Claims Director-TPA Oversight
4 days ago
Claims Director - TPA Oversight
A leading Property & Casualty insurance carrier is seeking an experienced Claims Director to oversee Third-Party Administrator (TPA) relationships. This role is responsible for ensuring operational excellence, regulatory compliance, and strategic alignment with organizational claims objectives.
Compensation Package
- $120,000 to $150,000+/year total compensation (based on experience)
- Annual bonus potential
- Comprehensive benefits package (health, dental, vision, 401k, etc.)
- Opportunities for professional development and advancement
- Oversee relationships with assigned TPAs, ensuring compliance with company guidelines, service level agreements, and regulatory requirements.
- Monitor and evaluate TPA performance metrics, including claims quality, timeliness, and expense management.
- Collaborate with TPAs to implement process improvements, claim strategies, and operational initiatives.
- Provide leadership, guidance, and escalation support for complex claims issues.
- Partner with internal claims leadership, underwriting, and actuarial teams to ensure alignment on business objectives and portfolio performance.
- Conduct regular audits and reviews to ensure claims practices comply with company standards and applicable regulations.
- Develop and deliver performance reports, trend analysis, and recommendations to senior leadership.
- Participate in strategic planning and assist in TPA selection, contract negotiation, and renewals.
- Bachelor's degree in Insurance, Risk Management, Business, or related field; advanced degree preferred.
- Minimum 10 years of claims experience within the insurance industry, including significant experience managing TPAs.
- Strong knowledge of P&C insurance claims operations, including liability, property, workers' compensation, and commercial lines.
- Proven leadership and team management experience.
- Excellent analytical, negotiation, and communication skills.
- Experience with claims technology systems and reporting tools.
- Ability to influence and collaborate with internal and external stakeholders.
Disclaimer: Please note that this job description may not cover all duties, responsibilities, or aspects of the role, and it is subject to modification at the employer's discretion.
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