Claims Team Lead

The Team Lead will oversee a group of Claim Analysts responsible for managing professional liability claims and lawsuits. The Team Lead will focus on ensuring consistency in macro-level case development, ensuring that optimal defense strategies are consistently implemented throughout the life of each file, and on the strategic management of defense counsel. By leveraging advanced data analytics and predictive modeling, the Team Lead will develop and implement data-informed, innovative, and proactive approaches to managing claims, and monitor team performance to drive superior outcomes for our PolicyOwners.

Strategic Leadership & Development & Process Improvement 

• Lead a team of Claim Analysts in the implementation of optimal strategies and tactics at every stage of the claims process to drive superior claim outcomes.
• Contribute to the strategic development of macro claims strategies, relying on data-driven insights, ensuring consistent application across all claims.
• Foster a culture of innovation, continuous learning and development, and transparent communication with team members, PolicyOwners and other key stakeholders.
• Work collaboratively across departments to ensure optimal support for PolicyOwners.
• Work closely with the Chief Claims Officer and other senior leaders to align team performance with company-wide strategic goals.
• Partner with cross-functional teams to evaluate metrics, develop and refine processes, and implement initiatives that improve overall claims resolution and PolicyOwner experience.

Claims Performance & Data Analytics

• Analyze macro-level claims data and trends using structured data and AI-driven insights to enhance strategic decision-making.
• Utilize data visualization tools (e.g., Qlik Sense) to present claims performance to key stakeholders and drive process improvements.
• Monitor key performance indicators and provide actionable insights to the Chief Claims Officer and other senior leaders through detailed reports and dashboards to evaluate the effectiveness of claims strategies.
• Utilize data analytics and predictive modeling tools to identify high-exposure claims and proactively adjust strategies.

Defense Counsel Management

• Provide high-level oversight of defense costs, maintaining effective defense strategies while ensuring alignment with financial targets.
• Provide oversight to ensure DCC reserves are accurately set based on historical payment data and case attributes.
• Take responsibility for ensuring defense counsel performance meets established benchmarks team wide.

• Bachelor’s degree required
• 7-10 years of experience in claims management, insurance adjusting, or JD with medical malpractice litigation experience.
• Demonstrated leadership or supervisory experience in a claims, legal, or risk management setting, with the ability to mentor and develop high-performing teams and the ability to collaborate cross-functionally and work closely with executive leadership.
• Ability to analyze complex data sets to identify trends, risks, and opportunities in claims performance.
• Proficiency in legal software (e.g., LSS), Excel, and data visualization tools (Qlik Sense or similar).
• Strong understanding of reserve management, defense cost containment, and financial oversight of claims.
• Strong strategic acumen and critical thinking skills, with the ability to recognize potential liability issues and adapt strategies accordingly.
• Ability to operate in a fast-paced, dynamic environment, managing multiple priorities effectively, while adapting to change.
• Excellent written and verbal communication skills, capable of conveying complex information to diverse stakeholders, including executives and Board members.
• Commitment to continuous learning and staying current on state, federal, and industry trends.