Director, Claims Operations

Summary:  Under limited supervision and with significant independent judgment, serves as head of the technical operations function of claims. Is responsible for maintaining and overseeing Claims Handling Guidelines for all lines of business, leading re-insurance operations, claims reporting and analysis, and for the management of personnel in the unit, leading and managing all staff to achieve unit goals by performing the following duties:

Essential Duties and Responsibilities: 

1. Provide technical oversight and management expertise for all lines of business, including:
   1. Implement and execute claim handling standards and strategy
   2. Ensure high quality, appropriate and timely claims outcomes, service excellence and compliance with fair claims handling principles
   3. Provide guidance and direction on large or complex losses
   4. Maintain claims audit program, focusing on claims outcomes and best practices
   5. Analyze claims trends to develop appropriate action plans, improve processes, and recommend best practices

1. Manage vendors.
   
2. Manage the re-insurance operations.
   
3. Manage claims reporting and analysis, project planning and implementation.

1. Functions as the Manager of employees of a major organizational business unit, generally through subordinate leaders, including but not limited to:
   1. Communicates vision. Develops and recommends strategic and operational plans.
   2. Organizes and manages resources to achieve business results. Trains, coaches and leads staff.
   3. Oversees and conducts performance management, including performance planning, performance appraisal, and development of subordinates.
   4. Recommends and implements employment actions, including employment/termination, corrective action, promotions/demotions, salary changes, etc.
      
2. Serves as a member of the company management team, representing the technical claims function in various planning and operational activities, including:
   1. Participates on the Corporate Planning Team
   2. May serve as a Business or Technical Sponsor on one or more tactical initiatives

1. Performs other duties as assigned.
   

 Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education/Experience:

Level 6:   Master’s degree (M.A.) or equivalent; or six to ten years related experience and/or training; or equivalent combination of education and experience.