Crum & Forster Company Overview

Since 2000, Crum & Forster’s Accident & Health division (A&H) has offered a diverse portfolio of specialty insurance and reinsurance products nationwide. We place a strong focus on product development and creative distribution methods, along with excellent client service and support.

In addition to our robust domestic portfolio, which spans both special risk and medical solutions, A&H works on an international basis through various partnerships. Our global capabilities provide our partners with even broader flexibility in underwriting solutions.

The qualities and capabilities of Crum & Forster Accident & Health demonstrate our philosophy of building meaningful, long-term partnerships and our dedication to providing alternative strategies in an ever-changing insurance market.

Job Description

Information about the Role, Line of Business and Team:

The successful candidate will work as part of the Operations team to proactively manage a team of claims professionals including the Claims Program Management teams, Training & Development team, and oversight of Stop Loss and Travel vertical operations. This candidate with be tasked with implementing and managing a long-term strategy that aligns to the division’s objectives.

What you will do:

Develop long-term plan for the Medical Business Unit program claims organization as the division continues its growth path
Establish and monitor benchmarks and metrics for effective oversight and team performance
Develop and provide innovative solutions that provide strategic impact to the division and deliver on approved strategic roadmap initiatives
Cultivate and maintain excellent relationships with reinsurers, business units and client partners
Establish, negotiate and maintain vendor relationships and contracts that have a direct impact on divisional results
Collaborate with management team on planning, staffing and budgeting
Manage audit process that integrates meaningful quality standards, validates appropriate controls and provides value to the division and client partners
Work with vertical partners to ensure alignment with divisional objectives and standards; on an ongoing basis monitor that alignment
Manage assignment of work/division of responsibilities to ensure that client needs are being met and response times managed to standards
Provide directions to staff on litigated, complex and potential high exposure claims
Prepare detailed reports summarizing results of risk management reviews of specific clients as needed but no less often than monthly
Prepare portfolio analysis summary reports for delivery to management in Operations and the Business Unit monthly
Partner with Analytics to identify persistent claims error trends and report those trends regularly to management
Partner with IT team to innovate, test and implement technology solutions that improve efficiency and productivity of the claims team
Ensure that all Claims administrators are informed of and in adherence to applicable state unfair claims practices laws
Work with Claims Account Management team to ensure that all customer interactions are documented using appropriate tools with strict adherence to confidentiality agreements, policies and procedures.
Work with Claims Account Management team, Direct team and verticals to ensure that the process to monitor claim denials Is consistent across the division and being handled within guidelines, consistent with policy provisions and clearly, professionally and courteously communicated to the certificate/policyholder
Provide the leadership necessary to maintain a motivated, productive and competent team through open communication and delegation of responsibilities and authority.
Be a team leader and builder who has an eye for talent with the ability to maximize resources and capability to deliver business results.
Demonstrate strong mentoring, relationship-building, planning and organizational skills.
Guide and direct team members in their personal and professional development.
Drive performance excellence through goal setting, quality feedback, and performance appraisals within the team (midyear and annual).
Create a working environment where productivity can be sustained and accomplished, and where innovation and personal growth is encouraged and realized.
Drive and role model the A&H culture, values and C&F core competencies within their teams.
Other duties and/or projects as assigned.

What YOU will bring to C&F:

In-depth understanding of medical terminology, healthcare delivery systems, insurance contracts, and legal principles
Proven ability to manage teams, drive results in a matrix environment, and manage change
St

AVP or VP MBU Claims Leader - Eatontown, NJ or Remote at Crum & Forster