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VP of Claims

Company: P&C / Life / Health Insurance, Jacksonville, FL
Location: Jacksonville
Posted on: September 15, 2018

Job Description:

Overview

Under minimal supervision, responsible for assisting the Department in developing and implementing strategic goals for the department. Oversees appealed cases and monitors litigated cases. Oversees cases submitted to HEC/CSC. Provides claims technical expertise both inside and outside the department. Contacts with employees at all levels of the company, policyholders, claimants, Board of Governors, attorneys and vendors.

Qualifications Bachelor’s degree or equivalent, preferably in Insurance or General Business. Ten (10) years Professional liability claims experience, including management of high-exposure claims ($500K and above). Seven (7) to ten (10) years Insurance industry management experience. Three (3) to five (5) years previous or current Assistant Vice President role, in good standing. Responsibilities

Strategic Planning & Budgeting Participates in developing the overall claims strategy in support of the general company strategy Analyzes prior year(s) performance and needs to construct anticipated budgetary needs with input from management team. Partners with ROO to refine and finalize annual strategic plans and budgets. Monitors key performance metrics, including % closed with indemnity, trial %, average severity, etc. Manages to strategic plan/budget and makes course corrections to strategic plan and budget where necessary. Process Improvement Ensures that processes and training programs are in place to support new products, policies and procedures or reporting requirements. Reviews key performance metrics/audit results to ensure compliance with all critical claim functions. Works with management teams to analyze opportunities for system enhancements and develop supporting processes. Policy / Procedures Development & Compliance Works in conjunction with other regional claims leaders, Legal and ROO’s to develop, revise and update claims procedures, guidelines and policies. Ensures processes are in place to confirm alignment with procedures/guidelines, compliance with regulations, and good faith claims handling. Responsible for quality assurance performance and ensures remedies are in place when performance issues arise. People Development & Deployment Set regional staffing resources in relationship to case volumes and service goals. Partners with ROO to determine needed staffing levels and changes. Obtains input from management team on training needs and identifies appropriate regional or national resources for staff development. Coaches and mentor’s regional claims team to ensure desired results and individual development. Oversees the selection of new claims hires, promotions and succession planning. Litigation Management & Claims Resolution Reviews and monitors cases planned for trial. Participates in round-table of high exposure cases and provides indemnity, demands and trial authority up to the RCL limits of authority. Ensures regional reserve adequacy, coverage analysis and ensures cases with high exposure are evaluated at the appropriate authority level. Internal / External Customer Collaboration & Support Finds opportunities to advance collaboration with our internal/external customers. Develops understanding of the business environment of our internal/external customers. Achieves success when working with internal partners and members. Networks with peers across departmental lines to improve service, support and retention of our members. Culture Management Articulates and demonstrates TDC values to external and internal customers and serves as a role model for regional team members. Communicates and develops programs or processes to reinforce TDC values and behaviors. Presents and discusses TDC values with direct reports. Provides feedback to direct reports on performance against TDC values Claims Investigation / Analysis Ensures that claims information that impacts decisions in other departments (e.g., UW, Patient Safety, etc.) is communicated. Business Development Represents TDC claims in meetings with prospective accounts. Assists Marketing/Business Development in identifying key accounts and prospects for new business targeting. Provides analysis of claims data for acquisition targets and retention of key accounts. Ensures that claims resources can be deployed to support acquisition and renewal process. Other duties as assigned Performs other duties/projects as assigned by the ROO’s and/or executive management.

Keywords: P&C / Life / Health Insurance, Jacksonville, FL, Jacksonville , VP of Claims, Executive , Jacksonville, Florida

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