Technical Director, Claims - Workers Compensation

Nationwide Insurance; United States; Remote; USD 100,000 - 130,000; Full time

Job summary

A leading insurance company is seeking a Technical Director for their Workers Compensation team. The role involves ensuring compliance, driving technical excellence in claims handling, and managing associates. Ideal candidates will have extensive experience in claims operations and a strong customer focus.

Benefits

Medical/Dental/Vision

Life Insurance

Short and Long Term Disability Coverage

Paid Time Off

401(k) with Company Match

Company-Paid Pension Plan

Qualifications

• Minimum of ten years of experience in a claims operation role.
• At least two years in claims management.

Responsibilities

• Drive workers’ compensation claims technical excellence across geographies.
• Analyze claims zone results and make recommendations for improvements.
• Manage associates, including performance management and training.

Skills

Attention to Detail

Communication

Organization

Education

Undergraduate degree

Tools

Microsoft Suite

Job description

If you’re passionate about helping people protect what matters most to them, as well as innovating and simplifying processes and operations to provide the best customer value, then Nationwide’s Property and Casualty team could be the place for you! At Nationwide, “on your side” goes beyond just words. Our customers are at the center of everything we do and we’re looking for associates who are passionate about delivering extraordinary care.

Territory:

The location of this position is flexible and open to virtual and/or remote based applicants.

What you can Expect:

This opportunity is within the Workers Compensation team and will be responsible for facilitating compliance performance for the operation. Key responsibilities include ensuring adherence to regulatory requirements, managing and responding to state audits and exams, coordinating remediation plan activities, collaborating closely with the Regulatory Operations team, and acting as a liaison between state compliance authorities and the department. Additionally, the role involves utilizing internal and external reports and information to analyze performance and develop recommendations for improvement. Based on current team needs, this opportunity is an individual contributor role.

The ideal candidate will have:

• Strong understanding of Workers Compensation claims handling is highly preferred
• Compliance background preferred
• Great attention to detail, written/verbal communication, and organization skills

Job Description Summary

Do you have a strong desire to provide prompt, courteous, and fair service to customers? Are you a skilled investigator, negotiator, and communicator? If you thrive in an environment where you can problem-solve workers’ compensation claims resolution, while following processes that provide fair resolution, customer satisfaction, and cost management, then we want to hear from you!

As a Technical Director, you’ll drive workers’ compensation claims technical activities and excellence. We’ll count on you to develop, implement, and distribute best practices for a specialty line(s) of business. In addition, you’ll compile and communicate trend information to field personnel and provide technical expertise on related specialty in complex coverage and service issues.

Job Description

Key Responsibilities:

• Drives workers’ compensation claims technical excellence across geographies and is a technical resource to the field.
• Partners with Claims Directors on developing implementation plans for corporate, organizational and regional plans and helps develop long range, measurable goals and objectives.
• Communicates and assists with implementation of claims technical initiatives to the claim’s zones.
• Partners with industry leaders to help promote industry and legislative changes that benefit stakeholders.
• Analyzes claims zone results and makes recommendations to Claims Directors on process improvements, workflow improvements or other initiatives to drive results.
• Delivers a positive customer service experience to internal, external, current and prospective Nationwide customers.
• Resolves customer complaints according to best practices. Monitors customer satisfaction to drive action plans for improvement.
• Identifies, develops and retains high potential/high performing associates who have the potential for or are ready to fill critical roles in the organization.
• Manages associates, including performance management, salary planning and administration, training and development, workflow and organization planning, day-to-day management, hiring and placement, and disciplinary actions for direct and possibly indirect reports.

May perform other responsibilities as assigned.

Reporting Relationships

Reports to Technical Claims AVP or Claims Director. May be responsible for field-based claims specialty personnel such as Quality Audit, Medicare Compliance and Reporting, Bureau of Rehabilitation and Reemployment Services, etc.

Typical Skills and Experiences:

Education: Undergraduate degree or post-graduate studies preferred.

License/Certification/Designation: State licensing where required. Successful completion of required/applicable claims certification training/classes.

Experience: Minimum of ten years of experience in a claims operation role, including at least two years in claims management.

Knowledge, Abilities and Skills: Requires advanced knowledge of claims best practices, technical claims operations, procedures and claims performance strategies, day-to-day claims operations, as well as claims best practices. Extensive, discipline specific, knowledge desired. Excellent customer focus to proactively identify and understand customer needs. Ability to effectively communicate interpersonally with individuals and groups and manage an internal staff. Demonstrated decision-making skills, including the ability to recognize, analyze and improve claims performance situations such as loss control, loss adjustment expense, customer satisfaction, employee development and engagement. Effective listening, verbal and written communication skills necessary for customer contact, negotiation, presentations, project management, and personnel management. Ability to make decisions, establish priorities, and set strategic directions. Ability to organize and deal with a variety of situations, discern problems, and recommend/implement resolutions. Ability to use personal computer and applicable software, including Microsoft Suite, preferred. Ability to analyze data.

Other criteria, including leadership skills, competencies and experiences may take precedence.

Job Conditions:

Overtime Eligibility: Exempt (Not Eligible)

Working Conditions: Normal office environment. May require ability to sit and use telephone and personal computer for extended periods. Must be willing to work extended hours and travel with possible overnight requirements. Must be available to work catastrophes (CAT) which may include working extended periods including holidays and weekends.

ADA: The above statements cover what are generally believed to be principal and essential functions of this job. Specific circumstances may allow or require some people assigned to the job to perform a somewhat different combination of duties.

Credit/Background Check: Due to the fiduciary accountabilities within this job, a valid credit check and/or background check will be required as part of the selection process.

Benefits

We have an array of benefits to fit your needs, including: medical/dental/vision, life insurance, short and long term disability coverage, paid time off with newly hired associates receiving a minimum of 18 days paid time off each full calendar year pro-rated quarterly based on hire date, nine paid holidays, 8 hours of Lifetime paid time off, 8 hours of Unity Day paid time off, 401(k) with company match, company-paid pension plan, business casual attire, and more. To learn more about the benefits we offer, click here.

Nationwide is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive culture where everyone feels challenged, appreciated, respected and engaged. Nationwide prohibits discrimination and harassment and affords equal employment opportunities to employees and applicants without regard to any characteristic (or classification) protected by applicable law.