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JONATHAN J. HINES

Workers' Compensation/Loss Containment Expert
Division Level Marketing/Sales
Vision Driver 		11521 Brothers Blvd.
Germantown, PA 19144
H: (215) 202-1234
C: (609)-707-9921
jj.hines_.1234@roadrunner.net
mr.mgr@yahoo.com

Product Development Creative Manager developing and deploying new products
Conceived, designed and successfully marketed new reinsurance products resulting in significant loss-prevention savings and increased revenue.
Goal Driven Track record of success in meeting and exceeding aggressive metrics
Developed and negotiated profitable business relationships, built effective business processes, increased product revenue and expanded market coverage.
Product/Process Expertise Demonstrated depth of knowledge across a wide range of operational responsibilities
Recognized technical proficiency with catastrophic injury cases, workers' compensation, due diligence and operational reviews.
Team Building/Leadership Departmental bridge builder to optimize operations, build team morale and drive new business
Common vision management style with strong presentation and interpersonal communication skills that inspire a results-oriented team approach with a "can-do" attitude.
Content Expertise Collaboration and leadership in operations and business development
In depth knowledge with increasingly responsible positions from claims examinations to workers' compensation matters plus management and marketing of managed-care portfolios. Recognized as the "go-to" person for classes of complex cases requiring exceptional expertise.
Process & Performance
Improvement 		Demonstrated leadership in operations and business process development
Chosen to head inter-departmental task forces to build new administrative processes to increase branch efficiency and improve audit capabilities.
Vision and Strategy Visionary and strategic thinker addressing industry-wide issues
Consistent contributor as consultant to both internal and external audiences regarding enterprise level planning and decision making on catastrophic injury and medical cost management. Guest speaker at numerous professional conferences and seminars.


PROFESSIONAL EXPERIENCE
National Reinsurance, Philadelphia, PA 1998-Present
A leading reinsurance firm marketing primarily within the United States, providing customized property/casualty reinsurance products and services to primary insurance carriers and self-insured corporations and institutions. The firm manages approximately 1,000 people and generates $2.5-$3.0 billion in annual premiums.
Division Manager, Healthcare Claims, Germantown, PA Office 2002-present
Challenged to assume a key role in a start-up division marketing managed-care products and services through a strategic business partner/client network. Responsibilities included market research, product creation, marketing, pricing, collections, product enhancements and vendor relationships. Additional responsibilities included providing ongoing catastrophic-injury assistance to clients and providing lifetime medical-cost projections on spinal cord, brain damage, severe burn and multiple trauma cases.
  • Collaborated in the successful creation, marketing and deployment of a unique set of managed care products and services resulting in $40 million in savings for client companies over four years.
  • Designed and deployed a medical bill negotiation service. This service increased client savings by 25% with no additional increase in client operating costs.
  • Negotiated a vendor relationship with a high profile client increasing program volume by 40%..
  • Conceived the program and promoted the need for highly specialized managed-care services. The implementation of the program with these services resulted in a unique and highly profitable product niche for the company.
Director, Claims Division/Claims Manager, Philadelphia, PA 1998-2002
Responsible for the development of programs to reduce medical cost exposure from catastrophic injury claims to vendor/clients. Tasked to uncover more cost effective resources and create processes to reduce costs.
  • Consulted with internal consultants and external insurance company clients resulting in the successful development of comprehensive programs to better manage costs.
  • Identified specialized medical treatment centers and rehabilitation facilities, designed recommendations for nurse case managers and developed individualized development plans to reduce medical losses.
  • Recognized as an expert in the component of workers' compensation claims related to medical management and the evaluation of lifetime medical costs associated with catastrophic injuries.
  • Conducted due diligence and operational reviews to determine the adequacy of reserve projections. Named as Workers' Comp Team Leader for a multimillion dollar project for a major insurer, one of the largest reviews done by National Reinsurance.
  • Developed a tool to enable client companies to plan more effectively regarding the projection of lifetime costs associated with catastrophic injury cases, significantly reducing loss exposure on high profile large dollar cases.
Provident Insurance Company, Trenton, NJ 1987-1998
A leading national insurance company with 150 years of service.
Division Workers' Compensation Claims Examiner 1993 - 1998
Supervising Claims Examiner (promoted from Claims Examiner) 1987 - 1993
Supervised 5 senior division examiners responsible for approximately 5,000 complex workers' compensation claims that exceeded branch office authority limits and required higher level technical direction. Responsibilities included managing complex case quality control by directing case investigations, recommending reserve figures and evaluating and providing settlement authority. Also provided technical claims services for branch claims offices involved with less complex, lower exposure claims. The division initially supported branch claims offices in seven separate state jurisdictions subsequently expanded to thirteen states plus federal cases in the mid-Atlantic Region.
  • Created and deployed an innovative branch office claims evaluation system that improved claims handling practices, increased loss dollar savings and corporate profitability and resulted in higher customer satisfaction.
  • Chosen to head a task force that designed more effective guidelines when defining and referring complex cases for division-level review.
  • Led an examiner team responsible for creating and implementing an improved branch claims audit program.
  • Recognized for improved claims handling practice with high visibility accounts such as Longshoremen and Harbor Workers' cases resulting in significant loss dollar savings for the company.

EDUCATION & PROFESSIONAL DEVELOPMENT

B.S. Business Administration, Providence University, New Rochelle, NJ
Certifications - Certified Case Manager, Certified Insurance Rehabilitation Specialist
Professional Development - Strategy and Tactics seminar, Columbia Graduate School of Business; Negotiation Skills for Senior Executives, Harvard School of Business; Certificate of Risk Management Skills; Life Care Planning seminar; Managed Care courses


AWARDS/RECOGNITION

Bonus Awards for outstanding service - 1998-2002 Corporate Innovation Award, new portfolio launch - 1993