Vice President, Claims

Join Our Team as Vice President of Claims at Stealth Partner Group, an Amwins Group Company!

The Vice President of Claims is responsible for providing strategic direction and oversight to Stealth's Claims Department, with an emphasis on developing effective systems and procedures, ensuring operational excellence, and upholding high service standards.

At Amwins, we value our team members and offer a range of benefits to enhance your work experience:

• Flexibility: Enjoy a hybrid work environment with flexible scheduling options.
• Comprehensive Benefits: Access a competitive benefits package from day one, including generous Paid Time Off (PTO) and paid holidays.
• Continual Learning: Thrive in a collaborative, education-focused work environment.
• Annual Bonus Program: Earn incentives through our performance-based bonus program, designed to reward you for achieving key goals and contributing to the company's success.

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• Departmental Strategy: Defines a clear vision aligned with organizational goals, setting short-term priorities for process optimization and immediate performance improvements. Implements long-term strategies focused on ongoing innovation, technological advancement, and talent development.
• Operational Oversight: Oversees process workflows to ensure scalability, efficiency, quality, and integration of technology-based solutions.
• Claims Policies Procedures: Responsible for owning and leading the end-to-end development, implementation, and enforcement of claims policies and procedures with a focus on Stop Loss interpretation and contract compliance.
• Regulatory Compliance: Proactively assesses regulatory and industry changes, translating them into departmental policy adjustments and training.
• Collaboration: Build strong relationships with internal and external partners to ensure seamless service delivery. Promote a culture of accountability, innovation, and continuous improvement.
• Training and Development: Accountable for the training and professional development of Claims Department staff.
• Alignment: Drive cross-location process alignment to enhance consistency, streamline workflows and improve overall operational performance.
• Subject Matter Expertise: Provide subject matter expertise on complex claims issues and guide internal teams to resolution.
• Other duties and projects as needed

• Leadership
  
  Experience:
  
  5+ years in a Senior Leadership role. Exceptional leadership, analytical, and communication skills are a must. A proven track record of building and mentoring teams, including indirect reports and cross-departmental collaboration.
• Industry
  
  Experience:
  
  Strongly prefer 10+ years working in Group Benefits Claims with Stop Loss experience a plus.
• Industry Knowledge: Deep knowledge of Stop Loss contract terms, exclusions, reimbursement protocols, and industry best practices including HIPAA, PHI, COBRA, and ACA standards. Proven experience managing complex claims portfolios, including high-dollar reimbursements and escalated case reviews preferred.
• Improvement Mindset: Proven track record implementing and maintaining production environment standards that focus on quality control and maximizing efficiencies to drive timely execution of deliverables.
• Education: Bachelor's degree strongly preferred but not required.
• Tech Proficiency: Strong technical aptitude with experience working within all Microsoft Office programs (Excel, Outlook, SharePoint, Teams etc.) and data reporting tools.

The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities, or physical requirements. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.