Senior Manager, TPA Claims Strategy – Governance

Assurant

. Set the strategy, operating model, and governance framework for TPA claim programs across products, programs, jurisdictions, and business segments .

Posted 11/10/2026full-timeRemote • United StatesSenior💰 $103,800 - $173,300 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates extensive experience in managing TPA claim programs, including governance frameworks, performance standards, and vendor relationships. Proven ability to lead teams, drive accountability, and implement continuous improvement initiatives in claims operations.

Highest-signal resume keywords

TPA Claims OversightClaims Financial ControlsGovernance ModelsExecutive CommunicationContract Negotiation

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims InvestigationPolicy InterpretationCoverage AnalysisLitigation ManagementSettlement PracticesFraud IndicatorsClaims AnalyticsBudget ManagementPerformance ScorecardsQuality Assurance Programs

Soft Skills

Relationship ManagementChange LeadershipNegotiation SkillsInfluencing StakeholdersCoaching and Development

Tools & Technologies

Performance DashboardsData Security SystemsOperational Data AnalysisReporting SystemsClaims Management Software

Certifications & Qualifications

Adjuster LicensesAICCPCUSCLA

Industry Keywords

P&C InsuranceVendor Risk ManagementClaims Audit ProgramsService-Level AgreementsContinuous Improvement

About the role

Key responsibilities & impact

Set the strategy, operating model, and governance framework for TPA claim programs across products, programs, jurisdictions, and business segments
Establish and improve service-level agreements, performance scorecards, claim-handling guidelines, authority levels, escalation protocols, and reporting standards
Lead TPA selection, onboarding, implementation, renewal, transition, and termination activities
Serve as senior relationship owner with TPA leadership and lead business reviews, performance discussions, escalations, and negotiations
Hold TPA partners accountable for claim inventories, cycle time, customer experience, claim quality, reserve adequacy, settlement accuracy, leakage, litigation activity, regulatory compliance, and contractual commitments
Assess TPA capacity, staffing, training, licensing, business continuity, data security, and catastrophe readiness, and drive action plans when risks emerge
Provide strategic direction on complex, high-exposure, litigated, escalated, or disputed claims
Lead the audit, calibration, and quality assurance framework for TPA claim handling
Identify performance trends and root causes and ensure corrective actions deliver sustainable improvement
Lead, coach, and develop managers, claim consultants, relationship managers, and vendor oversight professionals
Build leadership capability and bench strength and create a culture of accountability, sound judgment, collaboration, and continuous improvement
Partner with Legal, Compliance, Finance, Actuarial, Underwriting, Procurement, Operations, Technology, and business leaders on contracts, controls, data, reporting, systems, and service delivery
Develop and present performance dashboards, trend analysis, risk assessments, and strategic recommendations to senior and executive leadership
Lead continuous improvement initiatives across TPA processes, controls, technology, training, and operating models
Oversee department expenses, TPA fees, loss adjustment expenses, claim payments, reserves, vendor charges, and audit-related costs within delegated authority
Identify leakage and adverse financial trends, validate contractual billing and service outcomes, and drive corrective action
Establish financial performance targets and communicate results, trends, and risks to senior leadership
Travel for TPA site visits, business reviews, audits, implementation meetings, and leadership sessions as required

Requirements

What you’ll need

High school diploma or equivalent
10+ years of claims or related P&C insurance experience, including experience with TPA, vendor, program, or outsourced claims oversight
5+ years of progressive leadership experience, including leading managers or multiple teams
Adjuster licenses for applicable states, with the ability to obtain and maintain additional licenses as needed
Deep knowledge of claim investigation, policy interpretation, coverage analysis, reserving, litigation management, settlement practices, fraud indicators, regulatory requirements, and claims financial controls
Demonstrated experience establishing governance models, service levels, vendor performance standards, claims audit programs, and corrective action plans
Experience interpreting and negotiating contracts, statements of work, authority levels, fee structures, reporting obligations, and governance requirements
Demonstrated ability to influence senior internal stakeholders and external business partners and drive accountability without direct authority
Experience managing budgets and using operational and financial data to identify trends, determine root causes, and drive measurable action plans
Strong executive communication, presentation, negotiation, relationship management, and change leadership skills
Bachelor's degree in business, insurance, risk management, finance, or a related field (especially desired)
Experience leading multiple TPAs, outsourced claim programs, complex vendor relationships, or multi-state claims operations
Experience with procurement, contract negotiation, vendor risk management, implementations, conversions, or TPA transitions
Professional insurance designation such as AIC, CPCU, or SCLA
Experience with claims analytics, dashboards, quality assurance programs, process improvement, or enterprise change initiatives
Experience presenting to senior and executive leadership and contributing to broader claims strategy

Benefits

Comp & perks

Salary growth within the position
U.S. benefit information available
Occasional schedule flexibility to support urgent claims issues, catastrophe events, regulatory deadlines, or other critical operational needs