The Opportunity
We are looking for an experienced claims leader to lead the strategy, governance, and performance of our third-party administrator (TPA) claim programs across multiple products, business segments, and jurisdictions.
This is a highly visible leadership role with responsibility for ensuring our TPA partners deliver fair, timely, accurate, and compliant claim outcomes while meeting our expectations for customer experience, financial performance, and operational quality.
You will serve as the senior business owner for key TPA relationships, lead a team of claims and vendor oversight professionals, partner closely with senior leaders across the organization, and influence how we manage outsourced claims operations at an enterprise level.
This role is ideal for a strategic P&C claims leader who knows how to balance technical claims expertise, vendor accountability, financial discipline, and strong relationships to drive results.
What You'll Do
Lead TPA strategy and governance
Set the strategy, operating model, and governance framework for TPA claim programs across products, programs, jurisdictions, and business segments.
Establish and continuously improve service-level agreements, performance scorecards, claim-handling guidelines, authority levels, escalation protocols, and reporting standards.
Lead TPA selection, onboarding, implementation, renewal, transition, and termination activities while protecting claim continuity and customer service.
Own TPA performance and relationships
Serve as the senior relationship owner with TPA leadership, leading business reviews, performance discussions, escalations, and negotiations.
Hold partners accountable for claim inventories, cycle time, customer experience, claim quality, reserve adequacy, settlement accuracy, leakage, litigation activity, regulatory compliance, and contractual commitments.
Assess TPA capacity, staffing, training, licensing, business continuity, data security, and catastrophe readiness, and drive action plans when risks emerge.
Provide senior claims leadership
Provide strategic direction on complex, high-exposure, litigated, escalated, or disputed claims, including coverage, reserves, litigation strategy, and settlement approach within delegated authority.
Lead the audit, calibration, and quality assurance framework for TPA claim handling.
Identify performance trends and root causes and ensure corrective actions deliver sustainable improvement.
Lead and develop a high-performing team
Lead, coach, and develop managers, claim consultants, relationship managers, and vendor oversight professionals.
Build leadership capability and bench strength while creating a culture of accountability, sound judgment, collaboration, and continuous improvement.
Set clear goals and expectations and ensure the team has the tools, resources, and direction needed to deliver results.
Drive enterprise partnership and improvement
Partner with Legal, Compliance, Finance, Actuarial, Underwriting, Procurement, Operations, Technology, and business leaders on contracts, controls, data, reporting, systems, and service delivery.
Develop and present performance dashboards, trend analysis, risk assessments, and strategic recommendations to senior and executive leadership.
Lead continuous improvement initiatives across TPA processes, controls, technology, training, and operating models.
Manage financial performance
Oversee department expenses as well as TPA fees, loss adjustment expenses, claim payments, reserves, vendor charges, and audit-related costs within delegated authority.
Identify leakage and adverse financial trends, validate contractual billing and service outcomes, and drive corrective action.
Establish financial performance targets and communicate results, trends, and risks to senior leadership.
What You'll Bring
Required Qualifications
High school diploma or equivalent.
10+ years of claims or related P&C insurance experience, including experience with TPA, vendor, program, or…