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Company

James River Insurance Company · 5 hours ago

VP, Claims - Program Claims

Richmond, VA

Full-time

Remote

Lead/Staff

15+ years exp

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Responsibilities

Continuously exhibit and uphold Core Values of Integrity, Accountability, Communication and Teamwork, Innovation and Customer Service.

Develop and implement long-term strategies to drive continuous improvement, streamline processes, and enhance overall productivity and quality standards throughout the department, while establishing and maintaining Claims Best Practices

Direct the day-to-day operations of the Program Claim Team, including claim intake, investigation, evaluation, and settlement processes

Responsible for the results of TPAs engaged by the company. Communicate the results effectively with internal partners and senior management.

Determine financial authority framework for TPA’s, TPA Oversight Managers and provide financial oversight and authority on claims matters.

Works closely with underwriting team and reinsurance partners in the vetting and onboarding of new Programs, MGA’s and TPA’s.

Advise and assist the SVP, Chief Claims Officer on strategic initiatives and operational priorities

Prepare and maintain operational expense and salary budget for the Program Claim Team

Oversee management of staff to include ensuring correct staffing levels and Claims Best Practices are met, development and communication of department goals, setting of individual performance goals, talent and performance management and training

Evaluate efficiencies of the team and departmental processes to identify gaps, and areas of improvement

Oversight of internal and external portfolios and claim reporting.

Review, edit, and approve coverage declination letters, Reserve Reports and Large Loss Reports

Ensure accurate payment of claims and estimation of claim exposures.

Communicate with and report to Underwriting, Risk Management, Legal, Finance, and the Ceded Re department on claims-related matters

Communicate with the Segment President & CEO and Underwriting leaders on significant claim activities and developments affecting company business

Identify ongoing educational and training needs within the claims department and assist in coordinating relevant training initiatives

Ensure compliance with state regulations, industry standards, and best practices in claims handling, maintaining a high level of professionalism and integrity.

Qualification

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P&C insurance knowledgeClaims management expertiseLitigation managementWorkers' compensation knowledgeAdvanced MS OfficePeople managementChange managementBusiness acumen

Required

Bachelor’s Degree required

Minimum of fifteen years P&C claims handling experience including working with complex coverage issues, workers compensation experience, handling liability and coverage issues, multi-jurisdictional claims, and negotiating settlements with claimants and attorneys required

Minimum of ten years of people management experience (supervision, mentor, lead) required

Expert knowledge of P&C insurance industry, reinsurance, fronting market, MGA’s, regulatory environment, and subject matter expertise in workers’ compensation

Expert knowledge of the theories, principles, practices and procedures of claim and litigation management within an insurance organization

Advanced/Expert knowledge and skills in a variety of claims specialty areas

Expert knowledge in litigation process and management

Demonstrated leadership and team building skills

Advanced proficiency in MS Office (Word, Excel, Outlook)

Demonstrated experience in the ability to attract, lead, motivate, influence, and mentor staff

Excellent written, verbal, and presentation skills

Ability to identify and make process and procedure improvement recommendations, including documentation and communication of changes through appropriate change management processes

Ability to effectively mitigate and drive change

Strong analytical skills

Strong negotiation skills

Ability to build relationships and influence decisions

Active listening skills

Excellent organizational skills

High level of initiative and motivation

Proven ability to provide exceptional customer service

High degree of business acumen

Able to identify, analyze and develop solutions for complex claim issues