Senior Manager, TPA Claims Strategy – Governance

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🔥 3 minutes ago

🇺🇸 United States – Remote

💵 $103.8k - $173.3k / year

⏰ Full Time

🟠 Senior

🎲 Risk

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Assurant

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1892

💼 Consulting

📦 Logistics

💸 Finance

💰 Post-IPO Debt on 2023-02

Consulting • Logistics • Finance

Assurant is a global company specializing in providing consumer-centric support and protection services. With a presence in over 21 countries across regions like North America, Europe, Latin America, and Asia-Pacific, Assurant helps over 300 million consumers through services like technology protection, claims resolution, and financial services. The company emphasizes innovation, remote work opportunities, and global collaboration, with teams skilled in technology, claims, customer service, and finance. Assurant offers a competitive benefits package and is committed to equal employment opportunities and work-life balance.

📋 Description

• Set the strategy, operating model, and governance framework for TPA claim programs across products, programs, jurisdictions, and business segments • Establish and 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 • Serve as senior relationship owner with TPA leadership and lead business reviews, performance discussions, escalations, and negotiations • Hold TPA 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 strategic direction on complex, high-exposure, litigated, escalated, or disputed claims • 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, coach, and develop managers, claim consultants, relationship managers, and vendor oversight professionals • Build leadership capability and bench strength and create a culture of accountability, sound judgment, collaboration, and continuous 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 • Oversee department expenses, 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 • Travel for TPA site visits, business reviews, audits, implementation meetings, and leadership sessions as required

🎯 Requirements

• High school diploma or equivalent • 10+ years of claims or related P&C insurance experience, including experience with TPA, vendor, program, or outsourced claims oversight • 5+ years of progressive leadership experience, including leading managers or multiple teams • Adjuster licenses for applicable states, with the ability to obtain and maintain additional licenses as needed • Deep knowledge of claim investigation, policy interpretation, coverage analysis, reserving, litigation management, settlement practices, fraud indicators, regulatory requirements, and claims financial controls • Demonstrated experience establishing governance models, service levels, vendor performance standards, claims audit programs, and corrective action plans • Experience interpreting and negotiating contracts, statements of work, authority levels, fee structures, reporting obligations, and governance requirements • Demonstrated ability to influence senior internal stakeholders and external business partners and drive accountability without direct authority • Experience managing budgets and using operational and financial data to identify trends, determine root causes, and drive measurable action plans • Strong executive communication, presentation, negotiation, relationship management, and change leadership skills • Bachelor's degree in business, insurance, risk management, finance, or a related field (especially desired) • Experience leading multiple TPAs, outsourced claim programs, complex vendor relationships, or multi-state claims operations • Experience with procurement, contract negotiation, vendor risk management, implementations, conversions, or TPA transitions • Professional insurance designation such as AIC, CPCU, or SCLA • Experience with claims analytics, dashboards, quality assurance programs, process improvement, or enterprise change initiatives • Experience presenting to senior and executive leadership and contributing to broader claims strategy

🏖️ Benefits

• Salary growth within the position • U.S. benefit information available • Occasional schedule flexibility to support urgent claims issues, catastrophe events, regulatory deadlines, or other critical operational needs

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