Responsible for Claims Strategic Operations and Systems Technology, inclusive of the development and oversight of System needs including overall Claims system strategy, defining service standards, developing metrics to support the standards and integration of the claims systems across the claims organization, Vendor Management group, Metrics group, Claims Technology and strategy. Serves as a liaison with numerous business areas within the Company including IT, BSU, Financial Planning, Actuarial, Regional offices, and the SBU's. Establish, implement and monitor effectiveness of claims handling policies, procedures and automation. Ensures all claims systems are up-to-date and operational. Sets the vision and establishes direction for policies and practices ensuring Best of Class Claims technology. Acts as claims liaison with IT, BSU, Financial Planning, Actuarial, Regional offices, SBU's, employees for systems and equipment.
Ensures all systems are up-to-date and operational. Manages personnel equipment for entire claims organization.
Responsible for all claims systems including core claim system maintenance and enhancement.
Manage Vendor Management Group, directing strategy and development for all claims vendors.
Compiles and maintenance of detailed claim metrics that will be used to quantify expected benefits from proposed claim system implementation.
Serves as the Claims System Strategy Lead and sponsor of all claims systems and technology initiatives. Interacts with the EPMO on Claims Specific initiatives.
Develop a strategic planning process that effectively enables the claims organization to achieve short term and long term technology objectives.
Partner with business and functional leaders to identify and communicate key strategies, initiatives, opportunities, metrics and goals that effectively drive and improve claim performance as well as implement initiatives to address any issues.
Identify and monitor key factors that could influence claim performance while evaluating and recommending new influences. Insure that insights from this information are incorporated into strategic and financial plans.
Establish a partnership with functional leaders / Senior Mgmt and develop a clear understanding of needs and issues. Works with them to perform detailed analytical review of claims activity, evaluate and pursue opportunities to control leakage, improve efficiency and reduce costs.
Must have the ability to perform problem definition, scope and design appropriate business solutions.
Demonstrated capability in leading projects and pilots.
Financial and Analytical Acumen.
Technology Expertise - System Design, Strategy, and Implementation (SDLC).
College degree (Master's Preferred) in management, finance, information technology marketing or a related field is preferred.
10 years of claims and management experience.
Must have superior Claims System development experience and maintenance.