Senior Manager
Insurance

N/A

TPA & Programs Claims Shared Services Lead

AXIS
Alpharetta

2 years ago

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AXIS is seeking a TPA & Programs Claims Shared Services Lead to join our TPA, Litigation and Vendor Management Services North America Claims team.

  • Developing and executing the vision of the Axis Claim TPA & Program function and integration within Axis North America Claims in conjunction with Axis Claims Program business
  • Understanding, reporting, and enhancing due diligence in the management of Axis TPAs through all necessary stages (onboarding, offboarding, loss fund management, run-off, wind down and, oversight, bordereau ingestion etc.), including contract review and negotiation in collaboration with internal and external stakeholders
  • Ensuring superior customer service quality, delivering a holistic and consistent contract management process, and developing productivity management and tracking for TPA claims & Programs business
  • Driving initiatives to improve data acquisition, analytics and reporting metrics related to TPAs in partnership with TPAs and internal stakeholders in the development and execution of enhanced reporting, KPIs and scorecards to assist AXIS in understanding ongoing TPA relationships
  • Managing costs, continuously improve operations, develop and enhancement of the TPA and Programs panels
  • Scheduling and attending stewardship meetings with TPA’s, and required stakeholders, building relationships, creating, and tracking action plans
  • Reviewing, critiquing, measuring and, executing the processes around bordereau ingestion, data extraction and report creation to drive efficiency of TPA data
  • Providing monthly, quarterly, and yearly dashboard reporting on TPA & Program claim metrics, financial impacts, and overall results
  • Establishing policies, standards, processes, controls, and related documentation of best practices, guidelines, and workflows to ensure a center of excellence within TPA & Program claims
  • Collaborating with Claims Quality Assurance and Compliance to implement appropriate quality and compliance reviews of vendor resources and support remediation initiatives with a focus on TPA’s
  • Driving key performance metrics and meet target audit results from all TPAs, in collaboration with key Axis stakeholders
  • Collaborating with NA Claims Head of Claims, and Head of TPA & Program Claims, to support, create and/or deliver training to claim professionals and other stakeholders about TPA & Program handled claims guidelines, workflows, and processes
  • Building and maintaining key relationships with internal stakeholders (e.g., peers, Underwriting, Actuarial, various claim management leaders) and external stakeholders (e.g., TPA’s and Vendor’s)
  • Identifying and mitigating risks, managing, and resolving workflow, operational and any other issues related to the operating environment for Axis TPA & Program Claim management.
  • Collaborating with NA Claims Head of Claims, Head of TPA & Program Claims, Program UWs, claim and underwriting operation and technology functions to identifying effective Change Management actions designed to facilitate organizational understanding, acceptance, and adoption of new process, procedures, and techniques to deliver a best-in-class TPA & Program handled claims over all lines of business in North America
  • 5-10 years of experience with TPA managed claims in P&C commercial claims or reinsurance organizations and proven experience with TPA operations including management, oversight, reporting, and integration
  • 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
  • Broad experience working in a P&C Insurer or reinsurer other financial institution with a complex operating environment including both domestic and international operations
  • 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 and skills in use of various software and insurance platforms and systems including Bill Review systems such as Legal Exchange and claims systems as well as Word and Excel
  • College and advanced degree (JD a plus)
  • Travel is associated with this role
Salary
$
100000
-
$
140000
Responsibility
Scope
-
Workplace
-
Level
N-3
Travel
30%
Date Added
05-30-2024

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