Divisional Vice President of Health Claims (Hybrid)

At Globe Life, we are committed to empowering our employees with the support and opportunities they need to succeed at every stage of their career. We take pride in fostering a caring and innovative culture that enables us to collectively grow and overcome challenges in a connected, collaborative, and mutually respectful environment that calls us to help Make Tomorrow Better.Role Overview:Could you be our next Divisional Vice President of Health Claims? Globe Life is looking for a Divisional Vice President of Health Claims to join the team!This role is responsible for leading and overseeing the health claims portfolio for Globe Life's limited benefit health products across all Divisions, including strategic and operational leadership for health claim adjudication. The role oversees the implementation of a transformative new claims adjudication system enterprise-wide and provides Third Party Administrator (TPA) oversight for a designated division, ensuring performance standards, compliance, and service quality are consistently met. This position also cultivates a culture of trust, engagement, and development within a long-tenured team navigating significant organizational change, while partnering cross-functionally to ensure standardized processes, regulatory compliance, and continuous improvement across Globe Life's health insurance lines.This is a hybrid position located in McKinney, Texas (WFH Monday & Friday, In Office Tuesday-Thursday).What You Will Do:Oversee the end-to-end health claims portfolio for limited benefit health products across all Divisions, ensuring operational excellence, regulatory compliance, and adherence to organizational policies.Direct the accurate and timely adjudication of health claims, maintaining quality standards and service level agreements (SLAs) across all teams.Direct and implement forecasting and capacity planning strategies to ensure appropriate staffing levels and workload management.Develop contingency plans to sustain operations during challenging circumstances, including staffing shortages, high claim volumes and system transitions.Establish, monitor, and report on key performance indicators (KPIs) including claims turnaround time, quality scores, SLAs, and customer satisfaction metrics.Lead, mentor, and develop a long-tenured claims team through a period of significant organizational transformation, fostering a culture of trust, accountability, and continuous improvement.Build strong relations with team members at all levels, serving as a visible, accessible, and supportive leader who champions their people while driving necessary change.Set clear performance expectations, create accountability structures, and provide ongoing coaching to elevate individual and team performance.Serve as a role model for professionalism, collaboration, and adaptability across the Claims organization.Advise Senior and Executive leadership on operational performance, trend analysis, best practices, issue resolution, and risk mitigation to support strategic decision-making.Develop and present complex data and operational performance, trend analysis, best practices, issues resolution, and risk mitigation to support strategic decision-making.Develop and present complex data and operational insights to key stakeholders in a clear, compelling manner that influences acceptance of strategic recommendations.Develop and interpret regular and ad hoc reports to identify issues requiring escalation to Senior management.Collaborate cross-functionally to implement claims initiatives that improve departmental and enterprise-wide best practices.Build and maintain relationships with key internal and external stakeholders, including regulatory agencies and business partners, to support compliance and operational alignment.Assist with responding to regulatory inquiries and ensure the organization remains current with regulatory changes and industry trends affecting health claims.What You Can Bring:Bachelor’s degree in business administration, Health Administration, Health Management, Finance or a related field Minimum of 10 years of progressive experience in health claims operations, with at least 5 years in a senior leadership or management role Minimum of 10 years of progressive experience in health claims operations, with demonstrated expertise in limited benefit, supplemental, or similar health insurance products.Minimum of 7-10 years in a people leadership or management role, with direct experience leading managers and multi-layered teams.Demonstrated experience leading teams through organizational change, including system implementations, process redesigns, or cultural transformation.Proven track record of building and sustaining high-performing teams, including performance management, coaching, and development of long-tenured staff.Experience overseeing or collaborating with Third Party Administrators (TPAs), including contract performance monitoring and issue resolution.Experience developing and managing operational metrics, SLAs, and quality standards in a claims environment.Demonstrated ability to present complex operational data and strategic recommendations to Senior and Executive leadership.Experience serving as an operational sponsor or key leader in a claims adjudication system implementation or large-scale technology transformation preferred.Experience operating across multiple business divisions or in a multi-state insurance environment is preferred.Familiarity with regulatory compliance requirements governing health claims at the state and federal level preferred.Formal leadership development training, executive coaching, or participating in a structured leadership program preferred.Deep knowledge of health claims adjudication principles, practices, and compliance requirements for limited benefit health insurance products.Ability to review and resolve complex, high-cost, or escalated claims exceeding individual examiner authority levels, ensuring accuracy and regulatory compliance.Strong understanding of TPA operational models, contract performance standards, and vendor oversight best practices.Familiarity with claims adjudication systems and the ability to lead or actively participate in system implementation and optimization efforts.Demonstrated ability to lead, engage, and develop teams through organizational change, particularly within long-tenured or change-resistant environments.Skilled at identifying training gaps and ensuring team members are equipped with the tools, knowledge, and resources needed to succeed.Ability to collaborate with team leaders and HR Business Partners to develop action plans for underperforming associates in adherence to progressive disciplinary guidelines.Experience writing and delivering value-based performance appraisals and conducting meaningful, constructive performance discussions.Proven ability to positively influence team morale, motivation, and engagement during periods of significant change.Ability to conceptualize and implement innovative operational and technical solutions that drive efficiency, accuracy, and scalability within the claims function.Strong analytical mindset with the ability to translate data into actionable insights and process improvements.Experience leading or supporting enterprise-level system implementations with a focus on change management and team adoption.Exceptional written and verbal communication skills, with the ability to present complex information clearly to diverse audiences including Senior and Executive leadership.Strong interpersonal skills with the ability to build trust, navigate competing priorities, and influence outcomes across all levels of the organization.Ability to balance team needs with the strategic direction of the organization while driving necessary change.Applicable To All Employees of Globe Life Family of Companies:Reliable and predictable attendance of your assigned shift.Ability to work full time and/or part time based on the position specifications.How Globe Life Will Support You:Looking to continue your career in an environment that values your contribution and invests in your growth? We've curated a benefits package that helps to ensure that you don’t just work, but thrive at Globe Life:Competitive compensation designed to reflect your expertise and contribution.Comprehensive health, dental, and vision insurance plans because your well-being is fundamental to your performance.Robust life insurance benefits and retirement plans, including company-matched 401k and pension plan.Paid holidays and time off to support a healthy work-life balance.Parental leave to help our employees welcome their new additions.Subsidized all-in-one subscriptions to support your fitness, mindfulness, nutrition, and sleep goals.Company-paid counseling for assistance with mental health, stress management, and work-life balance.Continued education reimbursement eligibility and company-paid FLMI and ICA courses to grow your career.Discounted Texas Rangers tickets for a proud visit to Globe Life Field.Opportunity awaits! Invest in your professional legacy, realize your path, and see the direct impact you can make in a workplace that celebrates and harnesses your unique talents and perspectives to their fullest potential. At Globe Life, your voice matters.SummaryLocation: McKinney, TXType: Full time