Director, Claims Program Management, Occupational Risk

This is a fully remote position, open to applicants in New Jersey.

📋 Description

• Develop and implement the strategy for the Occupational Risk claims program, including the operating model, service standards, and annual objectives.

• Create, mentor, and sustain a high-performing team of program managers and specialists.

• Take ownership of financial, operational, customer service, quality, compliance, and talent outcomes for the designated portfolio.

• Establish governance frameworks for Third Party Administrators (TPAs), Managing General Agents (MGAs)/Managing General Underwriters (MGUs), independent adjusters, and other service providers.

• Lead operational evaluations, readiness for implementation, data mapping, staffing validation, control assessments, catastrophe preparedness, and go-live governance.

• Conduct annual or bi-annual audits and provide guidance on complex, high-severity, coverage-sensitive, and litigated claims.

• Collaborate with Legal on counsel guidelines, litigation strategies, legal expenditures, panel performance, alternative dispute resolution, and vendor outcomes.

• Ensure adherence to regulatory, compliance, licensing, privacy, market conduct, record retention, and internal policy standards.

• Maintain a risk-based auditing program that encompasses coverage, investigation, reserving, payments, communications, litigation management, subrogation, salvage, and compliance.

• Create dashboards and portfolio reviews utilizing leading and lagging indicators; report on trends, exposures, root causes, and recommended actions.

• Enhance tracking for fraud referrals, subrogation, salvage, deductibles, and aggregates.

• Foster timely, clear, empathetic, and brand-consistent communication with customers and brokers.

• Collaborate with Underwriting, Actuarial, Legal, Compliance, Finance, Reinsurance, Distribution, and Technology to promote profitable growth.

⛳️ Requirements

• Bachelor’s degree in insurance, risk management, business, finance, law, or a related field.

• Over 10 years of progressively responsible experience in commercial or specialty claims, including significant leadership roles.

• At least 5 years of experience in people leadership, program management, or delegated claims oversight within an insurance carrier, TPA, MGA/MGU, or similar organization.

• Extensive experience in Occupational Accident and Texas Non-Subscriber business; familiarity with Employer’s Liability, General Liability, Auto Liability, Physical Damage, or related occupational risk products is highly preferred.

• Proven track record in managing complex claims, litigation, reserving, audits, regulatory responses, partner remediation, and executive reporting.

• Proficient in utilizing claims platforms, business intelligence tools, and structured performance metrics to drive operational decisions.

• Relevant adjuster licenses, certifications, or continuing education as required by jurisdiction or assignment.

• Willingness to travel for partner due diligence, governance reviews, partner onboarding, business meetings, and employee activities.

• Advanced proficiency in Microsoft Office applications – Outlook, Excel, Word, and PowerPoint.

• Ability to thrive in a fast-paced environment and demonstrate adaptability.

🏝️ Benefits

• Competitive compensation package.

• Generous 401K employer match.

• Employee Stock Purchase plan with employer matching.

• Generous Paid Time Off.

• Health, dental, and vision benefits.

• Programs for physical, mental, and financial wellness.

• Tuition reimbursement.

• Opportunities for industry-related certifications and professional training.

• A dynamic, ambitious, fun, and exciting work environment.

• Matching donation program.

• Volunteer opportunities.

• Employee-driven corporate giving program.