Director, Claims Management – Excellence

Job not on LinkedIn

🔥 1 minute ago

🏄 California – Remote

🏄 California – Remote

💵 $95k - $130k / year

⏰ Full Time

🔴 Lead

👔 Director

🦅 H1B Visa Sponsor

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Venbrook

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2000

💼 Consulting

📦 Logistics

🛡️ Insurance

Consulting • Logistics • Insurance

Venbrook is a U. S. -based holding company and full-service insurance brokerage that develops and distributes commercial and private insurance solutions, specialty programs, wholesale brokerage offerings, and integrated claims services. The firm partners with carriers and clients to manage risk, design custom coverage (including employee benefits, student and travel insurance, and high-net-worth private client policies), and deliver technology-enabled claims and program management services.

📋 Description

• Set the vision, roadmap, and annual goals for claims optimization • Map and assess claim workflows from first notice of loss through closure • Identify bottlenecks, handoffs, rework, and leakage and measure their effects • Design future-state workflows, standard operating procedures, authority levels, and best practices across lines of business • Lead process improvement projects using Lean, Six Sigma, or similar methods • Lead the claims team and oversee day-to-day claim handling against quality and production standards • Manage inventory, file assignments, caseloads, service standards, escalations, and reassignment of files • Provide technical direction on complex, high-exposure, or litigated claims • Review and approve reserves, payments, and settlements within authority • Present large-loss and roundtable reviews to clients and carriers • Oversee defense counsel, independent adjusters, experts, and other vendors • Ensure claim handling follows client instructions, fair claims practices rules, and applicable state regulations • Pilot new workflows, tools, and quality standards with the claims team • Build and own the claims technology roadmap • Evaluate and roll out claims systems, workflow tools, insurtech partners, AI, document intake automation, robotic process automation, predictive analytics, and client reporting portals • Act as business owner for system changes, including requirements, prioritization, user acceptance testing, and adoption • Partner with data teams on data quality and models for severity, litigation risk, fraud, and recovery opportunities • Ensure tools meet data privacy, security, and AI governance standards • Build and lead the claims quality assurance program • Prepare for client, carrier, and regulatory audits and lead remediation • Monitor compliance with claims practices, service instructions, reserving guidelines, and authority levels • Convert quality findings into training, process fixes, and system controls • Set and track claims performance indicators and lead monthly operating reviews • Build performance reporting and dashboards for leadership, claims managers, and clients • Benchmark performance against industry standards and client service agreements • Use data to support staffing models, capacity planning, and caseload balance • Partner with sales and business development to design new claims products and services • Assess market need, competitor offerings, pricing inputs, and operating requirements and build business cases • Support client proposals, finalist presentations, and client onboarding • Represent Venbrook’s claims capabilities with clients, carriers, brokers, and in industry settings • Lead, mentor, and develop claims professionals, analysts, and quality assurance specialists • Direct cross-functional project teams and manage performance reviews and performance issues • Lead change management through communication, training, and coaching • Create training programs to strengthen technical skills and spread best practices • Manage project timelines, budgets, and vendor relationships • Collaborate with claims, IT, legal, finance, and client-facing teams • Work with finance on process and technology investment costs and returns • Escalate significant matters to the Head of TPA Claims and executive leadership

🎯 Requirements

• Bachelor's degree required • CPCU strongly preferred • MBA or other relevant industry designations, such as AIC, ARM, AIM, AIS, SCLA, or CRM, preferred • 10 or more years of property and casualty claims experience across several lines of business, including hands-on claims handling and claims operations • 5 or more years of progressive leadership experience in claims operations, including managing claims supervisors and examiners • Experience in operational excellence or process improvement, ideally in a TPA, carrier, or self-insured setting • Record of redesigning claims processes or operating models, with measurable gains in quality, cycle time, cost, or client results • Experience leading technology or process modernization, including claims system implementations, analytics, automation, or AI tools • Experience building quality assurance programs and KPI frameworks, and turning data into decisions • Experience designing or launching new products, services, or service models, and supporting business development and client retention • Deep knowledge of claims best practices, reserving, litigation management, fair claims practices rules, and multi-state regulatory requirements • Lean Six Sigma, project management (PMP), or business intelligence tool experience, such as Power BI or Tableau, is a plus • Strong business sense, including experience with budgets, vendor spend, business cases, and financial reporting • Excellent communication, change leadership, and executive presence, with ability to influence clients, partners, and senior leadership

🏖️ Benefits

• Reasonable accommodations for qualified individuals with disabilities during the application process and throughout employment • Equal opportunity employment