Senior Claims QA Manager – Hybrid Governance Leader

HINCX Hiscox Inc.; Chicago (IL); Hybride; USD 100 000 - 130 000; Plein temps

Avantages offerts par ce poste

Competitive salary and bonus

401(k) with company matching

Health insurance, vision and dental

Group term life and disability

Parental leave

Sabbatical after 5 years

Adoption assistance

Well-being programs

Modern open offices

Résumé du poste

Hiscox USA is seeking a seasoned Quality Assurance Manager to lead the claims QA program across internal and third-party operations. You will own the QA framework, drive risk-based reviews, and report findings to senior leadership.

Collaborate with Claims Leadership, Compliance, Legal and Operations to ensure regulatory requirements and Hiscox Best Practices are applied, deliver sustainable improvements, and develop a high-performing QA team in a hybrid Chicago/Atlanta setting.

Qualifications

• 10+ years of progressive multi-line claims experience with QA, auditing, compliance, or risk responsibilities.
• Experience leading and developing a team within a quality assurance program.
• Deep knowledge of claims handling, regulatory expectations, state DOI standards, compliance, and risk.
• Ability to collaborate across internal and external teams, including third-party administrators.
• Proven ability to influence stakeholders and communicate clearly at all levels.
• Ability to translate complex findings into executive insights, risk assessments and actionable recommendations.
• Strong organizational skills and change leadership with a commercial, customer-focused approach.
• Track record of driving corrective action and reducing repeat quality deficiencies.

Responsabilités

• Set annual claims quality assurance strategy, plan, methodology, and risk-based priorities across internal and TPA claims operations.
• Lead, coach, and develop the Claims Quality Assurance team; set objectives and calibrate assessments.
• Own the quality assurance framework and governance standards in line with best practices and regulatory obligations.
• Oversee monthly and thematic claim reviews with coverage and evidence.
• Deliver concise management information and executive reporting on trends and risks.
• Present findings and recommendations to Claims Leadership and stakeholders with clear risk communication.
• Partner with leaders to implement corrective action plans and monitor delivery for sustainable improvement.
• Drive calibration, training, and continuous improvement based on reviews and regulatory developments.
• Maintain governance, documentation, issue escalation, and quality controls across the end-to-end review process.
• Serve as senior contact for claims QA matters and provide practical, commercially balanced advice.
• Monitor program effectiveness and adjust priorities, resources, and coverage as needed.

Connaissances

Quality assurance

Team leadership

Claims handling

Regulatory compliance

Stakeholder management

Data analysis

Description du poste

Hiscox USA is seeking a seasoned Quality Assurance Manager to lead the claims QA program across internal and third-party operations. You will own the QA framework, drive risk-based reviews, and report findings to senior leadership.

Collaborate with Claims Leadership, Compliance, Legal and Operations to ensure regulatory requirements and Hiscox Best Practices are applied, deliver sustainable improvements, and develop a high-performing QA team in a hybrid Chicago/Atlanta setting.