates of Brown University Health and Brown University Health itself.

Actuarial operations :

• Summarize and analyze claims and statistical data prior to actuarial submission.
• Provide independent actuary with information for analyses and funding development.
• Develop class rates concerning the indemnified physicians of the BHMP.
• Review actuarial reports to ensure the information reflects the self-insurance program criteria and data submitted.

Contract negotiations :

Customer services operations :

Manage the purchasing activities of BUHRS.