Claim Quality Director, Commercial

Posted 3 Days Ago
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Chicago, IL
Hybrid
87K-178K Annually
7+ Years Experience
Cloud • Insurance • Professional Services • Analytics • Cybersecurity
The Role
Leads the Claim Quality Review process in partnership with Claims LOB leads, identifies trends, and partners to create strategies for improvement. Manages team of claims quality reviewers and ensures common approach to quality best practices and guidelines across claims. Takes a creative approach to improving quality measurements and strategies with the goal of creating a culture of quality. Responsible for maintaining and updating tools and resources related to quality review.
Summary Generated by Built In

You have a clear vision of where your career can go. And we have the leadership to help you get there. At CNA, we strive to create a culture in which people know they matter and are part of something important, ensuring the abilities of all employees are used to their fullest potential.
Leads the Claim Quality Review process in partnership with Claims LOB leads. Through collaboration with lines of business and quality review team, identifies trends and partners to create strategy of improvement. Manages team of claims quality reviewers and ensures common approach to quality best practices and guidelines across claims. Takes a creative approach to improving quality measurements, approaches and strategies with the goal of creating a culture of quality across the claims organization. with accountability to maintain and update the associated tools and resources, including the technology platform. Through collaboration with the Quality team and the lines of business, identifies trending of strengths and gaps across Claim. Ensures common approach to quality best practices / guidelines across Claim where there is consistency in practice and desired behaviors. Ensures accurate and timely data is reported and distributed to Claim leadership.
JOB DESCRIPTION:
Essential Duties & Responsibilities
Performs a combination of duties in accordance with departmental guidelines:

  • Leads the claim quality review team and process to ensure reviews are conducted accurately, timely and consistently in order to determine trends.
  • Has full management accountability for direct reports with an emphasis on talent management and succession planning in accordance with corporate strategic direction.
  • In collaboration with the lines of business, ensures relevant and accurate data, trends and insights are reported to Claim leadership for efficient, effective and engaging use with the goal of improving quality results.
  • Develops new approaches to quality metrics, file selections and unique approaches to measure quality within claims files.
  • In collaboration with the lines of business and quality review team, reviews Claim Opportunity Review (COR) / Management Claim Opportunity Review (MCOR) reports and other relevant inputs for trending, calibration and organization-wide insights. Participates in strategic creating of quality improvement plans and holds teams accountable for necessary improvements.
  • Ensures a common approach to questionnaires, and best practices / guidelines across the lines of business where there is consistency in practice and desired behaviors. Process owner to implement measures to improve calibration between claims and claims quality as well as claims managers and claims handlers.
  • Works in collaboration with the lines of business and Claim leadership to create a culture of continuous improvement where our people own quality, compliance and learning excellence.
  • Provides leadership and coordination of resources for quality review programs: regulatory reviews, SOX compliance, Claim Operations, Third Party Administrators (TPA), other quality reviews and ad hoc audit requests.
  • Stays current on trends and developments within the insurance industry.


May perform additional duties as assigned.
Reporting Relationship
Typically AVP or above
Skills, Knowledge & Abilities

  • In depth knowledge of the insurance industry, its practices and operations; technical expertise in multiple lines of business.
  • In depth knowledge of quality procedures, principles and tools and broad knowledge of system and technology alternatives as well as strong knowledge of related products and services.
  • Ability to effectively lead, coach and motivate staff and project teams at all levels.
  • Ability to exercise professional judgment and assume responsibility for decisions which have an impact on business goals, people and expense.
  • Ability to effectively interact and build trusting and collaborative partnerships with all levels of internal and external business partners within scope of responsibility, team and/or matrix environment.
  • Excellent written and verbal communication and presentation skills, including the ability to communicate business and technical information effectively.
  • Excellent analytical and problem solving skills. Demonstrated creativity in resolving unique and challenging business problems.
  • Ability to build credibility quickly and influence others.
  • Ability to drive and achieve results, with ability to manage multiple projects to meet both short and long range goals and objectives.
  • Strong computer skills including Microsoft Office Suite and other business related software systems.


Education & Experience

  • Bachelor's degree or equivalent.
  • Typically, a minimum of ten years of related and progressive work experience, with a minimum of three year's recent management experience.


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I n certain jurisdictions, CNA is legally required to include a reasonable estimate of the compensation for this role. In District of Columbia , California, Colorado, Connecticut, Maryland , New York and Washington, the national base pay range for this job level is $87,000 to $178,000 annually.Salary determinations are based on various factors, including but not limited to, relevant work experience, skills, certifications and location. CNA offers a comprehensive and competitive benefits package to help our employees - and their family members - achieve their physical, financial, emotional and social wellbeing goals. For a detailed look at CNA's benefits, please visit cnabenefits.com .
CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact [email protected] .

What the Team is Saying

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The Company
Chicago, IL
7,000 Employees
Hybrid Workplace
Year Founded: 1897

What We Do

CNA is one of the largest U.S. commercial property and casualty insurance companies. Backed by more than 125 years of experience, CNA provides a broad range of standard and specialized insurance products and services for businesses and professionals in the U.S., Canada and Europe.

As a company of allies, we understand the importance of fostering an inclusive and supportive culture for all employees. Our eight Employee Resource Groups elevate the voices of underrepresented groups and champion critical DEI initiatives in the workplace and beyond. We strive to promote an environment of inclusion and continuously work to ensure all employees feel valued and respected.

Why Work With Us

CNA knows the importance of having the tools you need to expand your expertise and develop your career. With a variety of cross-discipline and cross-functional opportunities, CNA provides you with the tools and resources needed to customize your career path and understand what is needed to be effective in your role.

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CNA Offices

Hybrid Workspace

Employees engage in a combination of remote and on-site work.

Typical time on-site: Flexible
Chicago, IL

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