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VP, Claims Adjudication
Pie Insurance. Lead and oversee Pie's claims adjudication function across all jurisdictions .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates extensive expertise in workers' compensation claims adjudication, including strategic leadership, team development, and regulatory compliance across multiple jurisdictions. Proven ability to drive operational excellence and continuous improvement in claims outcomes while fostering a diverse and inclusive team culture.
Highest-signal resume keywords
Workers' Compensation Claims ManagementClaims Adjudication LeadershipPeople Management ExperienceAnalytical Skills and Claims MetricsRegulatory Compliance Expertise
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims Adjudication ProceduresClaims Strategy DevelopmentPerformance ManagementCrisis CommunicationRisk Management Protocols
Soft Skills
Oral and Written CommunicationCoaching and MentoringStakeholder Relationship Management
Tools & Technologies
Claims Technology RoadmapAutomation Vision
Industry Keywords
Insurance IndustryClaims OperationsLitigated Claims ManagementDiversity and InclusionDigital Transformation
About the role
Key responsibilities & impact- Lead and oversee Pie's claims adjudication function across all jurisdictions
- Plan and direct daily and long-term claims adjudication operations
- Implement workers' compensation claims programs
- Serve as lead claims adjudication authority and advise the Pie Executive Team
- Direct quarterly review and settlement of large loss and catastrophe claims
- Develop claims adjudication procedures and policies
- Collaborate with the Chief Claims Officer on overall claims strategy
- Inform enterprise-wide claims initiatives and departmental objectives
- Determine organizational structure, expectations, span of control, role expectations, and KPIs
- Develop, measure, and coach performance and productivity goals
- Build claims talent and cultivate a diverse, equitable, and inclusive team culture
- Lead and develop Directors and Senior Managers through goal-setting, performance management, coaching, and mentoring
- Manage fiscal reporting, budgeting, headcount planning, and operational expenses
- Monitor claims metrics and performance trends
- Drive continuous improvement in loss ratios and claims outcomes
- Align claims adjudication operations with profitable growth and underwriting objectives
- Collaborate on the claims technology roadmap and automation vision
- Champion innovative technologies and processes
- Partner with Product and Enterprise Tech on claims technology investments
- Lead digital transformation initiatives
- Participate in Claims and Pie Executive Team strategic planning and decision-making
- Collaborate with Claims, Underwriting, Actuarial, Reinsurance, Product, Finance, Legal, and other departments
- Represent claims adjudication in product development, pricing, and risk management decisions
- Represent Pie externally as a claims subject matter expert
- Ensure regulatory compliance across multiple jurisdictions
- Oversee fraud investigation efforts with Claims Regulatory Compliance
- Manage regulatory relationships and reporting
- Develop and maintain claims adjudication risk management protocols
Requirements
What you’ll need- 15+ years of experience with workers' compensation claims, field claims operations, and claims adjudication
- 10+ years of people management experience with a track record of developing next-generation leaders
- Experience building and managing claims adjudication teams of 15+
- Experience managing second-line managers (Directors and Senior Managers)
- Expert knowledge of managing disputed and litigated claims across multiple jurisdictions
- Strong industry leadership track record with experience in senior leadership roles across the insurance industry
- Broad knowledge of workers' compensation claims and claims adjudication best practices
- Expert proficiency in analytical skills and understanding of claims metrics
- Proven ability to contribute strategic insight to enterprise claims strategy
- Superior oral and written communication skills with ability to present to C-suite executives and external stakeholders
- Proven ability to represent the organization externally as claims subject matter expert
- Experience in crisis communication and managing high-stakes stakeholder relationships
- Must live and work in the United States (territories excluded)
- Access to reliable, high-speed internet
Benefits
Comp & perks- Competitive cash compensation
- Comprehensive health plans
- Generous PTO
- Future focused 401k match
- Generous parental and caregiver leave
- Discretionary bonuses may be granted annually to eligible team members