Cost Containment Lead

Primary Details Time Type: Full time Worker Type: Employee Position: Cost Containment Lead Location: USA – Marblehead, MA (Hybrid if within 50 miles from office) Salary Range: $47,000 – $220,000 Opportunity Manage a portfolio of complex claims by conducting loss investigations, evaluations, and settlements on moderate to high level claims for the Accident and Health business unit.Assure timely and accurate reserves.Communicate and collaborate effectively with Underwriting, Actuary, Legal, and Risk.Work within specific limits and authority, conduct and coordinate loss investigations on technically complex claims to provide accurate facts for disposition. Responsibilities Implement the administration of insurance coverage to complex claims by conducting loss investigations, analyzing factual information, interpreting insurance policies and applying legal and technical knowledge to independently resolve claims files in a timely manner. Negotiate claims settlements by collaborating with subject matter experts and involved parties, recommending appropriate reserve modifications for assigned claims, and communicating solutions to mitigate risks and coverage conflicts to achieve cost‑effective outcomes. Inform internal and external stakeholders on claims‑resolution processes by summarizing factual information, reporting out‑of‑scope specialized exposures, and accurately managing documentation of assigned claims to ensure effective communication of current claims status. Facilitate strong working relationships by communicating across the organization and reporting on approved, cost‑effective claims strategies to promote understanding of claims operations and encourage a collaborative approach to business enhancement. Participate in claims specialist onboarding by sharing technical knowledge, recommending solutions to complex escalated issues, training on department processes and procedures, and demonstrating application of best practices to develop new team members. Support workflow efficiency by accurately documenting portfolio progress, referring high‑risk exposures beyond authority levels, and seeking opportunities that enhance operational knowledge to achieve individual and department objectives. Ensure correct, cohesive and efficient customer solutions by collaborating and supporting team decision‑making to foster a partnered approach to claims undertakings. Establish a personal, empathetic connection with customers by providing comprehensive communication to ensure thorough understanding of available claims deliverables. Contribute to a positive work environment by demonstrating cultural expectations and influencing others to reward performance and value “can do” people, accountability, diversity and inclusion, flexibility, continuous improvement, collaboration, creativity and fun. Required Education Bachelor's Degree or equivalent combination of education and work experience. Required Experience 5 years relevant experience. Preferred Competencies & Skills Utilize effective communication to effectively influence and persuade decision makers; understand customer needs and goals, actively seeking ways to meet them. Mediate and resolve conflict using a logical approach. Identify relevant information and understand its impact. Maintain the integrity of the claims portfolio and evidence. Use multiple resources to gather and analyze significant data. Leverage technical knowledge to make cost‑effective decisions. Encourage open communication, cooperation and knowledge sharing. High attention to detail. Implement planning to organize, prioritize and measure individual work. Preferred Experience Experience in a claims department or the insurance industry. Experience handling workers' compensation claims. Preferred Licenses & Certifications Registered Nurse (RN) Preferred Knowledge Working knowledge of claims administration best practices and procedures. Working knowledge of insurance products and services. Broad understanding of relevant laws and regulations across multiple jurisdictions. Basic understanding of market trends and organizational strategies. Working knowledge of Microsoft Office Suite, general computer software and database systems. Compensation & Benefits The salary range for this role is $47,000 – $220,000. The base salary will be determined based on role complexity, location, and the candidate’s professional background, including education and experience. Eligible employees will participate in QBE’s annual discretionary bonus plan based on business and individual performance. Benefits include hybrid working, 22 weeks of paid leave for family growth (12 weeks available to all parents), a competitive 401(k) program with company match up to 8%, a well‑being program with holistic wellness coaching, gym membership, confidential counseling, financial and legal advice, tuition reimbursement for professional certifications, and participation in employee networks and community giving. Equal Employment Opportunity QBE is committed to providing equal employment opportunities to applicants and employees without regard to race, color, gender, gender identity, sexual orientation, religious practices and observances, national origin, pregnancy, childbirth or related medical conditions, protected veteran status, disability or any other legally protected status. We operate internationally and comply with equal employment opportunity legislation in each jurisdiction we serve. Accommodation Statement QBE provides reasonable accommodation for individuals with disabilities and disabled veterans. If you need accommodation because of a disability, please inform our Talent Acquisition team of your request and contact details. #J-18808-Ljbffr QBE Insurance Group