Managing Director, Strategic Claims Oversight, Healthcare Severity
Confidential
Managing Director, Strategic Claims Oversight, Healthcare Severity
About the Company
Top provider of insurance products & related services
Industry
Insurance
Type
Public Company
Founded
1897
Employees
5001-10,000
Categories
- Insurance
- B2B
- Enterprise
- Consulting & Professional Services
- Agents and Marketers
- Casualty
- Finance
- Multi-Line
- Property
- Property and Casualty Insurance
- Financial Services
- Information Technology
- Property Management
- Real Estate
- Risk Management
Specialties
- commercial insurance
- specialty insurance
- construction
- financial institutions
- healthcare
- manufacturing
- professional services
- real estate
- small business
- technology
- retail
- and wholesale distribution
Business Classifications
- B2B
- Enterprise
About the Role
The Company is seeking a Managing Director for Strategic Claims Oversight in Healthcare Severity. The successful candidate will lead a team that is responsible for the direct handling and oversight of the highest exposure claims in the healthcare sector. This role is pivotal in ensuring the effective execution of claims handling practices, driving operational initiatives, and leading continuous improvement efforts. The Managing Director will be accountable for the overall quality, customer service delivery, and productivity of the team, and will be expected to have a clear vision for their career, with the support of the company's leadership to help them achieve their professional goals. Key responsibilities for the Managing Director include leading and directing the work activities of the Severity Team, overseeing complex claim investigations, and determining claim strategies. The role also involves developing and maintaining collaborative relationships with internal and external business partners, and ensuring the team is in compliance with best practices. The ideal candidate will have a senior-level knowledge of claim and litigation management, excellent communication, negotiation, and facilitation skills, and the ability to manage ambiguous situations. A Bachelor's degree is required, with a JD preferred, and a minimum of ten years of claims or legal experience is typical, with a proven track record of positive results. The candidate should be value-driven, with a sense of urgency to advance the organization's priorities, and a strong ability to coach, mentor, and develop subordinate staff.
Hiring Manager Title
AVP
Functions
- Legal
- Operations
$97k - $189k
...employees are used to their fullest potential. The Managing Director Strategic Claim Oversight leads the Severity & Excess Accounts team that both directly handles and oversees the highest exposure claims in Healthcare. Ensures the effective execution of claims handling...ClaimsFull timeWork experience placementWork at office$97k - $189k
...market leader in insuring Healthcare providers and entities... ...liability claims. This role is responsible... ...driving claim resolution, managing complex litigation including... ...The Healthcare Claims Severity & Excess Team manages... ...management.Provide strategic guidance during trials...ClaimsFull timeWork experience placementShift work$97k - $189k
...professional services and healthcare providers and facilities.... ...currently seeking a Consulting Director to lead Claims Strategy and Execution... ...development and execution of strategic projects, trainings,... ...and possess strong project management and influencing abilities....ClaimsFull timeWork experience placementWork at officeFlexible hours$150.03k - $224.25k
...The Associate Director, R&D Strategic Sourcing, will lead strategic sourcing... ...services control objectives. Manage and identify key supplier... ...minimize cost with minimal oversight. Proficient in... ...application processing fee, even if claimed you will be reimbursed, this...ClaimsFull timeContract workTemporary workLocal areaFlexible hours- ...DDD Program Development & Operations Manager Company: Infinity Healthcare Services Department: New Jersey... ..., Billing and Authorization Oversight Develop and maintain compliant service... ...service notes, authorizations and claims. Monitor utilization to prevent...ClaimsHourly payFull timePart timeImmediate startWork from home
$72k - $141k
...market leader in insuring healthcare providers and... ...customers. Our Healthcare Claims team is seeking Complex... ...overall investigation, management and resolution of... ...claims to include on oversight/watch lists, and preparing... ...RelationshipTypically Director or aboveSkills, Knowledge...ClaimsFull timeWork experience placementWork at officeLocal areaFlexible hoursShift work$125.35k - $172.5k
...creates change and shapes the future of healthcare. Thinking differently is what we do best... ...Business and Cloud ASCP modules (e.g., Demand Management, Inventory Planning, ATP, MRP) and... ...location. Individual pay is determined by several factors including job-related skills,...Full timeTemporary workWork at officeRemote workMonday to Friday$125.35k - $172.5k
...shapes the future of healthcare. Thinking differently... ...analytics to the Senior Director of Finance, International... ...analytics, and strategic financial support for... ...preparing materials for management reviews/divisional presentations... ...pay is determined by several factors including job-...Full timeTemporary workWork at officeRemote work$225.4k - $316.25k
...change and shapes the future of healthcare. Thinking differently is what... ...EXCERCISED Directly manages a Quality system corporate team... ...to achieve success. Provide strategic direction and communication of... ...Individual pay is determined by several factors including job-related...Full timeTemporary workWork experience placement$87.6k - $97k
...Complex Care Case Manager, RNAmTrust Financial Services... ...medically appropriate healthcare to achieve a safe... ...holistic approach for each claim. These... ...utilization review, pharmacy oversight and care coordinationResponsibilitiesUses... ...peer reviews, medical director).Partner with adjuster...ClaimsWork experience placementWork at officeFlexible hours$225.4k - $316.25k
...shapes the future of healthcare. Thinking differently... ...forecasting, performance management and management... ...Team (ELT) and Board of Directors with clear, decision-relevant... ...alignment with strategic objectives, capital allocation... ...pay is determined by several factors including job-...Full timeTemporary workFor contractors- ...laws that govern its operations.Claims Performance Lead - North... ...and continuous enhancement of management information, performance reporting... ...portfolio metrics to support strategic decision-making and business... ...appropriate oversight of data quality with clear ownership...ClaimsFull timeWork at officeLocal areaImmediate startFlexible hours
$22 per hour
...of Maine? We’re reimagining medication management and transforming care. Who We Are and What... ...management solutions to support healthcare organizations serving seniors and individuals... ...processing customer bills and insurance claims in an accurate and timely manner. This includes...ClaimsHourly payFull timeTemporary workWork at officeFlexible hours$217.6k - $256k
...patients, the global healthcare community,... ...Proposition: Serve as a strategic partner... ...Summary: The Director, Regulatory Compliance... ...guidance and oversight for promotional,... ...approval, and lifecycle management of promotional... ...promotional strategy, claim development, and...ClaimsLocal area- ...Financial Services in Princeton, NJ is seeking a Workers’ Compensation Claims Examiner Associate. You will investigate and resolve employee injury claims, coordinating with injured workers, healthcare providers, employers, and legal teams to ensure fair outcomes. This in...ClaimsWork at office
$290k - $400k
...function providing assurance to the Board of Directors and senior leadership on the effectiveness of governance, risk management, and internal controls. The team operates... ...independenceOverseeing audit coverage across underwriting, claims, investments, finance, actuarial, operations...ClaimsFull time$151.4k - $311k
...seeking high-performing candidates to pursue strategic relationships at our largest and most... ...experience, strong relationship management skills and a proven track record in selling... ...a leadership role in pursuits and an oversight role in the development of proposalsCoordinating...$137k - $235.75k
...everything. Our strength in healthcare innovation empowers us... ...Science Portfolio Management Job Category People... ...talent for Associate Director, Patient Data Management... ...an accomplished and strategic leader to assume the role... ..., specialty pharmacy, claims, etc.) Lead the...ClaimsTemporary workLocal areaImmediate start- ...confidence of patients, the global healthcare community, collaborators and... ..., and culture. As a strategic partner and trusted advisor... ...Governance, Compliance & Vendor Oversight Build and sustain... ...design, and headcount management in partnership with Finance...Temporary workLocal area
- ...Financial Services in Princeton, NJ is seeking a Workers’ Compensation Claims Examiner Associate. You will investigate and resolve employee injury claims, serving as the link between injured workers, healthcare providers, employers, and legal teams. You’ll assess liability,...Claims
$45 - $80 per hour
...Medical DirectorThe Medical Director will provide clinical oversight and guidance for the administration of Non... ...guidelines, and serve as a liaison between healthcare providers, beneficiary... ...teams to implement best practices for claims processing and utilization reviewAct...ClaimsContract workLocal area$17 - $20.85 per hour
...assignment. Confirms charges / approves claim creations in system at Check-Out;... ...experience as receptionist or clerk in healthcare environment or one year customer service... ...When determining base salary and/or rate, several factors may be considered including, but...ClaimsFull timeTemporary workPart timeWork at officeFlexible hours- ...We are currently seeking a Managing Director, Industry Segment to join our... ...as our Managing Director, Healthcare Provider Client Segment... ....S. This is a high-impact, strategic role for a proven executive... ...Provide strategic direction and oversight to enhance team...Work at officeRemote workFlexible hours
$160k - $190k
...that govern its operations.AXIS Capital,Claim Manager – Casualty Programs About AXISThis is... ...dedicated to Casualty Programs and TPA Oversight with particular emphasis on New York Labor... ...and TPA/Contractor adjusters including strategic direction Recruiting, hiring and...ClaimsFull timeFor contractorsImmediate start$318k
...aftercare and long-term health management strategies Monitor... ...timely and efficient billing and claim submittal Attend training... ...Flexible Spending Account (FSA) Healthcare FSA Dependent Care FSA... ...base salary and/or rate, several factors may be considered including...ClaimsTemporary workFlexible hours- ...prohibited by the laws that govern its operations.Senior Manager, Quality Assurance and Compliance | North America Claims, Claims Shared Services-AXIS is seeking a Senior... ...direct handle, manager quality review and TPA oversight audit program. The role will also coordinate,...ClaimsFull timeWork at office
$127k - $155k
...high-quality medicines trusted by healthcare professionals and patients.As... ...Touching Lives. Job Summary:Senior Manager, Pricing & Contract Analytics is... ...-driven insights that support strategic business decisions.Reporting to the Director, Business Pricing Strategy & Contract...Contract workFlexible hours$72k - $141k
...for a business area. Supports the active management of a business area by interpreting data... ...Functions of this role include supporting strategic planning efforts, developing... ...Collaborates with Distribution, Actuarial, Claim, Government Relations, Product Development...ClaimsFull timeWork experience placementWork at officeRemote work$50k - $65k
...this role ensures accurate provider encounter processing, timely claim submissions, and effective denial resolution. Key... .... Provide regular collections updates and status reports to management. Vendor & Team Operations Serve as an operational liaison...ClaimsWork at officeLocal area- ...passion changes lives. As a management consulting and technology firm... ..., design, build and operate strategic data‑related capabilities.... ..., life science companies or healthcare data providers. Knowledge of... ...applications (e.g., patient‑level EHR, claims, omics, RWD/RWE projects)...ClaimsWork at officeLocal areaWork from homeWorldwideFlexible hours
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