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
...the work activities and has full management responsibility for the performance of the Severity Team. Exercises full management... ...most complex investigations of claims, liability and damages and... ...objectives in order to achieve strategic business results. Knowledge of...ClaimsWork experience placementWork at office- CNA Insurance is seeking a senior claims and litigation leader in Plano, TX. The role oversees the Severity Team, directing investigations and claim strategy, while fostering strong partnerships with Operations, Underwriting, Actuary, and Risk Control to share insights...Claims
$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...ClaimsWork experience placementShift work$150k - $350k
...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 Overview NTT DATA is a $3...SuggestedTemporary 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
- CNA Insurance in Plano, TX seeks a seasoned Healthcare Claims Severity & Excess strategist to lead handling of the most complex Allied Healthcare... ...with Underwriting and other units on trends and portfolio management across high-exposure cases. The ideal candidate holds a JD...Claims
$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- ...Insurance Coordinator. This full-time position involves managing the insurance claims process, interacting with insurance companies to resolve... ...skills, and a minimum of two years of relevant experience in healthcare. The role supports a collaborative environment with...ClaimsFull time
- Salience Health is seeking a Billing Specialist Agent to manage the financial aspects of patient care, including insurance claims, patient billing, and payment processing. The Billing Specialist Agent will ensure accurate and timely billing, follow up on unpaid claims...Claims
- ...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
- Lockton is seeking a Clinical Claims Specialist in Plano, TX, within our Specialty... ...Practice unit. The role focuses on reducing severity of complex claims and lowering costs... ...hold RN licensure or a Bachelor's in Healthcare Management with 5+ years of clinical/risk...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
$97k - $189k
...potential. The Large Loss Director is a technical... ...contributor responsible for the oversight, consultation, and... ...workers' compensation claims. This individual... ...coverages, litigation management, reserving, claim resolution... .... Identify emerging severity exposures and...ClaimsWork experience placementWork at office- ...OverviewFunctional Area: Supply Chain Management (SCM)Career Stream: Market... ...Manager 2Job Title: Manager, Strategic Supply Chain 2Job Code: MG2-... ...leadership oversight for all SCM related matters for... ...the team to ensure contractual claims for SCM related costs are recovered...ClaimsContract workWork at officeLocal areaRemote work
- The Vice President of Claims leads Aimbridge’s Workers’ Compensation... ...10 years of progressive risk management or claims leadership... ..., and manage complex or high‑severity claims. Strong legal, regulatory... ...accommodation matters. LIABILITY CLAIMS OVERSIGHT Oversee liability claims...ClaimsDaily paidFull timeTemporary work
$228.3k - $241k
...Executive/Senior Level Managers Employee Type FT... ...of the Credit Union’s strategic goals and objectives.... ...and management of fraud claims generated from in-person... ...procedures. 3. Assumes oversight responsibility for ensuring... ...Team and Board of Directors with short- and long-term...ClaimsFull timeTemporary workWork experience placementWork at office- Program Manager job at Scalepex. Plano, TX. Why Scalepex? Scalepex is a dynamic services... ...experience in health care data processing (claims and admin) (Required) Strong personality... ...and risks to executive leadership Strategic thinker who has solutioned integration and...ClaimsRemote job
- ...patients, clinics, and the Revenue Cycle Management team to ensure patients receive clear,... ...assigned. The ideal candidate has strong healthcare billing knowledge, excellent customer... ...issues, verify insurance coverage, refile claims when appropriate, and resolve complex patient...ClaimsWork at office
- ...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... ...procedures and documentation. Knowledge of medical insurance claims procedures and documentation. Needs to have thorough knowledge...ClaimsDaily paidWork at office
$52k - $72.8k
...closely with the Operations Manager, Director of Nursing, and Clinical Managers... ...and workers’ compensation claims. Oversee infusion... ...navigation, visit-frequency oversight, and resolution of patient concerns... ...care clinics, and other healthcare providers. Perform other...ClaimsFull timeContract workWork at officeRemote work- ...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 officeImmediate start
- ...5 Top Places to Work in Healthcare, is seeking a dynamic, strategic Senior Vice President (SVP... ...include oversight of hospital operations,... ...to CHC owned, leased and managed hospitals.The SVP is responsible... ...and hospital Boards of Directors.5 years CEO experience required...Full timeWork experience placementWork at officeDay shift
$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... ...Relationship Typically Director or above Skills,... ...strategies and strategic coordination with...ClaimsWork experience placementWork at officeLocal areaShift 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- ...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
$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- ...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
$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- ...quality outcomes, and medical expense management while nurturing critical strategic partnerships. Key... ...based care models Joint Venture Oversight: Serve as the primary operational... ...operational and financial performance in healthcare Analyze and "interrogate the...Contract workFlexible hours
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