Manager, Operational Excellence, Claims

Gore Mutual Insurance; Cambridge; Hybrid; GBP 60,000 - 80,000; Full time

Job summary

A leading insurance company is seeking a Manager of Operational Excellence in Claims to enhance service delivery and customer satisfaction. This hybrid role involves overseeing quality assurance, driving improvements, and leading a high-performing team. Ideal candidates will have strong leadership and analytical skills, with a background in the insurance industry.

Qualifications

• 5-7 years of experience in the insurance industry, focusing on claims quality assurance.
• Proven experience in leading and managing teams.

Responsibilities

• Oversee Quality Assurance Programs and ensure compliance.
• Drive continuous improvement and monitor performance metrics.
• Support the Chief Claims Officer with business updates.

Skills

Leadership

Analytical Skills

Communication Skills

Problem-Solving Skills

Customer Focus

Education

Bachelor's degree

CIP designation

Tools

claims management software

data analytics tools

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 Manager, Operational E xcellence, Claims plays a key role in the performance of the Claims Department at Gore Mutual. This role exists to lead and oversee Quality Assurance Programs, Workforce Management , Business /Performance Update s , and Data Analysis . The objectives are to drive continuous improvement, ensure high-quality service delivery, and enhance customer satisfaction. The expected end results include a highly productive and efficient claims team, improved claims processes, reduction in leakage , and improved customer experience, all contributing to the company's overall success.

What will you do?

Overseeing Quality Assurance Programs

• Directing the team in developing and maintaining quality assurance standards.
• Ensuring adherence to regulations, privacy, and compliance standards.
• Supervising regular audits and reviews of claims processes.
• Leading the identification of areas for improvement and implementation of corrective actions.
• Leading and providing direction on creating and optimizing the workforce management strategy for the claims department.
• Analysing volumes, trends, forecasting and determining optimal headcount requirements for the claims department in all functions and roles.
• Oversee compliance with scheduling, phone SLAs and vacation and time off practices.
• Optimize the use of resources including flexibility of resources based on seasonality, hiring plan, need for coverage focusing on productivity and customer service excellence.
• Partner and collaborate with Operations WFM resources on enterprise-wide strategy and approach.

Driving Continuous Improvement

• Leading the team in identifying opportunities for process improvements
• Monitoring performance metrics and adjusting strategies as needed
• Leveraging data to identify areas of opportunity to improve customer experience

Business/Performance Updates and Data Analysis

• Supporting the Chief Claims Officer with monthly and quarterly business updates
• Providing monthly performance update on overall Claims performance including trending and areas of opportunity
• Collaborating closely with Data Analytics to prioritize areas of focus
• Developing a strategy and plan for an adjuster scorecard

What will you need to succeed in this role?

• Bachelor's degree in relevant field and CIP designation are desirable.
• 5-7 years of experience in the insurance industry, with a focus on claims quality assurance.
• Leadership Experience: Proven experience in leading and managing teams.
• Project Management: Experience in managing cross-functional projects and initiatives.
• Analytical Skills: Strong ability to analyze data and metrics to drive performance improvements.
• Communication Skills: Excellent verbal and written communication skills for effective interaction with internal and external stakeholders.
• Problem-Solving Skills: Ability to identify issues and implement effective solutions.
• Technical Skills: Proficiency in using claims management software and data analytics tools.
• Customer Focus: Strong commitment to enhancing customer experience and satisfaction.
• Regulatory Knowledge: Understanding of industry regulations, privacy, and compliance standards.

Hybrid: This is a hybrid role with 2 In-office workdays per week at either our Cambridge or Toronto offices.

#LI-HYB & #INDHP

#IND-HP

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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