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Yyyyyy x. yyyyyy

88 McBride Dr. Portsmouth, RI 02781 401-662-0143 abc@xyz.com

 

Executive Profile

 

Hardworking, versatile and driven professional with more than 20 years of progressive experience. Regarded as an expert with regards to risk management and regulatory compliance. Adept in planning and developing project efforts in conjunction with colleagues and other important parties. Skilled in synthesizing conclusions into recommendations. Proven ability to effectively liaise with stakeholders at all levels. Pursuing a leadership role in the healthcare sector, with a focus on patient safety, risk mitigation, medical professional liability and claims avoidance.

 

Career Highlights

 

         Lead global clinical and safety educational and loss prevention services for all entities and levels of long-term care; develop and conduct all levels of workshops (AIG)

         Develop and present seminars; also contribute to marketing efforts carried out on behalf of AIG

         Facilitated a notable change within the Claims Team in working with a large client; increased client satisfaction and retention across the major client s account including multiple clinical sites. (AIG)

         Earned consistent, outstanding feedback from the AIG Senior Underwriting team for superb performance

         Led Marsh s execution of a long-term corrective action plan for a major teaching institute and healthcare provider; saved the organization several hundred thousands of dollars in claims reductions

         Worked as a lead for the Crisis Response Team for an extensive healthcare network that fielded various claims and a state licensure suspension (Marsh)

         Named as the Front Spokesperson for Marsh at major conventions and marketing events including ASHRM and regional ASHRM-affiliated meetings

         Successfully introduced a Captive Insurance Company for Southcoast within six months as the core member of the Senior-Level Team

         Handled Auto Liability matters; provided leadership resulted in an all-time auto claims decrease for Southcoast

         Trended for claims and employee illnesses; proposed a Southcoast Employee Wellness initiative in conjunction with the Directors of Employee and Occupational Health

         Produced a CME course focused on Informed Consent, later established as a template for all 50 medical societies associated with Norcal, spanning the states of RI, CA and AK, among others (Norcal)

         Created a rehabilitative program for Physicians in good risk standing with consensus from Underwriters and other parties (Norcal)

 

Skill Areas

 

Billing | Claims Management | Client Relations | Coaching & Mentoring | Cost Reduction | Data Research | Education & Prevention

Operations Coordination | Change Management | Information Collection | Insurance Marketing & Public Relations | Interviews

Healthcare Consulting | Legal & Business Intelligence | Needs Assessment | Process Improvement | Project Management & Profit

Profitability | Proposals & Sales Presentations | Quality Control | Recordkeeping & Reporting | Relationship Building

Research & Development | Resource Allocation | Risk Management | Strategic Planning & Analysis | Workflow Development

 

Professional History

 

 

AIG

Senior Risk Consultant, 2011-Present

         Serve as an internal client support provider for the East Coast, including the Mid-Atlantic region, upstate New York and Pennsylvania

         Assess underwriting trending data and executive-level strategic and business planning efforts

         Develop and deliver support for presentations and seminars that covered all facets of clinical safety best practices

         Lead an internal peer group to create measurable objectives, as well as related skills and training for the Casualty Risk Technical Career path team

         Research and develop presentations focusing on loss prevention, claims management and numerous categories of lessons learned

         Conduct clinical Best Practice Assessments and other important benchmarking endeavors

         Work in conjunction with claims and legal staff, often as a liaison between colleagues and clients specific to claims management

         Use claim and legal trending data to intensively work in resolving claims

         Confer with the legal defense team specific to matters and trends to share with colleagues and clients alike

         Recognized as the foremost contact and file manager for an established group of Physicians with high-risk patient groups

         Create a strong marketing presence for events hosted in the greater Northeast/Mid Atlantic area

         Selected amongst thousands of colleagues as a team leader for AIG s Innovation Boot Camp to address Medical Tourism; event is being developed in partnership with a global contact as a potential new concept to launch in the coming year

         Travel frequently with underwriting, claims and marketing teams to present risk and loss prevention data to clients and prospects; also share the most recently captive management related activity with the aforementioned parties

 

 

Yyyyyy x. yyyyyy

Continued

 

Klovir Risk Consulting

President & CEO, 2010-2011

         Worked in an independent consultant capacity with clients needing assistance and evaluation

         Collaborated with clients over the course of a series of quality, regulatory, safety, claims, risk management, business interruption, loss prevention and captive readiness projects.

         Provided services including education and follow up in varied settings e.g. hospital, ambulatory, senior care, and corporate settings

         Offered both onsite and remote assignments with attention to timeliness

 

Marsh Usa

Senior VP, Risk Management-Northeast Zone, 2005-2010

         Delivered holistic risk management services based on individual client needs

         Conducted research and gave updates on current risk, medical and legal issues

         Enhances sales, marketing and retention efforts for Marsh clients; was a Senior Care client lead for entire Northeast Zone, which brought about a 20% clams decrease

         Played a key role as an active member of the corporate team; partnered with clients during all insurance operations

         Actively supported colleagues and clients with detailed preparation and review of C-Suite and Board-level presentations and resources

         Led the successful resolution of a serious medication error at a major health institution

         Worked closely with sales and marketing colleagues to consistently provide them with breaking news and updates specific to legal matters and client updates

         Actively drove operations for and participated in the Requests for Proposal (RFP) process, along with prospect/renewal meetings

 

Southcoast Hospitals Group

Director, Risk & Claims Management & Employee Health, 2001-2005

         Developed and integrated a multi-site Risk Management service program that incorporated legal and claims management

         Became the Director of Employee Health services as well over six months time

         Was a principal presenter to domestic insurance markets, as well as London, Cayman and Bermuda, all of which returned promising fiscal results

         Founded key initiatives including consistent, integrated Sentinel Event, Critical Event, Incident and Failure Mode Analysis databases

         Developed and executed policies and systems used to assist numerous clients of all backgrounds and need levels

         Called on a large counsel network to initiate communication and quick, efficient responses to legal issues

         Consistently offer key healthcare legislative and regulatory updates to senior clinical and administrative team members

         Directed the self-insured Workers Compensation program which yielded a steady downward trend in claims

         Cooperated with third-party administrators to develop and implement system safety initiatives

         Worked with Administrative Assistants to fortify and further develop the new Captive claims database, created to avoid duplication, identify potential claims early on and further extend available resources to staff across the organization

         Actively participated in all marketing planning phases; focused on the possible legal impact on all processes

         Was the foremost contact to Public Relations staff; aided in preparing media statements involving possible legal matters

 

Norcal Mutual Insurance

Senior Risk Specialist, 1996-2001

         Created and introduced the Rhode Island Risk Management office for Norcal in response to a joint commitment by the company and the Rhode Island Medical Society Boards of Directors

         Quickly founded partnerships with key healthcare clients by arranging several meetings within the first 90 days of being hired

         Led interventions including a seminar series; expanded later into a general database comprised of continuing education efforts and other models utilized company-wide

         Founded a discourse for bridging the communication divide between Claims and Risk Management to prevent duplication

         Slashed the number of work hours expended to look into claims and build a heightened awareness of all claims medical/legal impacts

         Used Claims Loss Runs to institute parameters that improved upon Physician performance and lessened the possibility of future claims

         Garnered positive Customer Satisfaction survey results and optimistic feedback within other client correspondence; showed evidence of the value-added component of risk management offerings as a key element in acquiring and retaining business

 

Earlier Experience

 

Associate Director of Risk Management & General Counsel, Tufts-New England Medical Center, 1994-1996

Law Clerk for the Hon. Janet Cox, Department of Industrial Accidents, 1993

Risk Manager/Claims Manager/Quality Review Coordinator, Newport Hospital, 1983-1991

Orthopedic/Oncology RN, University of Massachusetts Medical Center, 1982-1983

Team Leader RN Orthopedics, Mission Bay Hospital, 1981-1982

GN/ Registered Nurse (RN) Medical Surgical, Memorial Hospital, 1981

Yyyyyy x. yyyyyy

Continued

 

 

 

Education & Involvement

 

Certification, National Patient Safety Foundation (NPSF, pending)

Juris Doctor, Southern New England/University of Massachusetts Dartmouth School of Law

Master of Arts, Organization and Management/Human Development, Salve Regina University

Bachelor of Science, Nursing, University of Massachusetts

Certification, Healthcare Risk Management (CPHRM) Practitioner

Certification, U.S. Supreme Court

Certification, U.S. District Court- First Circuit

Certification, Massachusetts State Court

Registered Nurse, Massachusetts and Rhode Island

Innovation Boot Camp, AIG- Medical Tourism

Continuing Medical Education, Southcoast Hospitals Group

 

Involvement

 

Board Member, Massachusetts Society of Healthcare Risk Managers

Member, American & Regional Societies for Healthcare Risk Management

Team Member, Technical Career Path, AIG-Casualty Risk Division

Developer/Researcher/Contributor, AIG Tools & Resources

Contributing Author, ASHRM s Pearls: Informed Consent

Published Author, NORCAL Mutual Insurance Publications

Volunteer, Wounded Warrior and Looking Upwards

 

Honors & Accolades

 

Distinguished Alumni Success Award, Dartmouth School of Law (First Recipient)

Sweet Success Marketing & Client Satisfaction Awards, Marsh USA, Inc.

President s Team Cultural Awareness Award, Southcoast Hospitals Group

President s Club Award, Norcal Mutual Insurance Company

 

 

 

 

 

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