Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

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
Confidential
Vacancy posted 4 days ago
Similar jobs that could be interesting for youBased on the Managing Director, Strategic Claims Oversight, Healthcare Severity in Plano, TX vacancy
  •  ...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... 
    Claims
    Full time
    Local area

    The Travelers Indemnity Company

    Richardson, TX
    17 hours ago
  •  ...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... 
    Claims
    Full time

    Star Dental Partners

    Plano, TX
    7 hours ago
  • Genpact is hiring a Healthcare Insurance Claims Associate / Collector for a remote, full-time role. You will research and review medical claims, collect on outstanding balances, and rebill or update claims to expedite adjudication with payors. The position requires strong... 
    Claims
    Remote job
    Full time

    Genpact

    Plano, TX
    1 day ago
  •  ...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... 
    Claims
    Daily paid
    Work at office
    Immediate start

    Baylor Scott & White Health

    Plano, TX
    1 day ago
  • $96k - $192k

     ...About this role The Global Strategic Accounts – Mission Critical...  ...Executive provides senior executive oversight and leadership for a...  ...high-performing team of project managers and execution staff. Serving...  ...disciplined change management and claims strategy as needed.... 
    Claims
    Contract work
    Temporary work
    Work at office
    Local area

    Carrier World

    Richardson, TX
    a month ago
  • $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... 
    Claims
    Work experience placement
    Work at office

    CNA Insurance

    Plano, TX
    3 days ago
  • 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... 
    Claims
    Daily paid
    Full time
    Temporary work

    Aimbridge Hospitality LLC

    Plano, TX
    7 hours ago
  • $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... 
    Claims
    Full time
    Temporary work
    Work experience placement
    Work at office

    Kids for the Future

    Plano, TX
    2 days ago
  • 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... 
    Claims
    Remote job

    Scalepex

    Plano, TX
    7 hours ago
  •  ...Hospital Collections Analyst to join our healthcare revenue cycle team. This role is ideal...  ...and internal teams. This role focuses on claim follow-up, denial research, and accurate...  ...Experience with working Medicare & Medicaid Managed Care Ability to manage repetitive tasks... 
    Claims
    Full time
    Flexible hours

    ERISA Recovery

    Plano, TX
    1 day ago
  •  ...must be able to effectively manage external managed services partnerships...  ..., and aligned with healthcare regulatory requirements, privacy...  ..., appropriate decisions.Strategic Planning and Organizing: Understands...  ...management, managed services oversight, project delivery, service... 
    Full time
    Contract work
    Flexible hours

    PAM Health

    Plano, TX
    1 day ago
  •  ...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 time
    Work experience placement
    Work at office
    Day shift

    Community Hospital Corporation

    Plano, TX
    1 day ago
  •  ...planning, contracting, vendor management, governance, communications,...  ...with PAM Health’s mission, strategic priorities, regulatory...  ...in Business Administration, Healthcare Administration, Information...  ...leading budget planning, contract oversight, governance processes, executive... 
    Full time
    Contract work
    Local area
    Flexible hours

    PAM Health

    Plano, TX
    4 days ago
  • $240k - $270k

     ...Senior Account Executive - Healthcare Practice Denver/...  ...integrator. For the last several yearswe'vebeen known as...  ...integration), Revenue Cycle Management orchestration (denial management, claim status visibility, AR...  ...-sell with the CEO on strategic accounts where... 
    Claims
    Immediate start
    Remote work
    Flexible hours

    GrabJobs

    Plano, TX
    4 days ago
  •  ...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... 
    Claims
    Daily paid
    Work at office
    Immediate start

    Baylor University Medical Center

    Plano, TX
    2 days ago
  •  ...team providing high-quality care across several modern facilities in the Dallas‑Fort Worth...  ...& Vision Insurance – Access to quality healthcare, including preventive and specialized...  ...Malpractice Coverage – Provides coverage for claims related to professional services... 
    Claims
    Full time
    Part time
    For contractors
    Relief
    Flexible hours
    Shift work

    Jobleads-US

    Murphy, TX
    2 days ago
  •  ...per week in Plano, TX Analyze billing, claims, and payment data to identify trends,...  ...Independently troubleshoot issues with minimal oversight—self-starter mindset required Create...  ..., medical claim workflows, and denial management Quality- and process-focused with... 
    Claims
    Contract work
    3 days per week

    Private Label Staff

    Frisco, TX
    17 hours ago
  •  ...analyze respiratory-related clinical and claims data to inform insurance coverage, risk...  ...engineers to build tools that better price and manage respiratory care benefits. We value...  ...opportunity to shape how respiratory healthcare is financed in an evolving digital market... 
    Claims

    Medical City Healthcare

    Richardson, TX
    4 days ago
  •  ...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... 
    Claims
    Temporary work
    Work at office
    Flexible hours

    SmithRx

    Plano, TX
    4 days ago
  •  ...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 contractors
    Work at office
    Local area

    PSN Services LLC

    Plano, TX
    22 days ago
  •  ...DATAQualification:Graduate (exclusion: BE/BTech/MCA) For Medical Management Bachelor’s degree in Nursing or any health science related...  ...communicate in a manner which is understood by clients / endusers.Claims, RCM and Member Services:• Efficiently Process predefined... 
    Claims
    Full time
    Shift work

    Cognizant

    Plano, TX
    17 hours ago
  • $72k - $141k

     ...authority limits, to manage complex hospitals, allied...  ...and physicians claims with high complexity and...  ...inventory of highly complex healthcare claims, with large...  ...claims to include on oversight/watch lists, and preparing...  ...Typically Director or above Skills, Knowledge... 
    Claims
    Work experience placement
    Work at office
    Local area
    Shift work

    CNA Insurance

    Plano, TX
    1 day ago
  • $194k - $308k

     ...overall leadership and direction for loss cost management, and major case oversight and outcome for the Workers Compensation line of business. Formulates strategic priorities and operational objectives for technical claim management and/or processes for the $1.1B portfolio... 
    Claims
    Temporary work
    Work experience placement
    Work at office

    CNA Insurance

    Plano, TX
    2 days ago
  • $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... 
    Claims
    Temporary work

    LotSolutions, Inc.

    Richardson, TX
    5 days ago
  •  ...compassionate, quality healthcare focused on the...  ...Job Summary: The Director of Revenue Cycle Management is a hands-on operational...  ..., providing direct oversight of coding...  ...operational and 20% strategic, requiring a leader...  ...aged or high-dollar claims. Monitor AR aging... 
    Claims
    Contract work
    Work at office

    PSN Services LLC

    Plano, TX
    22 days ago
  •  ...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... 
    Claims
    Work at office
    Remote work
    Flexible hours

    NTT DATA

    Plano, TX
    2 days ago
  •  ...Associate degree in Accounting, Business, or Healthcare Administration preferred.Minimum 1–2...  ...desirable.Strong knowledge of insurance claims processes, CPT/ICD-10 coding basics, and...  ..., and problem-solving skills.Ability to manage multiple accounts and prioritize tasks... 
    Claims
    Work at office

    Methodist McKinney Hospital

    Mckinney, TX
    2 days ago
  • About the RoleImpact you will make Are you an expert in healthcare insurance reimbursement? Do you thrive on solving complex insurance denials...  ...team using cutting-edge ARO software to streamline medical claims and collections. As a Denials Specialist II, you will also have... 
    Claims

    FinThrive

    Plano, TX
    2 days ago
  •  ...field underwriters and directly with UW managers on all mandatory referral cases and voluntary...  ...and partners (e.g., UW Support, Claims, Actuarial, NA Product Teams). Qualifications...  ...of and experience operating within several different industry segments - experience... 
    Claims
    For contractors
    Local area

    Liberty Mutual

    Plano, TX
    3 days ago
  • $116k - $165k

     ...leader in insuring Allied Healthcare Providers, including...  ...focused Complex Claims Consultant position, you...  ...overall investigation, management and resolution of Allied...  ...claims to include on oversight/watch lists, and preparing...  ...Typically Director or above. Skills, Knowledge... 
    Claims
    Work experience placement
    Work at office
    Local area
    Flexible hours
    Shift work

    CNA Insurance

    Plano, TX
    17 hours ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Managing Director, Strategic Claims Oversight, Healthcare Severity. Be the first to apply!