VP Claims Quality Assurance

The VP of Claim Quality Assurance is responsible for leading and developing claims handling standards and compliance, as well as providing oversight and direction on quality claims handling to field leadership. The position is a key stakeholder managing claim-level relationships with insurance carrier partners in compliance with contractual standards, including carrier reporting, audit management, and result coordination. Provides oversight and direction on all reserving and payments over field authority. Responsible for ensuring operations are within service level agreements. The position will hold regular 1:1 meetings with their direct reports and ensure all managers conduct regular 1:1s with their employees. The position is ultimately responsible for departmental work product and employee performance. Responsible for hiring, developing, disciplining, and terminating.

This position can work remotely from home or from within a CorVel office

Essential Functions & Responsibilities

• Develop claims handling standards and compliance, providing oversight and direction on quality claims handling to field leaders.
• Provide Large Loss oversight, reserve, and payment approval.
• Responsible for carrier relations; carrier correspondence
• Responsible, with claim leadership, for claim quality audit scores, compliance, and any action plans.
• Must understand all positions within the department and lead department employees to achieve performance goals.
• Ensures the highest level of customer service is delivered to all clients; conducts regular 1:1 meetings with direct reports.
• Set departmental objectives and establish policies and procedures to ensure compliance with best practices, state regulations, and client service requirements.
• Work closely with department managers to identify opportunities for improvement and how to continue to leverage existing efficiencies.
• Conduct external and carrier audits as needed.
• Oversee Quality Claim Standard Implementation and Management
• Internal claims oversight; training and documentation
• Provides strategic guidance regarding system and product enhancements, working closely with the Business Operations Team and software development.
• Oversees claim data corrections.
• Responsible for carrier Ad Hoc reporting as needed.
• Participates in client and insurance carrier stewardships and capabilities presentations.
• Performs other duties as assigned.
  
  

Knowledge & Skills

• Strong proficiency in Microsoft Office Suite is required
• Excellent written and verbal communication; demonstrated ability to provide superior service to internal and external stakeholders
• Sense of urgency and ability to multitask in a dynamic, fast-paced environment
  
  

Education & Experience

• Bachelor’s degree is required. AIC, CPCU, ARM, and SCLA are highly regarded.
• Ten (10) years prior progressive, related experience required, with 5+ in a related management capacity.
• Claims experience in workers' compensation, TX Nonsubscriber, USL&H, and liability. Property is a plus.
• Insurance carrier experience.
  
  

Pay Range

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range: $105,531 – $164,037

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

About CorVel

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.