Director - TPA Governance, Delegated Authority, Claims

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