Asia Claims Performance & Governance Director is responsible for driving operational excellence, performance analytics & management, governance, and reporting across Asia Claims operations. The role partners closely with market Claims teams, Regional Operations Performance, Risk & Governance, and Health leadership to establish performance standards, deliver actionable insights, strengthen governance frameworks, and support strategic claims initiatives.
The incumbent will act as a key regional coordinator for claims performance reporting, dashboard oversight, operational analytics, governance forums, and fraud, waste and abuse (FWA) reporting while providing adjudication support and continuous improvements in claims automation and straight-through processing (STP) capabilities.
Position Responsibilities
Claims Performance Management & Analytics
Establish, maintain, and continuously refine regional Claims KPIs while ensuring alignment with market-specific requirements.
Partner with Regional Operations Performance teams to align KPI definitions, measurement standards, data quality requirements, and corrective actions.
Conduct performance analytics using historical and current operational data to identify trends, gaps, risks, and opportunities for improvement.
Develop insights and recommendations to improve operational effectiveness, customer outcomes, and claims efficiency.
Support monitoring and reporting of claims performance indicators across Asia markets.
Claims Automation & STP Optimization
Analyze claims data, referral trends, and rule performance to identify opportunities for automation improvements.
Recommend enhancements to Automated Adjudication (AA) and Straight-Through Processing (STP) capabilities based on operational data and risk considerations.
Collaborate with Claims, Underwriting, and Risk stakeholders to support governance and implementation of optimization initiatives.
Dashboard Management & Business Insights
Serve as the Regional Claims Subject Matter Expert supporting claims dashboards and reporting initiatives.
Respond to dashboard-related inquiries from market stakeholders and provide guidance on data interpretation.
Review dashboard enhancements and User Acceptance Testing (UAT) outcomes to improve visibility of claims performance, trends, and operational insights.
Ensure claims reporting solutions provide meaningful and actionable business intelligence to stakeholders.
Governance & Regional Coordination
Coordinate regional governance activities, including scheduling meetings, tracking submissions, managing stakeholder communications, and following up on required actions.
Support targeted market audits and reviews, where required, in accordance with the Asia Claims Adjudication Audit Program (ACAAP).
Support preparation of meeting materials, document key decisions and outcomes, and monitor completion of agreed action items.
Support ongoing maintenance of regional governance processes and controls.
Reporting & Executive Communications
Partner with the broader regional and market Claims team members to consolidate and prepare reports and presentation materials for regional and global stakeholders.
Produce management reporting packs, analysis, and executive presentations that communicate claims performance, key risks, improvement initiatives, and business outcomes.
Support preparation of committee and leadership reporting materials.
SharePoint & Knowledge Management
Act as Records Coordinator for the Regional Claims SharePoint site.
Maintain governance, accessibility, and organization of claims-related documentation and collaboration resources.
Support knowledge sharing and information management across regional and market teams.
Support and Backup
Provide support, backup, and represent regional Claims team as needed and delegated.
Required Qualifications
Proven experience in insurance claims operations, operational performance management, governance, or business analytics.
Strong analytical skills with the…