DA Claims Manager

Overview

In this role you drive claims oversight and governance for a portfolio of delegated authority business across MGA and TPA relationships. You apply technical leadership to complex claims, ensure customer outcomes, and push regulatory compliance through data-driven insight and digital transformation. You lead performance reviews, identify risks and opportunities, and guide cross-functional teams in a forward-looking claims control framework. This hybrid role offers impact in analytics, governance, and continuous improvement.

Responsibilities

• oversee referral claims handling and coverage decisions outside of Delegated Authority
• provide technical guidance on complex or high-value claims
• manage portfolio of MGA/TPA relationships with governance and performance oversight
• conduct regular outsourcing partner performance reviews and identify trends and improvement opportunities
• drive analytics, MI interpretation, and data-driven insights to support efficiency and customer outcomes

Key requirements

• proven experience in claims handling, oversight, or portfolio management (MGA/Delegated Authority preferred)
• strong analytical capability with experience interpreting claims MI and performance data

• analytical mindset
• stakeholder management
• leadership and collaboration
• claims analytics
• MI interpretation
• data-driven decision making

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