Claims Services Manager

AXA UK; Manchester; On-site; GBP 60,000 - 80,000; Full time

Job summary

A leading insurance provider in Manchester is seeking a role focused on vendor management and claims process oversight. Responsibilities include driving continuous improvement in performance and ensuring compliance with quality metrics. Ideal candidates will have strong analytical skills and a proven track record in claims management. This position emphasizes teamwork and effective communication to enhance business objectives.

Qualifications

• Strong understanding of claims practices and procedures.
• Strong understanding of risk management and governance framework.
• Ability to use appropriate systems to the technical level required.

Responsibilities

• Manage performance and oversight of claims vendors.
• Drive continuous improvement in claims processes.
• Develop quality improvement plans in collaboration with teams.

Skills

Strong understanding of business objectives

Strong analytical and problem solving skills

Strong communication and rapport building skills

Ability to motivate and support a team

Strong mathematical and statistical ability

Intellectual curiosity

Ability to plan and organise own role effectively

Strong influencing skills

Ability to be assertive when appropriate

Strong knowledge of all relevant regulatory and legal requirements

Job description

Overall responsibility for the performance, processes, controls, oversight and reporting for all areas under role remit: vendors, TPA’s/delegated claims, recovery/salvage, audit (peer/internal/external), claims quality and training. Working with two direct reports and in close collaboration with US matrix colleagues to drive continuous improvement to performance and improved financial outcomes in oversight areas.

Key Responsibilities

• Vendor Management:
• Ensuring oversight and performance of claims vendors.
• Working with vendors and internal stakeholders to ensuring all vendor compliance requirements are met.
• Responsibility for ensuring the provision of adequate data and reporting to manage the performance in accordance with SLA’s/KPI’s.
• Oversight of vendor complaints and service performance.
• Utilising and implementing data/reports, tools and technology to analyse ALAE utilisation and implement strategies to improve efficiency and effectiveness of vendor utilisation.
• Manage the panel construction, rate negotiations and SLAs with all vendors. Support the claims dept vendor needs with efficient and effective vendor solutions.
• Work closely with Specialty Director to improve efficiency and reporting for Bill Review process.
• Delegated Claims Management:
• Overall responsibility for establishing infrastructure controls and policies to robustly review, manage and analyse performance of all vendors, this includes TPAs, lawyers and all outsourced arrangements.
• Drive remedial action against any areas of underperformance.
• Continuous improvement of all BDX processes and reporting.
• Leverage group infrastructure and relationships to maximise vendor relationships.
• Work closely with Claims Ops to develop and utilise MI to provide oversight of all vendor spend, usage and effectiveness of panel.
• Quality and Audit (peer/internal/external):
• In collaboration with the lines of business, ensures relevant and accurate quality data, trends and insights are reported to Claim leadership for efficient, effective and engaging use with the goal of improving quality results.
• Develops new approaches to quality metrics, file selections and unique approaches to measure quality within claims files.
• In collaboration with the lines of business and quality review team, reviews Claim Opportunity Review (COR) / Management Claim Opportunity Review (MCOR) reports and other relevant inputs for trending, calibration and organization-wide insights.
• Participates in strategic creating of quality improvement plans and holds teams accountable for necessary improvements.
• Ensures a common approach to quality questionnaires, and best practices / guidelines across the lines of business where there is consistency in practice and desired behaviors.
• Process owner to implement measures to improve calibration between claims and claims quality as well as claims managers and claims handlers.
• Works in collaboration with the lines Oversight of all areas of audit within Claims, including SOX, Internal Audit, External Audit and MCOR.
• Recovery, Salvage and Special Investigations Unit (SIU):
• Responsibility and continuous improvement of Recovery and salvage processes, monthly reporting and escalation.
• Responsibility and continuous improvement of SIU processes, monthly reporting and escalation.
• Learning and Development
• Responsibility for planning, co-ordination and monitoring of training requirements across claims organisation.

Skills, Knowledge & Experience

• Strong understanding of business objectives and the market in which we operate
• Intellectual curiosity
• Ability to plan and organise own role effectively
• Ability to motivate and support a team
• Strong mathematical and statistical ability
• Strong understanding of risk management and governance framework
• Strong understanding of claims practices and procedures
• Ability to promote own profile and CNA Hardy
• Strong analytical and problem solving skills
• Strong communication and rapport building skills
• Strong influencing skills
• Ability to be assertive when appropriate
• Ability to use appropriate systems to the technical level required
• Strong knowledge of all relevant regulatory and legal requirements applicable to the position

The Company

CNA Hardy is a leading specialist commercial insurance provider for clients within the Lloyd’s and company markets. We offer a highly specialised and comprehensive portfolio of innovative and market leading products. Coverage is available to businesses of all sizes for domestic, international and global exposures.