Vice President A & H Claims Services

Vice President A & H Claims Services

Oak Brook, IL

Position Overview:

This unique insurance Company is expanding the leadership team and is looking for a strong leader to provide strategy and high-level expertise.

You will provide operational and strategic direction to the Stop Loss, XOL and Provider Excess Claims department.

This role will be a key leader in the organization and will be a key contact by other departments in working through escalation of items.

Additionally, you will provide critical insights and direction on the High-Cost Claimant solution, creating a roadmap of future capabilities and competitive advantage insights.

This position will report to the VP of Service and Operations. 

Essential Elements 
  

You will provide strategic direction to the claims department, using management by performance metrics.  
 

You will lead by example in their process improvement and continuous learning direction.

You will work directly with Partner Organizations, TPAs, High-Cost Claimants (HCC) Specialty Vendors and Client clinical resources in the application of cost savings initiatives.   

Drive the expansion of relationships within the Partner Plan structure in Claims, Medical Management, and Provider Contracting.

Requirements

Education and Certifications 
  

Bachelor's Degree required 

Master's Degree preferred 

Six Sigma Certification preferred 

Experience  
  

Minimum of 12 years claims experience with at least 5 years in Stop Loss or Large Claims area required 

Stop Loss/Excess of Loss experience required 
  

15- 20% Travel Required