AVP, Programs Claims, North American Claims Group

Job Title:

AVP Programs Claims North American Claims Group

Department:

Claims

Job Summary:

Work with the members of the Programs Claims Team to drive strategic initiatives in the handling of various claims which are being directly handled by the Companys third-party administrators (TPAs). Engage in collaborative projects in support of other areas of the company including underwriting finance and accounting actuarial operations and technology.

Job Duties:

Develop project plans manage milestones and monitor key metrics to report progress to senior management.

Lead end-to-end claims projects from planning to execution implementation and post-go-live support.

Identify and eliminate obstructions to progress through better procedures training and policy enforcement.

Prepare and maintain regular reports on plan implementation key metrics and plan execution.

Work with members of the Programs Claims Team to help execute and drive forward strategic initiatives.

Help mentor members of the Programs Claims Team.

Approve reserves payments and other actions consistent with authority.

Conduct periodic claim file reviews and monitor claim litigation.

Provide back-up for claim staff.

Interact with outside TPA supervisors and program administrators regarding claims oversight trends etc.

Conduct TPA audits along with analysts on the team.

Interact with underwriters concerning claims trends and strategic initiatives.

Interact with Legal & Compliance as necessary regarding enhancements/modifications to policy forms and endorsements as well as the TPA service agreements.

Meet with actuaries and finance as required.

Interact with Claim Operations as necessary regarding enhancements to claims systems and other operational issues.

Assist with claims related queries in internal and external audits.

Work with reinsurers as needed.

Job Requirements:

A minimum of 10 years experience handling liability insurance claims or related relevant experience although experience in handling professional liability claims is preferred.

Experience overseeing TPAs is strongly preferred.

Bachelors degree is required but a J.D. is preferred.

Experience with project management including setting goals and metrics and managing the project through completion.

Strong leadership and communication skills with substantial knowledge of issues underlying a variety of General Liability Environmental and/or Property claims.

Excellent negotiation and communication skills including technical writing.

Ability to manage internal and external relationships and staff development.

Ability to develop and implement departmental policies and procedures analyze coverage and instruct and collaborate with counsel regarding litigation strategy and claim resolution and resolve claims and otherwise act within the scope of delegated authority.

Work requires the ability to read comprehend and analyze written materials quickly and to use a computer for long periods of time. Some travel required.