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Claims and Operations Executive | Profile 11978

The Candidate is a highly experienced insurance professional with a proven track record in leadership roles across various organizations. They have demonstrated exceptional ability in change leadership, claims management, strategic planning, client relationship building, cost management, process improvement, operations management, regulatory compliance, project management, and technology enhancements.

Skills and Accomplishments

Strengths and Skills:

  • Expertise in change leadership, claims management, and strategic planning.
  • Skilled in fostering key client relationships and enhancing client satisfaction.
  • Proficient in cost management, process improvement, and operations management.
  • Demonstrated ability in regulatory compliance, project management, and partnership building.
  • Strong background in technology improvements, executive development, and program management.

Professional Accomplishments:

Led the development and restructuring of an internal and external claims department, resulting in significant organizational improvements:

  • Managed a budget of $3M and built a 50+ member regional claim team.
  • Achieved double-digit increases in customer satisfaction through quality communications and a new 24-hour response time process.
  • Designed a new business compensation model to reduce churn and improve employee engagement and performance.

Directed strategic planning, performance improvements, and operations for a leading third-party claim administrator:

  • Managed a $20M budget and a team of over 200 employees.
  • Developed a national claim team servicing three Fortune 500 companies, ensuring high levels of satisfaction.
  • Led a transition to a remote workforce, increasing customer satisfaction scores and reducing legal and medical costs.

Established an Innovation Lab to drive innovation across a national insurer of churches and religious institutions:

  • Managed a $1M budget and a 6-member risk management and analyst team.
  • Led the development of a moisture monitor preventing $10M in water damage loss claims.
  • Developed a real-time alert system for policyholders to mitigate loss from West Coast wildfires, preventing over $60M in property loss.

Oversaw risk control operations, improving strategic planning, project development, and compliance:

  • Managed a $1M budget with three management direct reports and a 25-member staff.
  • Played a pivotal role in building marketing strategies and enhancing product offerings.

Led claims organization and property services, achieving major improvements in performance and customer satisfaction:

  • Managed a $10M annual budget and a 149-member national claim organization.
  • Implemented training and policies that significantly decreased the time for customer claims payments.

Directed the growth of a regional claim operation, improving service levels and stakeholder satisfaction:

  • Oversaw training and advancement of a 55-person regional claim operation.
  • Improved processes to enhance service quality and efficiency.

Certifications

  • Certified Leave Management Specialist (CLMS) since 2020.
  • Gold Designation: Society of Claim Law Associates (SCLA) since 2007.
  • Certificate in General Insurance in 1990.

Affiliations

  • Active member of the Customer Experience Improvement Committee (2016 to 2019).
  • Contributed to the Small Group Leadership Committee (2013 to 2016).

This resume showcases the Candidate's comprehensive experience and achievements in the insurance industry, highlighting their capability to lead and innovate within complex organizational structures. Their extensive background in managing significant budgets, leading diverse teams, and driving customer satisfaction and operational efficiency positions them as a valuable asset to any prospective employer.

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