After graduating from Rutgers University, upon her mother's suggestion Santiago took a job with medical malpractice insurance company Medical Inter-Insurance Exchange in Lawrenceville, N.J., as a medical representative, counseling doctors on how to avoid medical malpractice lawsuits. “If a patient stormed out, for example, saying they weren't going to follow medical advice, we would be drafting a letter dismissing them from care,” she says. “In addition, if a physician did get sued, I would go to their depositions, be present at their trials and the entire process. I'd be involved in any investigation.”

The position proved to be her introduction to the world of risk management. “It felt pretty natural, and from there I segued into NYU.”

Wisdom gained

In 1996 Santiago started at New York University Medical Center in Manhattan, where within three years she ascended the ranks to become director of insurance. “I really liked the academic medical center environment,” she says, noting her involvement in several patient-safety committees and day-to-day interactions with medical staff. She also enjoyed leading people and being a part of their professional development.

NYU retained a Bermuda-based captive insurance company for its physicians, which provided her first exposure to working with captives. “I thought this was a very cool way to finance risk,” she says of her initial experience managing a captive. “In its true sense, you are using your own money, not a third-party insurance company's—and that puts a different perspective on managing risk to avoid the payment of losses. I always considered it my 'own' money to protect, and this dovetailed nicely with my passion for managing risk.”

Working at NYU, Santiago says, afforded her the lesson that insurance-buying decisions vary greatly by company, “and according to the philosophy of the ultimate buyer who is either the CFO or whomever the risk insurance function reports into,” she relates. “It's really a question of how much risk you want to take and how much you want to transfer, and I have found that many companies prefer to transfer as much as possible to protect the balance sheet even when they can afford to take more risk and manage that risk effectively.”

Additionally, at NYU Santiago learned the value of putting one's reporting in the appropriate context. “I'd done an analysis related to workers' compensation and the number of injuries among various employees,” she recalls. “Clearly, one group had the majority of these injuries: the nursing staff, because they lift patients and deal with a lot of heavy objects.” Despite the number of protocols in place to deal with those exposures, she adds, “that's where we would see a lot of back and lifting-related injuries.”

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After releasing her findings that nurses were the employee group that saw the highest number of injuries, she recalls, “The head of nursing came back and said, 'Well obviously, yes. We're the largest employee population.' She wasn't too thrilled that I hadn't shown it in the perspective of how many people were employed at the center, which was a very fair statement. Lesson learned.”

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Time for a change

In June 2001 Santiago had her first child, and she went back to work on Monday, Sept. 10. She witnessed the destruction on 9/11 while her baby slept at home in New Jersey, and from then on working in Manhattan felt different; the energy level was not the same. She continued to work in the city for another year, and then decided it was time for a change.

“There was a brokerage in Montclair, N.J., called William H. Connolly & Co.,” Santiago recalls. “They have a very good reputation for hospitals and pharma in the New Jersey area, and they specialized in risk management insurance. I drove by and I thought, 'Hmm, this seems like a nice place to work.' So I went in and I gave them my resume. I think within a day or so, they contacted me.

“I explained to them, 'I don't have a broker's license,'” she says. “They said, 'Don't worry, we're going to send you to school.'”

After a month of instruction, Santiago took her exams and became licensed for property & casualty as well as life & health.

“That was quite a different environment,” she says. For example, when the brokerage was trying to gain the business of a new hospital, Santiago would go along on those sales visits. It was time spent generating new business and servicing accounts, the latter of which “is really where I was probably more comfortable and excelled more,” she adds.

“I believe one of my strengths as a broker was selling accounts to insurance companies,” Santiago notes. “It had something to do with the fact that I could forecast and predict the potential risks of the business activities, and then present the information in such a way as to address those risks and allay any concerns. I, of course, had to believe that those risks were being managed and would provide guidance to the business on the 'how' and the 'why.' It would be difficult for me to sell an account in which I had doubts regarding their business practices.

“I like to try to solve people's problems and find solutions,” she adds. “The flip side of that is, if they didn't really need to buy insurance, I would be the one to tell them — and that's when I realized brokerage was really not for me, because we were supposed to be selling insurance. I'd say, 'Listen, we can mitigate that risk. I know you can manage it.' I guess I'm a better risk manager than a salesperson.”

Still, Santiago's brokerage experience — understanding terms, conditions and endorsements, underwriting considerations, appropriate pricing and myriad other policy details — gave her a serious leg up in the business of risk management, where many risk pros often depend on their brokers for such perspective.

“A lot of people in risk management who haven't done brokerage don't know the meat and potatoes of insurance,” she says. “I learned a lot, and from an employer standpoint, they appreciate that I could bring that technical aspect.”

During her brokerage tenure, William H. Connolly & Co. was acquired by Arthur J. Gallagher, which brought several changes to the organization. “It was interesting, and a great experience,” she concludes, “but I wanted to go back to the risk management side.”

Santiago did so in June 2007 when she joined industrial company Ingersoll Rand, where she broadened her scope to include more global experience.

“Ingersoll Rand was a large corporation, a global corporation,” she says. While initially focused on managing domestic risks, Santiago requested more assignments pertaining to foreign territories.

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“They were willing to give me enough rope to see how I could do, and to me, it was just the next challenge,” she says. Santiago found herself placing coverage around the world through the company's network of brokers.

She recalls that there was much discussion at that time by risk managers around the need for purchasing Directors' & Officers' liability in various territories abroad. “We were always buying it in the U.S., but what were we supposed to be doing around the world?” says Santiago. “We thought it was a good idea to understand what the local laws required from the standpoint of indemnifying the directors and officers in the country. Once we understood that language, we would determine whether a policy was a good idea or not.

“So I set up a matrix with each country, and had the language noted, and then [went through] a decision tree as to whether we should buy or not,” she adds. Brazil, Russia and India were among the nations in which D&O was purchased.

There is a certain degree of serendipity to Santiago's career moves; many of them seem to have placed her in the right place at exactly the right time, her choices made intuitively. “I think people need to trust their intuition more,” she says, conceding the point. “Maybe for some, that intuition is more developed than in others. I've always lived under the premise of trusting your gut and [analyzing] how your body responds and acts to things.

“It's not always perfect, it's not always right,” she adds, “but probably 9 times out of 10 it is. If it's not, you make the mistake, learn from it, and you probably don't make the mistake again the second time.”

Other than the time she spent at Ingersoll Rand, she says, “I think for me, the healthcare theme clearly runs through my career. I kept coming back to it, and to be honest, I'm not sure that I did that consciously or not.”

Related: Insurance carrier compliance: The rise of the chief risk officer

By comparison, she adds, “I think my decision to join Novartis was more conscious, because when you work for an organization and really believe in what they do, for me it does make a difference, so that was important.” Feeling that her work does in a real way contribute to the well-being of those the company serves, “that tells me, OK, what I'm doing every day is worthwhile.”

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A new journey

In her time at Novartis, Santiago has been credited with several “wins,” not the least of which was closing down a large U.S. captive gained through an acquisition that was done under a very tight timeline shortly after joining the company in 2011.

“Management was clear that this was a difficult project, and they were concerned about my success and meeting the timeline,” she says. “From developing the project plan, the stakeholder map, the objectives, deliverables and timeline, we moved through the project without catching our breath until it was completed satisfactorily and on schedule.

“It was very rewarding to see the finish line, and really nice to receive the recognition for the team,” she adds. “This was a good example of how to lead and empower people who are not your direct reports and still get them to do their part of the work for the common good.”

Product liability, compliance, FDA approvals and cyber liability — a particularly serious risk for those who would store any type of medical data — are all part of risk mitigation for pharmaceutical companies. Santiago's newest role as director of risk management and investigations, she says, “is more about identifying, assessing, mitigating and managing healthcare risk. These are risks in the way we do business, and I am really excited to delve deeper into this area.”

Santiago keeps one key theme in mind in her work at Novartis, and endeavors to instill it in all who work there: Every employee is a risk manager. “I think people are aware of their responsibility, people are accountable to their role. And certainly from my perspective, that's a message that I'll drive and continue to drive as I go forward, as long as they'll have me,” she adds. “I'm excited to kick off this next phase in my journey.”

Of membership and service

It was in 1999 when Jennifer Santiago first became aware of RIMS. “I saw the advertisements for this great conference and thought, 'I've got to check this out.' I got the approval to go and the keynote speaker was Colin Powell, and it was in Dallas.

“It was such an amazing experience,” she recalls of the 37th annual conference and exhibition. “I remember standing outside waiting for them to open the doors so we could go in for the keynote, and there were just thousands of people. I think the power of that spoke to me, and I said, 'This is really an industry that I want to be a part of.' The education and networking that were offered at the conferences were tremendous.”

Santiago became a RIMS member. “I stayed in it from then on and I met folks along the way who said, 'We have these committees and councils and we'd like you to get involved.'” She joined the Quality Advisory Council, “and before I knew it I was the vice-chair and the chair.”

She joined RIMS' board in 2014 and in 2015 she was asked to become an officer. “I was a director for the first year and moved into the officer role last year as a secretary, and this year I'm the treasurer,” she notes. “I consider it a privilege to be on it, I'll serve in whatever capacity they like.”

First impressions

In November, Jennifer Santiago was given the opportunity to participate in the Spencer Educational Foundation's Risk Manager in Residence Program, which awards a grant of up to $4,000 to colleges and universities to cover transportation, housing and incidental costs for a lecturing risk manager who takes the time to share their experience with students.

At Temple University in Philadelphia, she spent nearly three days speaking before more than 10 classes, and met with nearly 10 professors in between. “It was an amazing experience,” she says. “You're in front of students who might not necessarily be decided on risk management as a career. Maybe they're on the fence or undecided, and then you're explaining to them, 'Here's what I do. This is my life, this is what I do every day.'”

The students were far more polished than she could have expected. “They were very impressive,” says Santiago, noting their verbal skills when asking intelligent career questions and their impeccable table manners.

“They prep the students so well,” she says. “I think about when I was that age, you'd hear, 'Get a job, clean yourself up, go buy a jacket.' These students know what they're interested in, and in large part they know what path they want to go down.”

Santiago came home to some 30 LinkedIn connection requests from students. “Some were reaching out for advice, some were reaching out for introductions to people; I thought that's the least I could do.

“These students don't have the hands-on knowledge yet, but they certainly have the technical information, and you just see the interest and the hunger and the drive that they possess,” she adds. “We need to better understand what the next generation's needs are.”

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