Claims Director-TPA OversightThe Jonus Group • Chicago, IL, United States

Claims Director-TPA Oversight

The Jonus Group • Chicago, IL, United States

9 hours ago

Job type

Full-time

Job description

Claims Director – TPA Oversight

A leading Property & Casualty insurance carrier is seeking an experienced Claims Director to oversee Third-Party Administrator (TPA) relationships. This role is responsible for ensuring operational excellence, regulatory compliance, and strategic alignment with organizational claims objectives.

Compensation Package

$120,000 to $150,000+ / year total compensation (based on experience)
Annual bonus potential
Comprehensive benefits package (health, dental, vision, 401k, etc.)
Opportunities for professional development and advancement

Job Description

Oversee relationships with assigned TPAs, ensuring compliance with company guidelines, service level agreements, and regulatory requirements.

Monitor and evaluate TPA performance metrics, including claims quality, timeliness, and expense management.

Collaborate with TPAs to implement process improvements, claim strategies, and operational initiatives.

Provide leadership, guidance, and escalation support for complex claims issues.

Partner with internal claims leadership, underwriting, and actuarial teams to ensure alignment on business objectives and portfolio performance.

Conduct regular audits and reviews to ensure claims practices comply with company standards and applicable regulations.

Develop and deliver performance reports, trend analysis, and recommendations to senior leadership.

Participate in strategic planning and assist in TPA selection, contract negotiation, and renewals.

Requirements

Bachelor’s degree in Insurance, Risk Management, Business, or related field; advanced degree preferred.

Minimum 10 years of claims experience within the insurance industry, including significant experience managing TPAs.

Strong knowledge of P&C insurance claims operations, including liability, property, workers’ compensation, and commercial lines.

Proven leadership and team management experience.

Excellent analytical, negotiation, and communication skills.

Experience with claims technology systems and reporting tools.

Ability to influence and collaborate with internal and external stakeholders.

Disclaimer : Please note that this job description may not cover all duties, responsibilities, or aspects of the role, and it is subject to modification at the employer's discretion.

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