AXIS is seeking a Head of Quality Assurance & Compliance, Claims Shared Services to join our Shared Services Claims team. As a direct report to the Head of Shared Services, the successful candidate should possess the ability to implement, develop and lead a successful Claims Quality Assurance and Compliance program for Axis Claims. The successful candidate will promote a continuous improvement culture, enhance the quality claims handling, define the framework, benchmarks and identify areas for improvement across the entire portfolio of Axis Claims with an immediate focus on North America Claims. The successful candidate is a results-driven team player with a can-do mindset focused on continuous improvement and will support claims quality assurance and compliance objectives and strategies in partnership with Axis Claims Leadership and related internal stakeholders.

• Developing and executing the vision of the Axis Claims Quality Assurance & Compliance function within Axis Claims with an immediate focus on North America claims, continuously improving, and enhancing this function in accordance with claims best practices and regulatory requirements
• Collaborating with claims leaders to develop and implement policies, standards, processes, controls, and related documentation of best practices, guidelines, and workflows to ensure a center of excellence within Claim Quality Assurance and Compliance
• Developing and implementing claims technical claims handling quality file review and audit processes for direct handled and oversight claims handling of Program and delegated/TPA claims as well as Manager Quality File Reviews conducted by the claims managers to drive best in class claims handling
• Developing and implementing appropriate quality and compliance reviews of delegated/TPA claims service providers and Vendors to ensure quality and appropriate claims service results and compliance with TPA reportable criteria and service level and/or master services requirements, to drive best in class claims handling
• Developing meaningful, updated audits/questionnaires calibrated to claims best practices and current regulatory requirements, analyzing audit results, reporting on the results, and developing post-audit management action plans (MAP) to drive continuous improvement and best in class claims handling
• Monitoring, coordinating, tracking, measuring, and reporting to internal stakeholders in regard to claim adjuster licensing requirements with an immediate focus on North America claims in partnership with a third-party vendor assisting in the management of adjuster licenses
• Monitoring, coordinating, tracking, measuring and reporting to internal audit and other internal stakeholders to ensure claims has the necessary controls to assist, prioritize, manage and mitigate risk.
• Developing and providing monthly, quarterly and annual dashboard reporting for Quality Assurance and Compliance metrics to drive continuous improvement, in collaboration with key Axis stakeholders
• Assisting with maintenance of Medicare policies and procedures, monitoring, summarizing, tracking compliance objectives and timelines in partnership with a third-party vendor, reporting to internal stakeholders
• Assisting with maintenance of SIU, Fraud reporting and other Compliance reporting and procedures as these may be required, monitoring, summarizing, tracking compliance objectives and timelines in partnership with a third-party vendor, reporting to internal stakeholders
• Collaborating with Axis Claims Leadership and related internal stakeholders on training initiatives, job aids, guidelines to continuously improve claims handling quality and execution in support of team and individual professional growth and development
• Building and maintaining key relationships with internal stakeholders (e.g., Peers, Underwriting, Actuarial, various executive management leaders) and external stakeholders (e.g., auditors, reinsurers, and vendors)

• 7-10 years of experience with Quality Assurance and Compliance in P&C commercial claims or reinsurance organizations with a complex operating environment including both domestic and international operations. Multinational claim handling and compliance experience is an asset.
• Ability to accomplish tasks in a dynamic environment with an aptitude for analyzing data and making practical and forward-looking decisions to drive success
• Excellent communication skills and demonstrated ability and experience supporting strategic initiatives impacting key stakeholders and reporting to senior management
• Experience working on cross functional teams, collaborating, actively participating, and delivering solutions
• Strong organizational, critical thinking, problem solving, analytical, and quantitative skills including the ability to analyze and interpret financial and claims data
• Experience supporting the management of claims and implementation of cost containment strategies related to TPAs, and other vendors for P&C insurers
• Experience preparing business cases and doing cost benefit analyses supporting strategic initiatives impacting key stakeholders
• Proven prioritization skills with the ability to balance both the immediate needs with broader organizational strategies
• The ability to issue spot and escalate issues that could present challenges to a project or the organization.
• Strong conflict resolution skills to effectively deal with people with differing expectations and viewpoints
• Strong knowledge of skills in use of various software and insurance platforms and systems, i.e. claims auditing platforms and claims systems as well as Word Excel, and Powerpoint.
• JD a plus, College and advanced degree
• Travel (domestic and international) is associated with this role