Subrogation Program Specialist

3 weeks ago

Pembroke Pines, United States Trova LLC Full time

Support Claims Teams in North America in becoming Claims Subrogation best-in-class.
- Define a clear strategy and the key priorities for the Subrogation program.
- Be accountable for the Subrogation targets achievement.
- Manage directly the most complex and high value subrogation cases.
- Support building and guarantee the right execution of the various action plans in close collaboration with the different involved Claims Teams.
- Design claims processes adaptation for maximizing our Subrogation opportunities in close collaboration with the Claims Team.
- Design automatic rules for Subrogation detection and guarantee their right and consistent implementation.
- Collaborate with UDW Team enabling to reinforce our Subrogation opportunities (e.g. co-insurance rules) in the T&Cs building / improvements.

**Principal Duties and Responsibilities**:
**Monitor the Subrogation KPIs and be accountable for target achievement.**
- Define, on a collaboration mode, yearly Subrogation targets with each claims department.
- Consolidate on a regular basis a Subrogation Dashboard embedding savings but also operational KPIs split per department, Business Partners, type of claims
- Set up an adequate governance framework to review results, main cases, trends with the respective claims teams.
- Ensure timely and accurate Subrogation reporting for compliance and regulation purposes.

**Reinforcing detection subrogation skills of the Claims Teams**
- Build and monitor dedicated action plans for each claim department.
- In close collaboration with Claims Teams, design and deploy Claims processes adjustments, in particular, at First Notification of Loss (FNOL) stage and allowing a:

- more systematic subrogation detection opportunity,
- an accurate Liability assessment.
- Design and deploy specific and adapted e-Learning modules for claims teams (jointly with the training department).
- Build and maintain a Subrogation Guideline including a clear and comprehensive articulation between the claims process and the full cycle time of a Subrogation case.

**Reinforce our IT capabilities in close collaboration with Claims Teams**
- Design automatic alerts for reinforcing Subrogation detection in the various Claims IT systems and guarantee their right and consistent implementation.
- Design / select a workflow capability for allowing an efficient monitoring of the Subrogation cases and guarantee its right and consistent implementation.

**Monitor carefully the most complex and high value subrogation cases.**

**Drive the performance of external Subrogation services providers.**
- Define a clear externalization strategy: types of Subrogation cases to be managed externally /internally.
- Manage the contractual relationship.
- Define clear KPIs and a clear Governance framework for driving the providers performance.

**Leadership**
- Act as a Subrogation expert within the company, supporting peers to continuously improve maturity level.

**Other responsibilities as assigned by Senior Director, Claims Technical Excellence.**

**Required / Desired Knowledge, Experiences and Skills**:

- Minimum of 8 years of prior knowledge and experience in healthcare and/or insurance field for processing claims and or subrogation management.
- Strong analytical skills required including demonstrated ability to analyze raw data, draw conclusions, and develop actionable recommendations.
- Knowledge of developing standards, procedures, guidelines etc.
- A minimum of 3 years’ experience in a management or supervisory role is preferred.
- Must be able to represent the organization in a professional and knowledgeable manner.
- Excellent verbal and written communication skills with ability to manage and prioritize multiple tasks.
- Computer skills necessary to work effectively: Windows Microsoft Word, Excel, and Power Point Proven ability to work under pressure, prioritize work and meet multiple deadlines.
- Excellent interpersonal and relationship building skills with a proven track record of leadership across functional lines that delivers business results.
- Excellent problem-solving skills and capability to troubleshoot the most difficult claim issues.

**Education/Certifications**:
**Requirements**:

- High School Diploma or Equivalent (GED) required.

Preferred:

- Associate’s degree or equivalent

Pay: $80,000.00 - $100,000.00 per year

**Benefits**:

- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance

Schedule:

- Monday to Friday

Ability to Relocate:

- Pembroke Pines, FL 33027: Relocate before starting work (required)

Work Location: In person

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