Risk Adjustment Coding Jobs in Kentucky

Overview

The Senior Vice President (SVP), Litigation and Risk serves as a senior executive leader responsible for the strategic oversight, governance, and operational effectiveness of Appalachian Regional Healthcare's Enterprise Risk Management, Litigation Management, Insurance, and Claims functions. Under the direction of the Chief Legal Officer (CLO), this position leads a significant enterprise portfolio spanning multiple hospitals, service lines, business units, and corporate functions and is responsible for developing and leading the ARH Enterprise Risk Management Program. The position drives a culture that prioritizes compliance with the law, ethical business practices, robust reporting, shared learning, and proactive risk management across the organization.

The SVP provides executive oversight for the day-to-day operations of the Risk, Insurance, and Litigation Management functions, including all matters pertaining to litigation, captive management, safety event management and prevention, claims administration, and insurance programs. The position partners with executive leadership and operational stakeholders to support organizational resilience, reduce enterprise risk exposure, strengthen governance, and drive risk-informed decision-making across the organization. The SVP also supports the Chief Legal Officer on governance-related matters as assigned. Consistent with the ARH Executive Level 1 (E1) framework, this position carries Tier 1 organizational impact and supports the development and execution of short-to-mid-term organizational and operational strategies across multiple facilities, departments, and business units.

Responsibilities

Litigation and Insurance Duties:

• Responsible for the analysis of each newly reported incident and/or claim to determine appropriateness of early resolution, coverage, timely reporting to carriers, assignment and proactive management of outside counsel, aggressive direct claims handling, direct litigation participation, oversight, and development of a plan to achieve a beneficial timely conclusion.
• Responsible for developing and updating defense counsel guidelines and ensuring guidelines are followed.
• Participate in site visits, mediations, and/or court proceedings.
• Oversee early resolution program.
• Work closely with Senior Director of Insurance and Claims to oversee placement and operational leadership for all ARH insurance programs.
• Keep Chief Legal Officer informed of material incidents, claims, and status of litigations.
• Provide education to providers and others within the organization on litigation trends, deposition skills, litigation avoidance.

Enterprise Risk Management:

• Implement and oversee Enterprise Risk Management roadmap milestones to strengthen enterprise risk maturity.
• Lead risk assessments and facilitate risk workshops with business units.
• Analyze and consolidate risk data to identify trends and emerging risks.
• Collaborate with business units to support the development of risk response plans.
• Oversee and supervise attorney-client privileged investigations related to significant incidents, sentinel events, losses, or alleged non-compliance, working closely with Clinical Risk, Insurance/Claims, Compliance, Quality, HR, IT, and external parties as needed.
• Ensures reporting systems are effective and robust for patient safety and general litigation related matters as evidenced by strong reporting numbers, early notice of claims and general freedom from surprises or citations related to underreporting.

General:

• Engage with the external environment including industry thought leaders in order to maintain real-time appreciation of new laws, regulatory developments and opportunities in the relevant areas. Makes connections and fosters external relationships that inures to the benefit of organization.
• Keep Chief Legal Officer informed of significant risk incidents.
• Assist with budget development and assign resources accordingly.
• Promote a culture of continuous learning and problem-solving.
• Establish long-term innovation and improvement strategies.
• Participate in regular Legal and Risk Department responsibilities including but not limited to offering legal advice, reviewing subpoenas and court documents, taking phone calls from internal clients with questions, and supporting the resolution of legal or risk issues.
• Perform other duties as assigned by the Chief Legal Officer.

Qualifications

Education

Juris Doctor (J.D.) from an accredited law school; active license to practice law in good standing (Kentucky or West Virginia preferred).

Minimum Work Experience

At least 5 years in healthcare related legal practice required. Medical malpractice and healthcare/hospital system experience are strongly preferred.

Required Skills, Knowledge, and Abilities:

• Litigation experience, preferably in the area of medical malpractice.
• Exhibits business operations knowledge.
• Highly developed communications, team player, change agent, strategic and creative, excellent project management skills and the ability to drive performance.
• Excellent judgment, executive presence, and ability to influence across all levels of the organization, including Board/committee interaction.
• Great interpersonal skills, including diplomacy and flexibility, and the ability to interface effectively and engender trust and confidence with personnel internally and externally to ARH.
• Handles confidential and sensitive information with discretion.