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Assistant Vice President - Workers Compensation Claims

PMA Companies Wallingford Full-Time
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Reporting to the Senior Vice President, the Assistant Vice President of Claims will have responsibility for managing the performance and productivity of PMA Management Corp.'s field claims operations in New England, delivering claim results in compliance with contractual and regulatory requirements and ensuring the achievement of corporate objectives for PMA's self-insured and unbundled clients.

 Responsibilities:

  •  Provide leadership and guidance for field claim operations in New England and initiate change when necessary.
  • Execute claims management strategy; analyze claims results and create annual operational goals and objectives for claim handling operation.
  • Plan, organize, and monitor the daily activities of field claim operations.
  • Lead state expansion efforts and ensure implementation requirements are fully vetted and on schedule.
  • Work closely with Managed Care Department on initiatives designed to drive positive results, effectiveness and profitability.
  • Ensure all Managed Care processes and protocols are effective executed.
  • Monitor and analyze significant legal developments and legislative changes in service territories that may affect claim operations. Communicate conclusions and recommendations to staff and other appropriate stakeholders.
  • Employ performance management and performance review processes to maximize performance of employees, correct performance problems, provide development opportunities and promote effective communication with employees.
  • Ensure claim quality in accordance with best practices and company guidelines.
  • Maintain appropriate staffing levels in conjunction with workloads.
  • Select, train and manage staff. Plan staff responsibilities and manage activities, utilizing staff resources effectively.
  • Ensure appropriate execution of quality assurance processes, inclusive of identification of strengths, deficiencies and implementation of action plans focused on improved results.
  • Ensure the delivery of excellent customer service and effective claim's operational services.
  • Lead by example in effectively supervising, coaching, developing, motivating, and evaluating staff.
  • Develop, recommend, and implement policy guidelines based on client needs, market conditions, and company objectives.
  • Analyze and report on field claim activities and initiatives.
  • Ensure regulatory compliance with jurisdictional workers' compensation rules and statutes.
  • Effectively communicate changes, feedback, and results.
  • Promote continuous improvement by monitoring pending, closing ratio, defense counsel guidelines, audit results, settlements and prompt contact.
  • Oversee the analysis of claim trends, training on claim developments and coverage, input on form development, marketing support and support of business initiatives.
  • Develops and manages the operating budget for the field claims operation ensuring that all financial goals are being met.
  • Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.
  • Bachelor's degree or equivalent combination of education and experience
  • 10+ years of multi state workers' compensation claims experience and 5+ years as a regional or corporate claims executive, preferably in a TPA environment.
  • Expert knowledge of Third Party Administration and/or Commercial Property and Casualty insurance, specifically workers' compensation, claim administration, and litigation management.
  • Demonstrable track record in influencing and executing strategy.
  • Excellent verbal, written communication and presentation skills.
  • Proven ability to effectively interact with executives and clients.
  • Ability to maintain confidential information and work independently and in a team.
  • Strong analytical skills.
  • Strong organizational skills.
  • Ability to multi-task.
  • Some travel is required.

Skills required

Business Development
Management
Business Administration
Team Building
Leadership
Relationship Building

Location

Salary Estimator

Based on Job Title, Location and Skills
$190K
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Job ID: 2298

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PMA Companies has nearly a century of successful business experience. Today, PMA Companies is a member of Old Republic Companies. Old Republic is among the nation's 50 largest publicly held insurance organizations, with a substantial interest in major segments of the industry. Old Republic is primarily a commercial lines underwriter, serving many of America's leading industrial and financial services companies as valued customers.

Since 1923, Old Republic has grown as a specialty insurance business, though its oldest subsidiary has insured lives since 1887. Old Republic's record as a long-term growth company is one of the best in the industry. Its performance reflects an entrepreneurial spirit, sound forward planning and a corporate structure that promotes and encourages assumption of prudent business risks.

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