Claims Communication and Process Enablement Lead

Bhhc; San Diego (CA); Hybrid; USD 85,000 - 110,000; Full time

Benefits offered by this job

Hybrid Work Schedule

Paid Time Off

Health Insurance

Tuition Reimbursement Program

Job summary

Bhhc is searching for a Claims Communication and Process Enablement Lead to join its team in San Diego, California. The successful candidate will translate complex Claims strategy and workflows into clear, executable standards across the organization, ensuring clarity and consistency in Claims operations.

A Bachelor's degree and 7+ years of experience in workers compensation claims management are required. This role also offers various benefits including a hybrid work schedule, health insurance, and a retirement savings plan.

Qualifications

• 7+ years of experience in workers compensation claims management.
• Ability to simplify complex processes into actionable guidance.
• Proven influence without direct authority across all organization levels.

Responsibilities

• Owns end-to-end documentation of critical Claims workflows.
• Translates complex workflows into structured process maps.
• Designs and delivers high-quality job aids for real-time decision making.

Skills

Claims management

Process documentation

Change management

Data analysis

Microsoft Office

Communication

Education

Bachelor's degree

Tools

Power BI

Claims Management Systems (CMS)

Job description

Berkshire Hathaway Homestate Companies, Workers Compensation Division, is searching for a Claims Communication and Process Enablement Lead to join its Adjusting Team! This individual is responsible for translating Claims strategy, system changes, and workflow design into clear, consistent, and executable practices across the Claims organization. This individual establishes and maintains disciplined standards for workflow documentation, job‐level execution, and practical job aids, ensuring that leadership intent is understood, adopted, and executed consistently along frontline teams. Partners closely with Claims leadership, Transformation, and Technology to ensure change is implemented with clarity, consistency, and accountability.

ESSENTIAL RESPONSIBILITIES:

• Owns end-to-end documentation of critical Claims workflows across Adjusting, Medical Management, and operational support functions.
• Translates complex workflows into clear, structured process maps and execution standards.
• Establishes and enforces documentation standards to ensure consistency across all Claims functions.
• Ensures the integrity and ongoing accuracy of a centralized repository for Claims workflows, updating documentation as processes evolve.
• Designs and delivers high-quality job aids that support real-time decision making.
• Ensures materials are usable in the flow of work, reducing reliance on tribal knowledge or inconsistent practices.
• Continuously refines tools based on frontline feedback and observed execution gaps.
• Partners with Claims leadership and Transformation team to translate system changes and process updates into clear, actionable communications.
• Ensures a singular, consistent voice across all Claims communication related to workflow and execution changes.
• Establishes a repeatable model for change rollout, including sequencing, reinforcement, and adoption tracking.
• Identifies breakdowns in adoption and drives correction actions.
• Monitors execution consistency across teams and identifies gaps between defined standards and actual practice.
• Utilizes data, audits, and frontline feedback to prioritize improvements.
• Drives continuous refinement of workflows, job aids, and communication practices.

QUALIFICATIONS:

• Bachelor's degree from an accredited four-year college or university.
• Licenses and certifications: One or more preferred:
  • Licensed to adjust workers' compensation claims in one or more jurisdictions.
  • Prosci Change Management Certification or Certified Change Management Professional (CCMP).
  • Project Management Professional (PMP).
• A minimum of seven (7) years of experience in workers compensation claims management, claims operations, or closely related functions.
• Demonstrated experience translating complex processes into clear, structured, and actionable guidance.
• Proven experience with Claims Management Systems (CMS).
• Experience supporting or leading operational change initiatives, including system implementations or workflow designs; experience driving adoption, not just awareness.
• Deep understanding of end-to-end Claims workflows, including Adjusting, Medical Management, and regulatory considerations.
• Strong process orientation with ability to simplify complexity without losing substance.
• Ability to convert strategy and system design into practical execution.
• Strong ability to influence without direct authority across multiple levels of the organization.
• Proven ability to bring structure, discipline, and clarity to ambiguous or evolving environments.
• Demonstrated proficiency in Microsoft Office suite of applications, Power BI, and currently adopted proprietary and vendor software programs.
• Ability to master and become proficient in additional proprietary and vendor software programs.
• Ability to think critically and adapt quickly in a flexible and dynamic environment.
• Proactive and inquisitive approach to work.
• Ability to derive appropriate conclusions from data and various sources and apply effectively.
• Ability to read, analyze, and interpret Claims laws and regulations, medical documentation, general business periodicals, professional journals, technical procedures, and data from various sources.
• Ability to develop clear, actionable workflows/SOPs maintaining strict adherence to regulations, and effectively communicate them to stakeholders/users both in individual conversations and presentations to groups.
• Ability to write effective business correspondence and clear, concise procedures. Makes persuasive arguments.
• Ability to solve practical problems and deal with a variety of variables in situations where only limited standardization exists.
• Ability to interpret instructions furnished in written, oral, diagram, or schedule form. Ability to derive appropriate conclusions and apply on the job.

BENEFITS:

• Hybrid Work Schedule (up to 2 days work from home upon eligibility)
• Paid Time Off
• Paid Holidays
• Immediate Vesting of Retirement Savings + Company Match
• Group Health Insurance (Medical, Dental, and Vision)
• Life and AD&D Insurance
• Long Term Disability Insurance
• Hospital Indemnity Insurance
• Accident and Critical Illness Insurance
• Flexible Savings Accounts
• Paid Community Volunteer Day
• Employee Assistance Program
• Tuition Reimbursement Program
• Employee Referral Program
• Diversity, Equity and Inclusion Program