Claims Lead Performance Analyst

Gore Mutual Insurance; Toronto; Hybrid; CAD 80,000 - 100,000; Full time

Job summary

Gore Mutual Insurance is seeking a Lead Performance Analyst to enhance claims processing through audits, performance metrics, and coaching. This hybrid role requires strong analytical skills and leadership experience to drive continuous improvement in claims handling processes. Join a forward-thinking company committed to innovation and excellence in the insurance industry.

Qualifications

• 5+ years of claims handling experience.
• 2+ years in a leadership position.
• Experience with insurance audit and claims processes.

Responsibilities

• Conduct audits of claims processes for accuracy and compliance.
• Evaluate performance metrics and report to Claims Performance Manager.
• Provide coaching and develop training programs for claims adjusters.

Skills

Data analytics

Performance metrics

Claims handling

Leadership

Regulatory compliance

Education

College or University diploma

CIP, FCIP, or CRM

Job description

Next Horizon is here. Fueled by investments in talent and technology, our bold strategy to transform is nearly complete.

At Gore Mutual, we’ve always set ourselves apart as a modern mutual that does good. Now, we’re proudly building on that legacy to transform our company—and our industry—for the better.

Our path forward sharpens our focus on business performance, driven by leading technology, innovation and an agile, high-performing culture. With Gore Mutual and Beneva announcing their intent to merge in 2026, we’ll be uniting two well-established, financially strong, and trusted brands to become the strongest mutual insurer in Canada, ensuring Canadians have purpose-driven insurance options for generations to come. Come join us.

The role of the Lead Performance Analyst is to lead the creation, implementation and execution of our claims file review program, including designing tools, program implementation, reporting and continuous improvement. This position is accountable for supporting the delivery of a best in class claims handling processes. This role will obtain both qualitative and quantitative metrics that can be provided to the Claims Performance Manager in order to identify areas of improvement, innovation and to improve processes. This position will also contribute to the learning and development program in Claims by providing insights and supporting training programs based on feedback from key stakeholders. This position will also manage vendor quality assurance on behalf of the Claims function.

Responsibilities:

Leading Claims Audit and Analysis

• Conduct thorough audits of claims processes, ensuring accuracy and compliance.
• Analyze audit outcomes to identify improvement areas and potential risks.
• Collaborate with the Claims Performance Manager to implement audit recommendations and refine processes.

Monitoring Unit Claims Performance

• Evaluate performance metrics of different claims units, identifying trends and discrepancies.
• Work with unit managers to develop and implement performance improvement strategies.
• Regularly report to the Claims Performance Manager on unit performance, highlighting key achievements and areas for improvement.

Providing Inputs on Claims Processing and Procedures

• Analyze current claims processes, suggesting improvements based on data-driven insights.
• Participate in the updating and enhancement of claims handling procedures.
• Liaise with IT and Data Departments to improve process efficiency through technological advancements.

Development and Management of Claims Metrics

• Develop and oversee a suite of performance metrics for claims operations.
• Continuously report on these metrics, offering insights and analysis to the Claims Performance Manager.
• Use these metrics for forecasting trends and guiding strategic decisions.

Performance Coaching for Claims Adjusters

• Offer data-driven performance coaching to claims adjusters.
• Collaborate with various supervisors to tailor coaching to individual adjuster needs.
• Create and implement training programs to improve adjusters' skills and knowledge in claims handling.

Influencing Supervisors to Adopt Modern Ways of Working

• Actively influence and persuade supervisors to embrace new, modern work methodologies.
• Showcase the benefits of new tools and processes through data and case studies.
• Facilitate workshops and training sessions for supervisors, emphasizing the importance of innovation and efficiency in claims processing.

Stakeholder Communication and Project Support

• Effectively communicate analytical findings and recommendations to a diverse range of stakeholders.
• Provide analytical support for projects led by the Claims Performance Manager, including planning and execution.
• Engage in ongoing professional development to remain abreast of industry trends and advancements in data analysis and claims management.

What you need to Succeed:

• College or University diploma.
• CIP, FCIP, or CRM is preferred.
• 5+ years of claims handling experience.
• 2+ years in a leadership position (supervisor and above)
• Experience with insurance audit, regulatory compliance, and claims processes & controls.
• Experience with data analytics, performance metrics (KPI's), data visualization and analysis.

Hybrid: We are a hybrid company and you will be required to be in office 2 days per week in either our Cambridge or Toronto office.

#LI-HYB & #INDHP

Gore Mutual Insurance is committed to providing accommodations for people with disabilities during all phases of the recruiting process, including the application process. If you require accommodation because of a disability, we will work with you to meet your needs. If you are selected for an interview and require accommodation, please advise the HR representative who will consult with you to determine an appropriate accommodation.

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