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
- ...residential wellness and healthcare infrastructure, we... ...Welltower isseekinga strategic, financially... ...company's enterprise risk management and insurance function... ..., captive insurance, claims oversight, and executive-level... ...professional liability, directors and officers, cyber,...ClaimsNight shift
- ...seeking an accomplished healthcare executive to lead its next... ...opportunity to drive strategic initiatives, strengthen... ...the need for extensive oversight or micromanagement.The exact... ...seven or more years of management experience, including several years serving in a senior...SuggestedLocal area
$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- ...underwriting strategy, portfolio management, underwriting governance, and risk oversight across multiple business units.... ...tolerances. Monitor emerging legal, claims, regulatory, and industry trends... ...and reinsurance brokers to strategically market and place reinsurance...ClaimsRemote work
- ...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...ClaimsLocal area
- ...note: Only applicants with vast knowledge of hospitals claim denials need apply. About Us ERISA Recovery is a... ...appeals process. We’re seeking on-site experienced Healthcare Revenue Cycle Trainer to develop, manage, implement educational material for the growth of current...ClaimsFull time
- ...and White is the largest not-for-profit healthcare system in Texas that empowers you to live... .... Knowledge of medical insurance claims procedures and documentation. Needs to have... ...accurate scheduling and registration. Manage incoming calls and patient inquiries...ClaimsDaily paidWork at office
$68.97k - $113.31k
...term and long-term disability claims. In this role, you will... ...functional capacity, collaborate with healthcare providers, and provide... ...Strong organizational and time-management skills with the ability to prioritize... ...**, who reports to our **Director, Clinical Services**.**...ClaimsFull timeTemporary workH1bWork at officeRemote workFlexible hours- ...Functional Area: Supply Chain Management (SCM) Career Stream: Market... ...Manager 2 Job Title: Manager, Strategic Supply Chain 2 Job Code: MG2... ...Provides 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
$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- ...leadership and operational oversight of nursing, therapy, and ancillary... ...leaders and clinical directors to address operational barriers... ...and designated department managers to address performance deficiencies... ...clinical discipline, healthcare administration, or a closely...Contract workLocal area
$72k - $141k
...market leader in insuring healthcare providers and... ...customers. Our Healthcare Claims team is seeking Complex... ...overall investigation, management and resolution of... ...claims to include on oversight/watch lists, and preparing... ...Relationship Typically Director or above Skills, Knowledge...ClaimsWork experience placementWork at officeLocal areaFlexible hoursShift work- ...G.J. Chavez & Associates, P.C. located in Plano, TX, primarily represents hospitals and healthcare providers in medical claims against insurance companies, ultimately for the benefit of their patients. The firm also specializes in providing tailored legal solutions in...ClaimsBase plus commissionFull timeImmediate start
- Empower is seeking a Revenue Cycle Specialist to manage billing, collections, and revenue cycle functions for healthcare organizations. You will prepare and submit claims, follow up with payers, and generate reports while addressing billing questions and setting repayment...Claims
- ...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
- CNA Insurance is seeking a Complex Claims Consultant to support varying healthcare provider segments in a hybrid role. You will investigate, manage, and resolve complex professional liability claims across multiple states with autonomy and partnership with Underwriting...Claims
- National Partners in Healthcare (NPH) is seeking a Customer Service Representative to promote strong relationships with patients, providers... ...include handling calls, addressing billing and claims questions, and documenting all interactions in the system. The...ClaimsRemote work
- ...TXContract: 12/22/2025 to 03/31/2026RN working in the insurance or managed care industry using medically accepted criteria to validate the... ...for performing accurate and timely medical review of claims suspended for medical necessity, contract interpretation, pricing...ClaimsFull timeContract workRemote work
- A healthcare analytics firm is seeking a Data Analyst II who will develop analytical insights to identify payment anomalies in healthcare claims data. The role requires strong proficiency in SQL, data visualization tools, and at least five years of analytical experience...ClaimsRemote job
- A leading healthcare organization is seeking a full-time remote RN responsible for validating medical necessity in the insurance industry. This role involves performing medical reviews on claims and requires a nursing license, alongside experience in claims processing...ClaimsRemote jobFull time
- Empower is seeking a seasoned Billing Auditor to join our healthcare administration team in Richardson, TX. The role focuses on pre-claim review, auditing medical records, and ensuring accurate billing through QA processes. You will work with Billing and Compliance teams...Claims
$100 per hour
...an impact. Position Overview The Director, Commercial Promotion Strategy &... ...Mobile, Verizon, AT&T). Acting as the strategic Product Manager and commercial authority for promotional... ...layered analysis of historical invoice claims, carrier billings, sell-in/sell-out velocity...ClaimsHourly payFull timeShift work- A healthcare management company in Richardson, Texas, seeks an experienced billing specialist to maintain private insurance accounts and assist the AR team. In this role, you will work on claims and denials, prioritize workloads, and ensure HIPAA compliance. The ideal...Claims
- ...Insurance Other Biz Services Services Banking Risk Management Specialties claims management risk management workers' compensation... ...affinity first and third party fleet programs healthcare risk management retail and consumer care services...Claims
$120k - $150k
...TransEleven Claims Managers is looking for a qualified attorney to join our team in the role of Senior Claims Counsel , handling a... ...for multiple professions such as architects and engineers, healthcare liability (PL/GL) such as long-term care and allied health,...ClaimsFull timeLive inWork at officeRemote workFlexible hours- ...that puts the “care” back in healthcare!At KabaFusion, our patients... ...pharmacies and nursing offices strategically placed to service 40+ states... ...integrity, supports clean claims, and ensures compliance... ...related duties as assigned by manager or designee.Job Requirements...ClaimsTemporary workWork at office
- ...Cycle Analyst to support contract reimbursement for healthcare accounts. The role emphasizes accurate billing,... ...revenue reporting, while collaborating with finance and managed care teams. Prior experience in UB-04 claims is preferred. #J-18808-Ljbffr The Addison GroupClaimsRemote jobContract work
- Overview The Director, Revenue Cycle & Patient Management Applications is responsible for the strategic leadership, implementation... ..., billing and claims operations, reimbursement... ...of the healthcare revenue cycle from... ...resolution. Provide oversight and support for Patient...ClaimsContract workWork at officeFlexible hours
$26 - $30 per hour
...completed work. The role supports Managed Repair Program (MRP), TPA,... ...Administrators, Project Directors, Regional and Office Managers... ...legal entity, and support the claim filings.Perform other related... ...Recovery Specialist provides oversight of revenue recovery and compliance...ClaimsWork at officeRemote work- ...Flexibility: the ability to juggle several projects simultaneously, to... ...part of this dimension. Management skills: ability to achieve... ...offers coming from people claiming to be Tanium employees.... ...amounts between health plans and healthcare providers. The machine-...ClaimsWork experience placementLive inWork at officeImmediate startWorldwideLong distance
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