Cost Containment Lead

Primary Details Work Arrangement: Hybrid if within 50 miles from office location. Salary Range: $47,000K-$220,000K. Time Type: Full time. Worker Type: Employee. Location: USA – Marblehead, MA. Opportunity Manage a portfolio of complex claims by conducting loss investigations, evaluations and settlements on moderate to high level claims for the Accident and Health business unit. Assure timely and accurate reserves. Effectively communicate and collaborate with Underwriting, Actuary, Legal, and Risk. Within specific limits and authority, conduct and coordinate loss investigations on technically complex claims to provide accurate facts for disposition. Responsibilities Implement the administration of insurance coverage to complex claims by conducting loss investigations, analyzing factual information, interpreting insurance policies and applying legal and technical knowledge to independently resolve claims files in a timely manner. Negotiate claims settlements by collaborating with subject matter experts and involved parties, recommending appropriate reserve modifications and communicating solutions to mitigate risks and coverage conflicts, achieving cost‑effective outcomes. Inform internal and external stakeholders on claims resolution processes by summarizing factual information, reporting out‑of‑scope specialized exposures and accurately managing documentation of assigned claims to ensure effective communication of current state for individual claims portfolio. Facilitate strong working relationships by communicating across the organization and reporting on approved, cost‑effective claims strategies to ensure understanding of claims operations and encourage a collaborative approach to enhancing the business. Participate in claims specialist onboarding by sharing technical knowledge, recommending solutions to complex, escalated issues, training on department processes and procedures and demonstrating application of best practices to assist in development of new team members. Support claims workflow efficiency by accurately documenting portfolio progress, referring high‑risk exposures outside authority levels and seeking opportunities that enhance operational knowledge to ensure achievement of individual and department objectives. Ensure correct, cohesive and efficient customer solutions by collaborating and supporting the team in decision‑making to foster a partnered approach to claims undertakings. Establish a personal, empathetic connection with customers by providing comprehensive communication to ensure thorough understanding of available claims deliverables. Contribute to a positive work environment by demonstrating cultural expectations and influencing others to reward performance and value “can do” people, accountability, diversity and inclusion, flexibility, continuous improvement, collaboration, creativity, and fun. Required Education Bachelor's Degree or equivalent combination of education and work experience. Required Experience 5 years relevant experience. Preferred Competencies Utilize effective communication to influence and persuade decision makers. Mediate and resolve conflict using a logical approach. Identify relevant information and understand its impact. Maintain integrity of claims portfolio and evidence. Use multiple resources to gather and analyze significant data. Leverage technical knowledge to make cost‑effective decisions. Encourage open communication, cooperation and knowledge sharing. High attention to detail. Implement planning to organize, prioritize and measure individual work. Preferred Experience Experience in a claims department or the insurance industry. Experience handling workers compensation claims. Preferred Licenses/Certifications Registered Nurse (RN). Preferred Knowledge Working knowledge of claims administration best practices and procedures. Working knowledge of insurance products and services. Broad understanding of relevant laws and regulations across multiple jurisdictions. Basic understanding of market trends and organizational strategies. Working knowledge of Microsoft Office Suite, general computer software and database systems. Compensation Package Salary range: $47,000K-$220,000K. The salary offer will be decided based on the role’s complexity, location and the candidate’s professional background, including education and experience. Eligible employees are also entitled to QBE’s annual discretionary bonus plan based on business and individual performance. Benefits Hybrid Working – mix of working from home and in the office. 22 weeks of paid leave for family growth, with 12 weeks available to all parents on a gender‑equal basis. Competitive 401(k) program with company match up to 8%. Well‑being program including holistic wellbeing coaching, gym membership, confidential counseling, financial and legal advice. Tuition Reimbursement for professional certifications and continuing education. Employee Network and Community – supports six Employee Networks and many ways to give back to your community. Commitment to Diversity QBE is committed to providing reasonable accommodation to, among others, individuals with disabilities and disabled veterans. If you need an accommodation because of a disability to search and apply for a career opportunity with QBE, please inform our Talent Acquisition team to let us know the nature of your accommodation request and your contact information. Equal Employment Opportunity QBE provides equal employment opportunities to applicants and employees without regard to race; color; gender; gender identity; sexual orientation; religious practices and observances; national origin; pregnancy, childbirth, or related medical conditions; protected veteran status; or disability or any other legally protected status. Skills Administration Management Analytical Thinking Communication Critical Thinking Customer Service Financial Risk Management (FRM) Intentional collaboration Managing performance Negotiation Operations Management Regulatory ComplianceRisk Management Stakeholder Management Strategic Management Team Management #J-18808-Ljbffr QBE North America