Description

JOB DESCRIPTION

The Head of Coverage and Complex Claims will lead all Complex Claims operations, providing strategic oversight and executive leadership across all complex and long-term exposure claims. This position reports to the Head of North America Claims and is responsible for directing high-stakes litigation strategies, ensuring effective claims resolution, managing long-tail exposure claims, and advising on legal and coverage-related and regulatory risks.

The successful candidate will possess extensive experience and technical expertise in complex and coverage litigation, with a proven record of developing and managing highly engaged, high-performance teams. This person will be a change agent with exceptional leadership skills, capable of driving efficiencies as a result of a deep understanding of complex claims environments. This role requires a strong executive presence, exceptional leadership skills, and the ability to foster collaborative relationships within the organization. A law degree is required to navigate the intricate legal and regulatory landscape of complex claims.

Key Responsibilities

Strategic Leadership:

• Exhibit a strong executive presence and communicate effectively with senior leadership on significant complex claims, issues and trends. Effectively present difficult claim matters at a high level to a senior audience.
• Identify and elevate potential issues before they arise, and take proactive steps to develop strategic solutions. Drive successful outcomes, and mentor, train and develop the claims teams to adopt the same mindset and priorities.
• Lead, mentor, and inspire a high-performing team of claims professionals, fostering a collaborative environment and supporting continuous professional development.

Operational Excellence:

• Oversee and manage complex claims operations, ensuring efficient and effective resolution strategies and compliance with company standards.
• Innovate service improvements that balance efficiency/productivity, defense and indemnity management, customer service and quality assurance controls.
• Develop and deliver an effective operating model, focusing on key strategic priorities and performance improvement initiatives. Leverage claim and data systems (in partnership with Finance, Actuary, Data Analytics) to improve claim processes, drive operational efficiencies and produce results. Use data-driven insights to improve claims processes and present regular performance and risk analysis reports to senior audience.
• Manage audit process that integrates meaningful quality standards, validates appropriate controls and provides value to leadership team.
• Litigation Strategy: Develop and lead litigation strategies for high-exposure claims, minimizing financial risk and defending company interests in collaboration with internal and external legal teams.
• Long-Term Exposure and Mass Tort Claims: Provide executive oversight of long-tail exposure and mass tort claims ensuring comprehensive analysis and risk assessment.
• Policy and Compliance: Ensure all operations are in full compliance with legal, regulatory, and corporate policies, while proactively addressing emerging risks.
• Stakeholder Collaboration: Collaborate with other departments, including legal, underwriting, actuarial, and compliance, to manage claims and align strategies with broader company goals.
• Risk Management: Identify, assess, and mitigate legal and financial risks associated with complex claims, developing proactive strategies for risk reduction.
• Data Analysis and Reporting: Leverage data-driven insights to improve claims processes, monitor performance, and present regular performance and risk analysis reports to senior leadership.
• Innovation and Process Improvement: Drive innovation in claims handling processes, leveraging technology and best practices to enhance efficiency, customer experience, and outcomes.

Requisition #: 25485

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