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Director of Claims Operations
WoodmenLife. Provide strategic leadership and oversight of claims operations across WoodmenLife .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates extensive experience in claims operations management, including oversight of complex claims, regulatory compliance, and operational strategy development. Proven ability to lead high-performing teams, optimize processes, and utilize data analytics to drive business results.
Highest-signal resume keywords
Claims Operations ManagementLeadership ExperienceInsurance Claims HandlingData Analytics and KPIsRegulatory Compliance
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 AdjudicationComplex Claims InvestigationsBudgeting and Resource OptimizationProcess ImprovementRisk Mitigation StrategiesOperational Strategy DevelopmentVendor ManagementQuality Assurance ProgramsClaims AnalyticsWorkforce Planning
Soft Skills
LeadershipCoachingCommunication SkillsRelationship BuildingProblem-Solving
Certifications & Qualifications
FLMICLUChFCFALUAALU
Industry Keywords
Life InsuranceClaims Administration PracticesCompliance ExpectationsCustomer SatisfactionContinuous Improvement
About the role
Key responsibilities & impact- Provide strategic leadership and oversight of claims operations across WoodmenLife
- Establish operational priorities, service standards, quality expectations, and performance metrics
- Direct claims adjudication and oversee complex, contestable, litigated, and other high-risk claims
- Review and direct escalated claims and represent the organization in legal proceedings, depositions, arbitrations, and related matters when required
- Lead quality assurance and control programs
- Build and develop a high-performing claims team through leadership, coaching, talent development, workforce planning, and succession planning
- Oversee third-party vendors supporting claims operations
- Lead audits, examinations, and regulatory reviews and ensure remediation of findings
- Monitor industry trends, emerging risks, regulations, and claims practices and translate changes into processes, training, controls, and business practices
- Partner across the organization on claims matters, enterprise initiatives, product enhancements, and customer experience improvements
- Manage department budgeting, operational planning, workload forecasting, resource optimization, and performance reporting
- Lead process optimization, automation, and continuous improvement efforts
- Build stakeholder relationships and ensure responsive, high-quality service to claimants, beneficiaries, members, sales teams, and business partners
- Use claims analytics and operational data to identify trends, improve outcomes, and support business decisions
- Establish and maintain claims policies, procedures, governance standards, and internal controls
Requirements
What you’ll need- Bachelor’s degree required; equivalent combination of education and relevant experience may be considered
- Minimum of 10 years of progressive claims operations experience, including complex claims
- Minimum of 7 years of leadership experience with direct responsibility for managing and developing teams
- Strong knowledge of insurance claims handling, insurance contract provisions, industry practices, compliance expectations, and related claims administration practices
- Knowledge of life insurance, annuities, settlement options, and related claims administration practices preferred
- Experience with complex claims investigations, fraud prevention efforts, and risk mitigation strategies preferred
- Demonstrated ability to develop and execute operational strategies that drive business results
- Demonstrated ability to develop high-performing teams through effective leadership, coaching, talent development, employee engagement, and succession planning
- Proven ability to lead complex operations, manage risk, establish effective controls, and achieve business outcomes
- Strong business and operational acumen, including budgeting, workforce planning, capacity planning, workload forecasting, resource optimization, and vendor management
- Demonstrated ability to use data, analytics, and key performance indicators (KPIs) to monitor performance, identify trends, and drive operational improvements
- Experience managing audits, market conduct examinations, regulatory reviews, and claims-related legal matters
- Experience developing business cases, securing stakeholder support, and leading claims-related projects and initiatives
- Proven success leading change, process improvement, and technology-enabled business initiatives
- Strong written and verbal communication and presentation skills
- Demonstrated ability to influence outcomes, build relationships, handle conflict, and collaborate effectively across all levels of the organization
- Strong critical thinking and problem-solving skills
- Strong commitment to customer satisfaction and continuous improvement of the claims experience
- Professional insurance industry designation (e.g., FLMI, CLU, ChFC, FALU, AALU, or similar) preferred
- Must be currently authorized to work in the United States on a full-time basis
- Must successfully pass applicable criminal background, credit, fingerprint, drug screen, and reference checks
Benefits
Comp & perks- Health insurance
- Dental insurance
- Vision insurance
- 401(k)
- Life insurance
- Equal opportunity employment
- Opportunities for growth, leadership, and service
- Special accommodations for applicants with disabilities
- Community outreach and community involvement