Manager, Carrier Operations Quality Management

jobgether; New York (NY); A distancia; USD 120.000 - 170.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Remote work

Travel up to 8 trips/year

Healthcare coverage

Life insurance

Disability coverage

Parental leave

HSA/FSA

Retirement plan

Paid time off

Volunteer time off

Pet insurance

Commuter benefits

Professional development

Employee Assistance Program

Inclusive workplace

Descripción de la vacante

jobgether is seeking a senior Quality Management leader to drive QA, audits, and regulatory oversight across delegated insurance operations in the United States. You will develop a risk-based quality framework, lead cross-functional audits, monitor performance, and present findings to senior leadership to drive remediation.

The role requires 7+ years in insurance operations with proven team leadership, and a track record of implementing corrective actions, improving processes, and ensuring

Formación

• 7+ years of professional experience in insurance operations, quality assurance, auditing, compliance, or a related field.
• Demonstrated experience leading, managing, and developing teams, including setting priorities and monitoring performance.
• Proven experience managing quality assurance programs, operational audits, or compliance monitoring.
• Strong understanding of insurance operations, delegated authority, carrier oversight, and regulatory requirements.
• Experience evaluating operational controls, identifying risks, and implementing corrective actions.

Responsabilidades

• Lead quality management, auditing, testing, and oversight programs across delegated insurance operations.
• Develop and maintain a risk-based quality assurance framework for compliance and operational effectiveness.
• Oversee audits and reviews across claims, policy administration, licensing, appeals, customer service, and fulfillment.
• Prepare reports on audit outcomes, risks, and remediation progress; support regulatory reviews and market conduct exams.
• Partner with business leaders to ensure adherence to regulatory requirements and carrier standards; act as escalation point for risk issues.
• Oversee corrective action plans and continuous improvement, evaluating processes and controls for opportunities.

Conocimientos

Leadership

Auditing

Quality assurance

Regulatory compliance

Data analysis

Communication

Project management

Detail oriented

Risk management

Educación

Bachelor's degree

Descripción del empleo

Accountabilities

Quality assurance and audit leadership

Lead quality management, auditing, testing, and oversight programs across delegated insurance operations. Develop and maintain a risk-based quality assurance framework that supports compliance, consistency, and operational effectiveness.

Operational audits and performance monitoring

Oversee audits and reviews covering claims, policy administration, licensing, appeals, customer service, fulfillment, and related activities. Monitor quality metrics, identify trends, assess operational risks, and recommend improvements based on audit findings.

Reporting and regulatory oversight

Prepare and present clear reports on audit outcomes, emerging risks, performance trends, and remediation progress. Support regulatory reviews, market conduct examinations, compliance assessments, and other carrier oversight initiatives.

Compliance and risk management

Partner with business leaders and delegated administrators to ensure adherence to regulatory requirements, contractual commitments, carrier standards, and internal policies. Act as an escalation point for significant quality, compliance, and operational risk issues.

Corrective actions and continuous improvement

Oversee the development, implementation, and validation of corrective action plans. Evaluate processes, workflows, internal controls, and system enhancements to identify improvement opportunities and strengthen operational effectiveness.

Policy and process development

Maintain quality management policies, procedures, audit standards, and training materials. Support the testing and validation of new processes, technologies, and regulatory changes to ensure continued compliance.

Team leadership and development

Lead, coach, and develop a high-performing Quality Management team. Manage priorities, workloads, and performance to ensure timely completion of audits and reviews while supporting recruitment, onboarding, professional development, and succession planning.

Cross-functional collaboration

Build strong relationships with internal stakeholders, third-party administrators, vendors, and external business partners to promote accountability, resolve issues, and embed a culture of continuous improvement.

Requirements

• At least 7 years of professional experience in insurance operations, quality assurance, auditing, compliance, claims, policy administration, or a related field.
• Demonstrated experience leading, managing, and developing teams, including setting priorities, monitoring performance, and supporting employee growth.
• Proven experience managing quality assurance programs, operational audits, compliance monitoring, or operational testing initiatives.
• Strong understanding of insurance operations, delegated authority arrangements, carrier oversight, and applicable regulatory requirements.
• Experience evaluating operational controls, identifying risks, developing corrective actions, and implementing sustainable process improvements.
• Strong analytical and problem‑solving skills, with the ability to interpret operational data, identify trends, assess complex issues, and provide actionable recommendations to senior leadership.
• Excellent written, verbal, and interpersonal communication skills, including the ability to present audit findings clearly and influence stakeholders to implement corrective actions.
• Strong organizational and project management capabilities, with the ability to manage multiple priorities, coordinate audits, and meet deadlines in a fast‑paced environment.
• High attention to detail, sound judgment, and a commitment to compliance, accountability, and operational excellence.
• A bachelor's degree in Business, Insurance, Risk Management, Compliance, Finance, or a related discipline is preferred. Equivalent combinations of education and relevant professional experience will also be considered.

Preferred qualifications

• Experience supporting insurance carrier operations and delegated authority programs.
• Familiarity with third-party administrators, vendors, and external business partners in regulated insurance environments.
• Experience managing remediation initiatives, corrective action plans, and operational risk improvement programs.
• Previous involvement in regulatory examinations, external audits, market conduct reviews, or compliance assessments.
• Professional certifications in auditing, compliance, quality management, insurance, or a related discipline.

Benefits

• Remote work: Fully remote position with travel requirements of up to eight trips per year to office locations across the United States and Canada.
• Comprehensive healthcare: Medical, dental, and vision insurance coverage.
• Life insurance: Basic life insurance provided at no cost to employees.
• Disability coverage: Company-paid short-term and long-term disability benefits.
• Paid parental leave: 12 weeks of parental leave at 100% pay.
• Health and spending accounts: Access to Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA).
• Retirement savings: Access to a retirement savings plan.
• Paid time off: Personal paid time off, paid holidays, and a company-wide Wellness Day.
• Volunteer opportunities: Paid time off to volunteer with nonprofit organizations.
• Pet-related benefits: Group pet insurance and access to a pet-friendly office environment.
• Commuter benefits: Available where applicable based on work location.
• Professional development: On-the-job training, skills development, and opportunities for career advancement.
• Employee well-being: Access to an Employee Assistance Program (EAP).
• Inclusive workplace: A commitment to accessibility, equal opportunity, and reasonable accommodations throughout the recruitment and employment process.

We appreciate your interest and wish you the best!