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
$150k - $350k
...be part of an inclusive, adaptable, and forward-thinking organization, apply now.We are currently seeking a Managing Director, Strategic Pursuit Lead - Healthcare to join our team in Plano, Texas (US-TX), United States (US).Company OverviewNTT DATA is a $30+ billion...SuggestedFull timeTemporary workWork at officeRemote workWorldwideFlexible hours- ...operations of Travelers Claim Medical initiatives... ...industry. Develop medical management strategies that help... ...to medical and healthcare trends. This includes... ...Medical Direction and Oversight:Participate in the design... ...engagement of Regional Medical Directors, Medical Consortiums...ClaimsFull timeLocal area
$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- ...seeking an accomplished healthcare executive to lead its next... ...opportunity to drive strategic initiatives, strengthen... ...the need for extensive oversight or micromanagement. The... ...seven or more years of management experience, including several years serving in a senior...Suggested
$100k - $130k
...Description Job Description The Senior Claims Adjuster, TPA Oversight will provide technical expertise and handle a wide variety of severity/complex claims as well as coverage... ...Work in partnership with the TPA Claims Manager to ensure that claims are proactively managed...ClaimsTemporary work- ...professional service billing operations, including insurance claims, patient billing, and payments. You will follow up on unpaid claims, manage accounts receivable, and ensure accurate documentation in a fast-paced healthcare environment. The ideal candidate has 2-4 years of...Claims
- ...serve as a one-stop-shop business partner for healthcare organizations to support their... ...for billing, collections, and revenue cycle management functions. ESSENTIAL FUNCTIONS: Prepares and submits insurance claims to appropriate payers Ensures claims are received...Claims
- ...Risk Manager OrthoMed Anesthesia is seeking a dedicated Risk Manager to join our anesthesia... ...expertise in malpractice insurance for healthcare clinicians, with a focus on anesthesia-... ...risk transfer strategies, claims oversight, and compliance with contractual and regulatory...Claims
- ...will help prepare and review insurance claims, assist with basic billing and coding tasks... ...document processing, scanning, and file management Support billing, reimbursement, coding,... ...options Long-term career path in healthcare administration Ideal Candidate The ideal...ClaimsWork at office
- ...communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well.Our Core Values... ...procedures and documentation.Knowledge of medical insurance claims procedures and documentation. Needs to have thorough knowledge...ClaimsDaily paidWork at officeImmediate start
- ...Operations provides strategic leadership for MB... ...receivable management, payer outcomes,... ...Provide executive oversight of the complete revenue... ...that improve claim acceptance rates,... ...Ability to manage several sectors of the Revenue... ...Administration, Healthcare Administration,...ClaimsContract workHome office
- ...career takes on new meaning. In our dynamic healthcare environment, experience the warmth of a welcoming... ...operations, budget development, analysis and oversight, marketing for volume growth and program development, FTE management, expense control, policy and procedure...Full timePart timeWork experience placementFlexible hoursNight shiftWeekend workDay shiftAfternoon shiftWeekday work
$83.3k - $137.4k
...detect and deter fraudulent claims. Leveraging advanced technology... ...to resolution with minimum oversight. Applies the techniques of... ...business and potentially across several states. Provides... ...process. Influence and conflict management skills to deal with crisis situations...ClaimsWork at officeLocal area- ...communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core... ...procedures and documentation. Knowledge of medical insurance claims procedures and documentation. Needs to have thorough knowledge...ClaimsDaily paidWork at office
- Medical City Healthcare, partnered with CryptoAnalyzer, seeks a Respiratory Therapist CRTT to support data‑driven respiratory care solutions... ...datasets, assisting with modeling risk for respiratory-related claims, developing dashboards and reports, and translating findings...Claims
- ...Hemophilia Account Executive- Paragon Healthcare - Texas Sales Territory: Texas Ideal... ..., including those submitted to hiring managers, are deemed to be the property of Elevance... ...at least once per week, and potentially several times per week. Specific requirements...Full timeTemporary workWork at officeLocal area1 day per week
- ...inefficient Pharmacy Benefit Management (PBM) sector by... ...believe that the U.S healthcare system is in need of transformation... ...items related to claims, eligibility, and... ...to effectively manage several tasks and competing... ...working directly with Director to C suite level executives...ClaimsTemporary workWork at officeFlexible hours
- ...become a nationwide leader in compassionate, quality healthcare focused on the patient and available to everyone.”... ..., quality care. About the Role The Senior Director of Strategic Sourcing & Contract Management is responsible for managing contracting, pricing, vendor...Contract workWork at office
$72.8k - $130k
...130,000/yearJob Area: Healthcare EconomicsCompany: UnitedHealth... ...contracting and trend management activities through... ...findings and strategic recommendations to leadership... ...with healthcare claims and reimbursement methodologies... ....Pay is based on several factors including but...ClaimsMinimum wageFull timeContract workWork experience placementWork at officeLocal areaRemote work- ...NTT DATA is seeking a Remote Claims Processing Associate to join the Plano, Texas team. In this role you will handle professional claims... ...of payable amounts. Candidates should have 3 years of healthcare claims processing experience and strong MS Office skills. #J-18...ClaimsRemote work
- DescriptionClinical Excellence Program Director Bring your passion to Texas... ...practice across the healthcare system Collaborative environmentQualificationsHere... ...This position oversees the strategic design and implementation of... ...programs as well as several other benefits.• Delivery of...Monday to Friday
$72k - $141k
...market leader in insuring healthcare providers and... ...customers. Our Healthcare Claims team is seeking... ...overall investigation, management and resolution of claims... ...claims to include on oversight/watch lists, and preparing... ...Typically Director or above Skills...ClaimsFull timeWork experience placementWork at officeLocal areaFlexible hoursShift work- ...to the community, delivering exceptional healthcare with a personal touch. Our culture is... ...About the Role The Referral Coordinator manages all aspects of the referral program in... ...to help prevent delays in care and avoid claim denials related to missing, expired, or...ClaimsWork at office
$17 per hour
...lifestyle isn’t always easy. That's where Kelly Professional & Industrial comes in. We're seeking Claims Specialist to work in a temporary to hire opportunity with a Top Healthcare Client in Richardson, TX. We're here to help you find something great that works for you-so...ClaimsTemporary workWork at officeLocal areaRemote workWork from homeMonday to FridayFlexible hoursShift work$122.1k - $153.3k
Commercial Executive Communications Manager Capital One is seeking a highly strategic communications professional to... ...expertise across industries such as Healthcare, Commercial Real Estate, and Food... ...One Financial is made up of several different entities. Please note that...Full timePart timeLocal area- ...leader in compassionate, quality healthcare focused on the patient and... ...of Real Estate is a strategic executive leader responsible... ...the Facilities and Project Management teams, ensuring that all properties... ...strategic leadership and oversight to the Facilities team responsible...For contractorsWork at officeLocal area
- ...with NTT DATA’s Sales organization and strategic alliances to drive expansion, solution adoption... ..., delivery standards, and performance management.Industry & Client LeadershipProvide deep... ...chain including policy administration, claims modernization, and underwriting...ClaimsWork at officeRemote workFlexible hours
- At Oceans Healthcare, we are passionate about helping adults and seniors attain... ...changes related to medication management or substance abuse and other... ...senior nursing executive, providing strategic leadership and enterprise-wide oversight of nursing operations, workforce...
- ...Hospitality LLC is seeking a Vice President of Claims to lead the Workers’ Compensation and... ...have 8-10 years of experience in risk management or claims leadership, strong legal... ..., and proven abilities in managing high-severity claims. #J-18808-Ljbffr Aimbridge HospitalityClaims
- ...compassionate, quality healthcare focused on the... ...responsible for the strategic direction, operational... ...cybersecurity, systems management, data platform, enterprise... ...Provide executive oversight of the IT Security function... ...reports at the director or vice president level...
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