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- ...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
$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- ...operational leader responsible for portfolio oversight, strategic growth, operational leadership, and... ...strategies, financial performance management, and organizational development efforts... ...for major contract negotiations, claims resolution, procurement strategies, and...ClaimsContract workFor contractorsFor subcontractorWork at officeWeekend workAfternoon shift
- ...Director Of Risk And Claims ManagementConcert Golf Partners is seeking... ...of Risk and Claims Management to join our growing... ...central leader and strategic partner for risk identification... ...& Litigation Oversight:Lead and oversee all... ...for complex, high-severity, litigated, or...Claims
- ...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
$67.2k - $115.92k
...Telephonic Nurse Case Manager I Location: This role... ...with Medical Directors and Physician Advisors... ...solving with providers, claims or service issues.... ...communities – and making healthcare simpler. We are a Fortune... ...week, and potentially several times per week. Specific...ClaimsFull timeTemporary workWork experience placementWork at officeLocal areaMonday to FridayAfternoon shift1 day per week- ...pharmacy services. Contact healthcare providers as needed to obtain... ...preferred. Pharmacy claim adjudication experience is preferred... ...those submitted to hiring managers, are deemed to be the property... ...once per week, and potentially several times per week. Specific...ClaimsTemporary workWork at officeLocal areaMonday to FridayShift work2 days per week1 day per week
- ...Technical Product OwnerWho We Are:TurningPoint Healthcare Solutions is a leader in advanced... ...and technology-enabled complex condition management. TurningPoint provides an innovative... ...strong working knowledge of healthcare claims and claims processing is essential to success...Claims
- ...Blue Cross Plans) to provide claims, customer service, and/or membership... ...those submitted to hiring managers, are deemed to be the... ...and communities - and making healthcare simpler. We are a Fortune 25... ...once per week, and potentially several times per week. Specific requirements...ClaimsFull timeTemporary workWork at officeLocal areaShift work2 days per week1 day per week
- ...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
- ...visibility to risk, change positions, claims, issues, and required... ...primary customer contact and strategic advisor, aligning on program... ...a Project Executive, Project Director, senior operations, program controls... ...'s degree in Construction Management, Engineering, Business,...ClaimsContract workTemporary workFor subcontractorLocal area
- ...will support the Director of Pricing in developing... ...responses, and strategic initiatives... ...Finance, Economics, Healthcare Administration, or... ...Experience with claims data analysis and... ...submitted to hiring managers, are deemed to be... ..., and potentially several times per week. Specific...ClaimsFull timeContract workTemporary workWork at officeLocal area2 days per week1 day per week
$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$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$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- ...Description Job Description Description: Claims Investigator - Desktop Remote... ...comprehensive report of daily activities, strategize cases and make professional recommendations... ...and reports through the companies’ management system, conduct social media and background...ClaimsFull timeLocal areaImmediate startRemote workWorldwide
- ...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
$87.6k - $97k
...for a Complex Care Case Manager, RN for Workers... ...medically appropriate healthcare to achieve a safe return... ...holistic approach for each claim. These... ...utilization review, pharmacy oversight and care coordination... ...peer reviews, medical director). Partner with adjuster...ClaimsWork experience placementWork at officeFlexible hours- ...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
$72k - $141k
...of all employees are used to their fullest potential. Individual contributor responsible for the overall strategic management and resolution of highly complex claims that involve personal and advertising injury exposures, including but not limited to intellectual...ClaimsFull timeWork experience placementWork at office- ...Services And Education Program Director At AdventHealth Orlando,... ...to the team: Incumbent oversight of all Advent Health Central... ...effectiveness of Formulary Management Subcommittee and Central Florida... ...degree in pharmacy or healthcare leadership Experience Required...Full timeWork at officeLocal areaImmediate startMonday to FridayShift work
- ...JOB TITLE: Wellness Director DEPARTMENT: Resident... ...for leading and managing all aspects of resident... ...management and payroll oversight to maintain efficient,... ...physicians and other healthcare providers. ·... ...Workers’ Compensation claims as directed. ·...ClaimsWork at officeNight shift
$58.5k - $83.5k
...Service Client Specialist To The Managing Partner New York Life's... ...recruiting initiatives, and strategic execution. The Service Client... ..., training, underwriting and claims Job Level: LEVELCS4 Pay... ...will be determined based on several factors but not limited to...ClaimsFull timeWork at officeMonday to FridayFlexible hoursShift work$128.64k - $185.81k
...Staff is to lead, develop and manage associate veterinarians in... ...veterinarian needs. Partner with the Director of Veterinary Quality and... ...to solve problems involving several variables. Requires... ...Spending Accounts (FSA): Save on healthcare and dependent care expenses...Full timeTemporary workPart timeLocal areaFlexible hoursShift work$72k - $141k
...to their fullest potential. Manages and coordinates operations and... ...customers.****Commercial P&C and Claims Experience Preferred****JOB... ...in accordance with corporate strategic direction. Sets direction and... ...RelationshipTypically Director or aboveSkills, Knowledge and...ClaimsFull timeWork experience placement$72k - $141k
...talents to their fullest potential.Under general direction manages a team of claims professionals for our General Liability line of business. Responsibilities... ...duties as assigned.Reporting RelationshipTypically Director or aboveSkills, Knowledge & AbilitiesKnowledge of the...ClaimsFull timeWork experience placementWork at officeLocal area
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