Insurance Program Specialist

Position Summary:The role is responsible for the administration, analysis, and oversight of the organization’s insurance programs. The position ensures adequate coverage across all lines of insurance, supports the renewal process, coordinates claims activities, and maintains compliance with regulatory requirements.Key Responsibilities:• Manages day-to-day operations of insurance programs and processing of policy audit requests.

• Assist with the insurance renewal process by gathering data, preparing submissions, reviewing proposals, and negotiating policy terms with

brokers and carriers. Assembles and processes annual GL/PL exposure data actuary reporting.

• Analyze insurance coverage, exclusions, and endorsements to ensure alignment with organizational risk exposure. Coordinates insurance

efforts between internal stakeholders, brokers, carriers, and third-party administrators.

• Track and monitor insurance claims, coordinate with adjusters and legal counsel, and maintain internal documentation. Full fills requests for

claims history, COIs, and new provider insurance coverage as appropriate or needed.

• Maintain certificates of insurance, policies, and other documentation for internal use and third-party requests.

• Manages, assembles and processes insurance policy renewals for the organization. Manages fully insured claim processing.

• Interfaces with insured to develop and submit property claims to insurance carriers.

• Field and respond to inquiries from current and former team members with insurance related questions and requests for evidence of

current or past insurance and claims history.

• Assist in identifying and assessing areas of risk and provide recommendations for mitigation and insurance solutions. Serves as direct

support for senior leadership with insurance related matters.

• Prepare insurance-related reports, dashboards, and audits for leadership and compliance.

• Ensure compliance with all applicable insurance regulations and reporting requirements.

Preferred Qualifications:

• Insurance Principle experience, coverages and industry practices

• Emergency Preparedness experience

• Insurance Policy experience

• Project Management experience

• Conflict of Interest experience

• Claims History experience

• Proficient in Microsoft Office Suite; experience with risk/claims management systems

• Strong organizational skills and project managementMinimum Qualifications:• 3 years of experience in Healthcare, Risk Management, Insurance Claims or Underwriting, Human Resources or a Legal Field or a Bachelor’s Degree required.Required Licensure/Certification:• Healthcare Risk Management (HRM) or Certified Professional in Risk Management Certification (CPHRM) within 24 months of hire.

EDUCATION:

LICENSES / CERTIFICATIONS: 

PHYSICAL REQUIREMENTS:

S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.

Any physical requirements reported by a prospective employee and/or employee’s physician or delegate will be considered for accommodations.

PAY RANGE:

$70,000.00 - $95,000.00Rochester14621

The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.