Healthcare Insurance Reciprocal of Canada (HIROC) is a trusted risk and safety advisor, offering a full spectrum of insurance products and risk management solutions to its partners in the health sector. Founded in 1987 with 52 Subscribers, today they insure over 600 healthcare organizations. As a reciprocal, HIROC is governed by its Subscribers and its services are continually evolving to meet the needs of a sector where change has become the norm. With their unique business model, HIROC is a differentiator in the health care insurance industry and remains as nimble and proactive today as when it was founded. HIROC’s philosophy is one of focused attention to customer service and unrelenting foresight and innovation that will enable it to meet the needs of its Subscribers both today, and tomorrow. This is where you come in.

Summary

Reporting to the VP, Claims, the primary responsibility of the Director, Claims is to direct overall Claims Department operations while ensuring compliance and meeting business needs.

Key Responsibilities

Claims Function

  • Review initial documentation, apply legal / claims analysis and set / amend reserves
  • Provide instructions to claims examiners, adjusters / lawyers on a continuing basis, settle / deny / defend decisions 
  • Authorize expense and indemnity payments, mediations and pre-trials
  • Settlement authority to $500,00 indemnity, $250,000 expense
  • Sole responsibility for HIV-related claims matters
  • Respond promptly to and handle concerns / recommendations of Subscribers
  • Oversee with our Adjuster and Legal Managers to ensure timely and quality work product
  • Monitor for and respond to deficiencies in claims management timelines and processes and in budget

Direct Department

  • Direct overall departmental operations
  • Direct the selection, development, promotion and termination of staff
  • Provide supervision, coaching and mentoring for staff
  • Prepare and conduct all direct reports performance development meetings and ensure this is effectively completed for all department staff
  • Lead the development of staff objectives related to departmental plan
  • Coordinate allocation of staff educational budget
  • Act for Vice President, Claims in their absence

Organizational Planning and Implementation

  • Contribute to HIROC and department planning and priority setting
  • Participate in HIROC management meetings and communicate initiatives to staff
  • Participate in Director-group meetings and related initiatives
  • Participate in the Board Claims and Risk Management Committee

Other Functions

  • Act as a resource to other HIROC staff
  • Act as HIROC representative while delivering presentations, participating on external committees, liaising with other organizations
  • Maintain ongoing lens of Subscriber needs
  • Other duties as required

Knowledge, Skills and Abilities

  • Excellent communication skills with an ability to present compelling business cases on sensitive, complex issues
  • Strong analytical skills
  • Ability to problem solve and balance multiple priorities to ensure timelines are met 
  • Enthusiastic and creative leader that drives for excellence
  • Passionate about creating the safest health care system possible for Canadians

Education, Training and Experience

  • Completed post-secondary education at the Bachelor or Masters Level and 10 years of related work experience or an equivalent combination of education and experience
  • Insurance Institute CIP, FCIP, and / or CRM 

How to Apply

Please submit your résumé to HR@hiroc.com.

In order to be considered for this position, please include a current résumé or detailed qualifications summary with your application. Only those selected for an interview will be contacted.


HIROC is committed to providing a barrier-free environment for all stakeholders, including our Subscribers, employees, job applicants, suppliers, the public and any visitors who may enter our premises, access our information, or use our services. As an organization, we respect and uphold the requirements set forth under the Accessibility for Ontarians with Disabilities Act (AODA) and its associated standards and regulations and will ensure that we offer a safe and welcoming environment that is respectful of each person's dignity and independence. 

As an organization, HIROC is dedicated to meeting the needs of individuals with disabilities in a timely manner. We understand that providing a barrier-free environment is a shared effort, and as an organization, we are committed to working with the necessary parties to make accessibility a reality for all.