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Assistant Vice President, Claims - Workers Comp

Job Description





Reporting to the Senior Vice President -- Chief Claims Office, the Assistant Vice President of Claims will have responsibility for managing the performance and productivity of PMA's field claims operations in the Midwest delivering claim results and superior customer service in compliance with contractual and regulatory requirements and ensuring the achievement of corporate objectives.



Responsibilities




* Provide strategic leadership and guidance for field claim operations in the Midwest and initiate change when necessary.
* Execute claims management strategy; analyze claims results and create annual operational goals and objectives for claim handling operation.
* Plan, organize, and monitor the daily activities of field claim operations.
* Lead state expansion efforts in the Midwest and ensure implementation requirements are fully vetted and on schedule.
* Work closely with Managed Care Department on initiatives designed to drive positive results, effectiveness and profitability.
* Ensure all Managed Care processes and protocols are effective executed.
* Monitor and analyze significant legal developments and legislative changes in service territories that may affect claim operations. Communicate conclusions and recommendations to staff and other appropriate stakeholders.
* Employ performance management and performance review processes to maximize performance of employees, correct performance problems, provide development opportunities and promote effective communication with employees.
* Ensure claim quality in accordance with best practices and company guidelines.
* Maintain appropriate staffing levels in conjunction with workloads.
* Select, train and manage staff. Plan staff responsibilities and manage activities, utilizing staff resources effectively.
* Ensure appropriate execution of quality assurance processes, inclusive of identification of strengths, deficiencies and implementation of action plans focused on improved results.
* Ensure the delivery of excellent customer service and effective claim's operational services.
* Lead by example in effectively supervising, coaching, developing, motivating, and evaluating staff.
* Develop, recommend, and implement policy guidelines based on client needs, market conditions, and company objectives.
* Analyze and report on field claim activities and initiatives.
* Ensure regulatory compliance with jurisdictional workers' compensation rules and statutes.
* Effectively communicate changes, feedback, and results.
* Promote continuous improvement by monitoring pending, closing ratio, defense counsel guidelines, audit results, settlements and prompt contact.
* Oversee the analysis of claim trends, training on claim developments and coverage, input on form development, marketing support and support of business initiatives.
* Develops and manages the operating budget for the field claims operation ensuring that all financial goals are being met.


* Bachelor's degree or equivalent combination of education and experience typically defined as 10+ years of multi state workers compensation claims experience and 5+ years as a regional or corporate claims executive.
* Expert knowledge of Commercial Property and Casualty insurance, specifically workers' compensation, claim administration, and litigation management.
* Demonstrable track record in influencing and executing strategy.
* Excellent verbal, written communication and presentation skills.
* Proven ability to effectively interact with executives and clients.
* Ability to maintain confidential information and work independently and in a team.
* Strong analytical skills.
* Strong organizational skills.
* Ability to multi-task.
* Some travel is required.

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

Job Requirements

 

Job Snapshot

Location US-IL-Schaumburg
Employment Type Full-Time
Pay Type Year
Pay Rate N/A
Store Type Insurance
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Company Overview

PMA Companies

PMA Companies provides risk management solutions and services, specializing in workers’ compensation and offering property & casualty insurance, in the United States. Headquartered in Blue Bell, PA, PMA Companies is a member of Old Republic Companies. Old Republic International Corporation (NYSE: ORI) is one of the nation’s 50 largest publicly held insurance organizations. Learn More

Contact Information

US-IL-Schaumburg
Snapshot
PMA Companies
Company:
US-IL-Schaumburg
Location:
Full-Time
Employment Type:
Year
Pay Type:
N/A
Pay Rate:
Insurance
Store Type:

Job Description





Reporting to the Senior Vice President -- Chief Claims Office, the Assistant Vice President of Claims will have responsibility for managing the performance and productivity of PMA's field claims operations in the Midwest delivering claim results and superior customer service in compliance with contractual and regulatory requirements and ensuring the achievement of corporate objectives.



Responsibilities




* Provide strategic leadership and guidance for field claim operations in the Midwest and initiate change when necessary.
* Execute claims management strategy; analyze claims results and create annual operational goals and objectives for claim handling operation.
* Plan, organize, and monitor the daily activities of field claim operations.
* Lead state expansion efforts in the Midwest and ensure implementation requirements are fully vetted and on schedule.
* Work closely with Managed Care Department on initiatives designed to drive positive results, effectiveness and profitability.
* Ensure all Managed Care processes and protocols are effective executed.
* Monitor and analyze significant legal developments and legislative changes in service territories that may affect claim operations. Communicate conclusions and recommendations to staff and other appropriate stakeholders.
* Employ performance management and performance review processes to maximize performance of employees, correct performance problems, provide development opportunities and promote effective communication with employees.
* Ensure claim quality in accordance with best practices and company guidelines.
* Maintain appropriate staffing levels in conjunction with workloads.
* Select, train and manage staff. Plan staff responsibilities and manage activities, utilizing staff resources effectively.
* Ensure appropriate execution of quality assurance processes, inclusive of identification of strengths, deficiencies and implementation of action plans focused on improved results.
* Ensure the delivery of excellent customer service and effective claim's operational services.
* Lead by example in effectively supervising, coaching, developing, motivating, and evaluating staff.
* Develop, recommend, and implement policy guidelines based on client needs, market conditions, and company objectives.
* Analyze and report on field claim activities and initiatives.
* Ensure regulatory compliance with jurisdictional workers' compensation rules and statutes.
* Effectively communicate changes, feedback, and results.
* Promote continuous improvement by monitoring pending, closing ratio, defense counsel guidelines, audit results, settlements and prompt contact.
* Oversee the analysis of claim trends, training on claim developments and coverage, input on form development, marketing support and support of business initiatives.
* Develops and manages the operating budget for the field claims operation ensuring that all financial goals are being met.


* Bachelor's degree or equivalent combination of education and experience typically defined as 10+ years of multi state workers compensation claims experience and 5+ years as a regional or corporate claims executive.
* Expert knowledge of Commercial Property and Casualty insurance, specifically workers' compensation, claim administration, and litigation management.
* Demonstrable track record in influencing and executing strategy.
* Excellent verbal, written communication and presentation skills.
* Proven ability to effectively interact with executives and clients.
* Ability to maintain confidential information and work independently and in a team.
* Strong analytical skills.
* Strong organizational skills.
* Ability to multi-task.
* Some travel is required.

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

Job Requirements

 
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