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$72k - $141k
...seeking a Complex Claims Consultant in our... ...primarily focus on high severity D&O and E&O claims... ...guidelines:Manages an inventory of highly... ...to include on oversight list, and preparing... ...RelationshipTypically Director or aboveSkills,... ...resolution strategies and strategic coordination with...ClaimsFull timeWork experience placementWork at officeLocal areaShift work$116k - $165k
...leader in insuring Allied Healthcare Providers, including... ...focused Complex Claims Consultant position, you... ...overall investigation, management and resolution of Allied... ...claims to include on oversight/watch lists, and preparing... ...RelationshipTypically Director or aboveSkills,...ClaimsFull timeWork experience placementWork at officeLocal areaFlexible hoursShift work- ...providers as warranted. Examines claims for compliance with relevant... ...payment. Researches new healthcare related questions as... ...including those submitted to hiring managers, are deemed to be the... ...once per week, and potentially several times per week. Specific requirements...ClaimsTemporary workWork at officeLocal area2 days per week1 day per week
- ...coordinating benefits, and running test claims to confirm coverage and... ...with insurance providers, healthcare teams, and patients to gather... ...those submitted to hiring managers, are deemed to be the property... ...once per week, and potentially several times per week. Specific...ClaimsFull timeTemporary workWork at officeLocal area2 days per week1 day per week
$20 - $24 per hour
...arrangements with patients Collect copayments, deductibles, and outstanding balances Follow up on outstanding and denied insurance claims Follow up with patients who have unscheduled treatment Monitor patients who are due for hygiene and periodic exams...ClaimsHourly payPrivate practiceImmediate start- ...Solution Architect Who We Are:TurningPoint Healthcare Solutions is a leader in advanced... ...and technology-enabled complex condition management. TurningPoint provides an innovative suite... ...authorization, utilization management, claims, provider, or member data workflows.Experience...ClaimsWork at office
$147k - $241.5k
...potential. Leads a team of Claims Consultants and Consulting Directors that are responsible... ...effective team management and the resolution of... ...activities of medium to high severity specialized Claims... ...and retention.Provides oversight and strategic direction on claim files...ClaimsFull timeWork experience placementWork at officeLocal area$25 per hour
...Billing Specialist Our client, a leading healthcare organization, is seeking a dedicated... ...Range: $25/hr What's the Job? Manage and process client billing information in... ...responsibilities Follow up on unpaid claims and resubmit rejected claims to ensure timely...ClaimsHourly payWeekly payFull timeTemporary workFlexible hours- ...Executive Director, Partnerships About the Company Leading healthcare organization expanding strategic partnerships across sports, entertainment... ...to lead the strategic management of a national portfolio... ...will be adept at contract oversight, valuation assessment,...Contract work
- ...an organization that invests in you as a Manager Case Management? At HCA Florida Lake Monroe Hospital, you come first. HCA Healthcare has committed up to $300 million in programs... ...functions of clinical risk management, claims management, program administration and risk...ClaimsTemporary workFlexible hours
$203.6k - $339.3k
...responsible for leading the strategic and operational... ...complex, highly regulated healthcare distribution... ...models, and performance management practices that drive consistency... ...and effective oversight.Promote a strong culture... ...employment, you’ll be offered several health-related...Full timeContract workLocal areaWork from home$16 - $24 per hour
...satisfaction scores. We deliver exceptional healthcare that reduces costs and significantly... ...care, performing basic medical procedures, managing patient records, and coordinating front-... ...or online inquiries regarding services, claims, benefits, eligibility, provider...ClaimsFull timeWork at office- ...multiple businesses, employs household staff and contractors, manages several residential properties, and maintains a fast-paced but... ...fatigue for principals Executive Support & Operational Oversight Serve as a liaison between principals and household/business...For contractorsWork at office
- ...The Director of Revenue Cycle owns the end-to-end billing... ...for a Central Florida healthcare services organization... ...locations. The role manages the department across... ...leadership role, not a pure oversight role. The company... ...and coding oversight, claims submission, payor...ClaimsContract workShift work
- ...RegisteredPharmacy Technician Reports To: Pharmacy Manager FLSA Status: Full time -Hourly,... ...to provide high-quality, comprehensive healthcare at a reasonable cost to everyone.... ...promptly, and resubmits rejected claims for payment on a timely basis Resolves...ClaimsHourly payFull timeImmediate startMonday to ThursdayAfternoon shift
- ...Planning and Performance Manager Company Overview At Mitsubishi Power, we're not just building better clean energy technologies... ...(TFA), Finance, Engineering, and Scheduling to provide strategic oversight to ensure efficiencies. Key Responsibilities Demonstrates...
- ...About the Company Flourishing healthcare & wellness services company Industry... ...the Role The Company is seeking a Managing Director for Business Operations within its... ...leadership role is pivotal in driving the strategic and operational functions that...Contract workTemporary work
- ...members provide therapy and healthcare system expertise to help patients... ...The purpose of the Program Manager is to serve Pharmaceutical... ...emphasizing excellence. Reports to Director, Pharmacy. Maintains and... ...curriculum, responsible for oversight and delivery of “on the spot...Contract workTemporary workWork at officeLocal areaImmediate start
$72k - $141k
...supported in using their talents to their fullest potential. This individual contributor role operates under broad authority to manage commercial claims of high complexity and exposure within the Commercial Auto/General Liability/ Construction Auto and General Liability line...ClaimsFull timeWork experience placementWork at officeFlexible hours$130k - $170k
...channel: We Are Limbach - YouTube From healthcare and education to government and... ...owner/builder, developer, construction manager, or general contractor. This individual... ...attorneys in evaluating branch clients' claims and financial pursuits, including disputed...ClaimsContract workFor contractorsFor subcontractorWork at officeLocal areaRemote workWork from homeHome office- ...Description The Patient Care Coordinator is responsible for the oversight and participation of patient's care of ongoing BioPlus pharmacy... ...calls to appropriate clinicians Adjudicate patients claim and bill patient for co-payment during the refill process Intake...Claims
$75k - $165k
...collaboratively across business units including but not limited to; claims, finance, risk engineering, actuary, and technical underwriting... ...Specialist or Executive Underwriter level. The hiring manager will determine the appropriate level based upon the selected applicant...ClaimsTemporary workWork at officeLocal area$33.5 - $45.3 per hour
...drug interactions and offering preventive healthcare services such as immunizations.... ...of the pharmacy and assists the pharmacy manager in identifying ways to optimize pharmacy... ...Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment...Hourly payInternshipLocal areaShift work- ...Commercial Claims Management 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...ClaimsWork at officeLocal area
$72k - $141k
...underwriting organization responsible for managing renewal business across multiple... ...people leadership, technical underwriting oversight, operational discipline, stakeholder partnership... ...-functionally with Field, Operations, Claims, Risk Control, Line of Business,...ClaimsFull timeWork experience placementWork at office- ...Reports any compliance issues to the Director of Operations. Coordinates the insurance... ...system to process payment for account. Manages the entry of client information into computer... ...form, etc.) is on file before submitting claim for payment. Follows up on all missing...ClaimsImmediate start
- ...execution to the Board of Directors. Partner with the... ...Provide executive oversight of Full Cart and Hunger... ...corporate engagement, and strategic growth opportunities —... ...business lines. Manage the VP of Finance & Enterprise... ...corporate, nonprofit, healthcare, and community sectors...
$124k - $199.8k
...locationThis position is responsible for the successful program management of assigned Captive programs. The Captives Underwriter will... ...aspects of program management such as actuarial pricing, claim or TPA oversight, reinsurance accounting and collateral management.Possesses...ClaimsFull timeTemporary workWork at office3 days per week$97k - $189k
...contributor position works closely with senior level leaders and within the broadest authority limits, to manage the most complex, highest exposure commercial claims for a specialized line of business. Responsibilities include the management of all claim resolution...ClaimsFull timeWork experience placementWork at officeLocal areaFlexible hoursShift work
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