Director - TPA Governance, Delegated Authority, Claims

At Trisura, we expect more because we believe it can be done better.

We are a young, growth oriented team with a commitment to exceptional talent and have been named one of Canada’s Top Small and Medium Employers since 2017. Our growth and our entrepreneurial style, niche market position and development opportunities ensure that our people see the results of their commitment reflected in the company’s success.

DIRECTOR – TPA GOVERNANCE, DELGATED AUTHORITY, CLAIMS

This position play’s a key role in maintaining the fronting insurer’s brand and interests while fostering strong working relationships with claim administrators and key stakeholders. This is a strategic, hands-on role, within a fronting insurer framework responsible for delivering oversight of entities with delegated claims handling authority – it involves leadership, analysis, and an eye towards continuous improvement within a program business model.

As an integral member of the team, you will bring

• Dynamic, motivated, and self-confident disposition
• Tenacious, resilient, and resourceful persona with the ability to thrive in a fast-paced environment involving multiple, competing priorities
• Dedication to exceptional customer service and good commercial awareness
• Proven ability to work effectively within a team environment
• Strong analytical and problem-solving skills, plus a pragmatic, process-oriented work style with a passion to learn and strive for continued professional growth
• Strong interpersonal and relationship-building skills, especially effective in delivering constructive feedback and in championing support
• Integrity and personal credibility along with effective and articulate communication skills

Responsibilities

• Relationship Management:  Foster relationships with program partners, and both internal and external stakeholders to maximize competitive advantage derived through confidence in the value proposition of Trisura’s Delegated Authority Claims unit
• Vendor Engagement:  Develop and maintain strong relationships with claim administrators to promote a cohesive and effective engagement

• Team Collaboration:  Work cross functionally to identify, optimize, and execute upon initiatives and objectives in support of Trisura’s risk appetite and disciplined growth trajectory

• Risk Management:  Execute third-party risk management activities specific to claims administration service providers and the like

• Portfolio Assessment:  Review, understand, and act on results, issues, and trends on existing portfolios and deliver insights on proposed new program opportunities from the experienced claim/program management perspective
• Performance Monitoring:  Continually analyze and evaluate the performance of claims administrators for contract certainty; identifying areas for improvement and seeing through for satisfaction any corrective action required
• Audit: Responsible for oversight of claims handling best practices auditor team and delivery of a findings report for presentation to program partners.  Correspondingly, coordinates with peer leadership for follow-up on any adverse findings to ensure that they are appropriately addressed through to proper resolution/satisfaction.
• Process Improvement:  Identify opportunities for process optimization within the delegated authority claims framework to enhance oversight efficiency and effectiveness

• Documentation & Reporting:  Develop performance metrics to meet key stakeholders’ needs such that regularly needed information is available at-a-glance (e.g., new dashboard presentation, enhanced exception reporting from warehouse data, Complex Claim Committee contribution, etc.)

• Travel as needed and/or warranted
• Perform other duties as required or assigned which are reasonably within the scope of the duties in this job description

Qualifications

• Minimum of five (5) years' experience in program and/or portfolio management, either directly (TPA or MGA experience) or in an oversight (Carrier or Insurer experience) capacity
• Minimum of two (2) years’ experience in direct performance of management and/or supervisory experience within the scope of claim handling and/or claims management specific to commercial property and casualty (P&C) lines of authority
• Bachelor’s degree in Risk Management, Accounting, Finance, or Business Administration preferred; Insurance industry recognized accreditation considered a plus
• Current and in good standing Resident State Adjusters License with P&C lines of authority
• Competent in the Microsoft suite of products