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Director, Field Claims Operations

Employer
AmTrust Financial Services
Location
Dallas, Texas
Salary
Not Specified
Closing date
Aug 4, 2019

View more

Category
Claims, Operations
Job Type
Not Specified
Career Level
Not Specified

Job Details

Overview

AmTrust Financial Services, a fast growing commercial insurance company, has an immediate need for a Director, Field Claims Operations. The role will primarily support WC Claims Managed Care and Clinical operations and work in collaboration with WC Claims and Managed Care teams to implement and execute strategy, and ensure operational processes and policies are in place.

Responsibilities

  • Partner with Managed Care on the organizational planning and implementation of the managed care strategic and operational initiatives inclusive of nurse case management and strategic vendor partnerships
  • Review and analyze activities, costs and operations to determine progress toward stated goals and objectives
  • Propose programmatic changes and innovative strategies to improve claim outcomes based on assessment of current practices
  • Direct, plan and implement WC Claims and Managed Care Operational initiatives
  • Implementation of OCR and IC to improve medical bill and file process
  • Develop provider strategies focused on e-billing and e-payment to better align practice for outcome based results
  • Develop and oversee HIT (health information technology) systems that support the coordination of services and analysis of utilization
  • Identify opportunities to leverage resources across the division and the enterprise to take advantage of new opportunities or address operational challenge
  • Take a lead role in the development of problem resolution and process improvement in the areas pertaining to overall claim management
  • Manage and direct the effective implementation of new technologies and the utilization of existing systems
Qualifications

  • 7+ years in a senior leadership role responsible for Operations or Managed Care and Clinical in support of workers compensation claims or a related field
  • Experience with State and external accreditation managed care audits and reviews
  • Strong verbal and written communication skills
  • Advanced analytical skills
  • Ability to prepare presentation documents and present to senior leadership
  • Advanced computer skills to include Microsoft Products
  • Proven ability to manage organizational change, to involve and influence others to accept new ideas or innovative approaches, to lead in a team based organization
  • Ability to manage a diverse team including clinical professionals in multiple locations
  • Ability to develop reports, metrics and improvement plans
  • Ability to interact collaboratively and work effectively with a multi-functional team and throughout the organization; fosters an environment of shared responsibility and accountability
  • Experience with leading company-wide initiatives a must, including ability to bridge across divisions and between Support Center and field teams.
  • Experience applying medical management treatment guidelines such as Interqual, MCG, ODG, or other practical management guidelines
  • Experience with writing and implementing program level policy and procedures

Education

  • MBA, Masters or related advanced degree preferred
  • BA/BS college degree preferred. Knowledge and skills acquired through undergraduate studies in areas of finance, insurance, management or business administration a plus.
  • Knowledge and skills acquired through undergraduate studies in the areas of healthcare administration or related field

Company

AmTrust Financial Services, Inc. was founded in 1998 to provide property and casualty insurance to small businesses. Through acquisitions and organic growth, AmTrust Financial Services has since grown to become a multinational property and casualty insurer specializing in coverage for small to mid-sized businesses. Our financial stability is based upon a philosophy of niche diversity with a focus on low-hazard risk.

Since its inception, AmTrust has crafted a balanced portfolio of insurance products including:

  • Multiline Small Business Insurance
  • Warranty and Specialty Risk Insurance
  • Specialty Program Business Insurance

In November 2006, the company became publicly traded on the NASDAQ Global Market under the symbol AFSI. With extensive underwriting experience and a prestigious "A" (Excellent) Financial Size "XI" rating from A.M. Best, AmTrust has earned a reputation as an innovative, technology driven provider of insurance products. Our commitment to excellence is the common thread connecting each of our businesses.

Company info
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