VP, NA Accident & Health Claims

JOB DESCRIPTION

Our award-winning Claim Department has an exciting career opportunity for an individual who enjoys independent problem solving and utilization of their interpersonal and collaboration skills to build relationships with insureds, agents and internal business partners.

The Claims Vice President role is focused on claim execution and outcomes, best practices development, and in building strategic capabilities (knowledge, processes, resources, etc.).

Key aspects of the job include being responsible for the day-to-day operation of our Accident & Health Claims Department functions to produce exemplary results via our Direct Handle adjusters and our TPA/MGU/MGA partnerships, as well as serving as a subject matter expert regarding all claims and claims functions.

The Claims Vice President will be responsible for driving claims performance specifically focusing on claims loss cost, frequency, and allocated loss adjustment expenses.

The Claims Vice President joins the management team and will work closely with senior business leadership, shared services claims functions, underwriting, actuarial, financial, legal, and compliance to ensure the overall success of North America A & H Claims.

MAJOR DUTIES & RESPONSIBILITIES:


* Provide oversight and direction for overall claims quality, outcomes, and customer service.


* Leverage data to understand performance and production, drive key audits, identify trends, determine service/quality gaps, and develop specific tactics and strategies to resolve issues.


* Manage all vendor (legal, TPAs, medical, etc.) relationships and ensure their performance meets or exceeds best practices and SLAs, cost containment, and quality assurance.


* Work closely with travel assistance providers on a national scale.


* Assist with TPA contracts and business placement to align with business goals and objectives.


* Provide technical and strategic oversight/support for the handling of large/complex losses.

Ensure all actionable insights/trends are identified and timely communicated to internal stakeholders.


* Ensure that the claim platform features/experiences are measured, requirements defined, and capabilities delivered based upon a clear strategic vision and roadmap.


* Ensure the functional performance of the claims operation by leading and supporting the development and implementation of claims best practices, operating models, and customer service standards.


* Ensure the A&H/Life Claims Strategy is aligned with business plans, needs and priorities.


* Develop and implement strategies for the effective reserving and handling of claims to achieve service delivery excellence.


* Identify ways that claims processes can generate data useful to the pricing, segmentation, and management of our business.

Work with underwriting, actuaries, and IT leaders to improve granularity, quality, and accessibility of claim data.


* Monitor and analyze changes in the legal and...