AVP, Claims Quality Assurance & Performance Management

Brookfield Wealth Solutions, Ltd•Springfield, MO

1d•$136,986 - $167,280•Onsite

About The Position

Clearbrook is looking to align the Quality Assurance function across both Argo and Farm Family, while keeping the function aligned with the individual lines of business underwritten by each business. The Quality Assurance function is referred to as Quality Improvement in Farm Family currently. The AVP, Claims Quality Assurance & Performance Management is responsible for leading the design, implementation, and ongoing evolution of Farm Family’s claims QA program. The role reports to the Clearbrook QA Lead, with a dotted-line to the Chief Claims Officer, Farm Family at the enterprise level. The AVP will work closely with Farm Family and Clearbrook senior leadership to align Farm Family’s QA program with other Clearbrook entities while positioning Farm Family as a leading example of data-driven claims QA. The role’s core function is claims quality assurance, including file audit methodology, claim handling evaluation, scoring, governance, feedback, and corrective action. In addition, the role will expand QA output into a broader claims performance management capability by linking QA findings to Guidewire data, KPI trends, process assessment analytics, adjuster and manager performance evaluation, and senior leadership reporting across Farm Family’s claims organization. This is a 100% in-office position. Candidates must be able to work on-site at a designated company office during standard business hours.

Requirements

Bachelor’s degree required
7 years of progressive P&C claims experience, with strong technical claim handling, coverage, reserving, litigation management, and claim strategy expertise.
Prior leadership experience building, rebuilding, or materially enhancing a claims quality assurance, claim file audit, or claims performance management program
Must have good business acumen (i.e. understand how an insurance company works and makes money, including how this role impacts both Farm Family and our customers’ ability to be profitable).
Recognized as a leader within the organization that provides advice and guidance to others.
A team builder, someone who understands that success is dependent upon the performance of the team and not individual team members. Creates strong morale and spirit within the team: shares wins and celebrates success as a team
Ability to establish mentoring relationships with key employees and participates in the development of succession and training plans for critical positions.
Ability to identify and resolve conflicts in a timely, objective manner, using sound judgment to reach a solution.
Strong focus on selection – determined to have the right people who do the best job.
Demonstrated ability to translate QA findings into measurable claim quality improvements, operational changes, training priorities, and performance management actions
Strong understanding of claims KPIs, audit scoring models, sampling methodologies, performance analytics, and executive-level claims reporting
Significant experience with Guidewire ClaimsCenter, including system utilization, data integrity, claim documentation standards, and reporting requirements
Proven ability to use data-driven insights to evaluate claim adjuster performance and identify broader claim operational and business performance trends
Experience developing structured feedback loops to LOB leaders, claims management, and claim handlers to ensure QA findings result in timely corrective action and sustained improvement
Experience developing and presenting training materials based on QA audit results, claim handling trends, system utilization gaps, and identified performance opportunities
Experience partnering with senior claims leadership, LOB leaders, business leaders, compliance, operations, IT/data teams, and training resources to implement enterprise-wide improvements
Strong change management skills, including the ability to reestablish governance, drive adoption, influence stakeholders, and improve consistency across claim teams
Excellent written and verbal communication skills, including the ability to prepare clear executive summaries, dashboards, findings reports, and leadership presentations,
A strong focus on execution in getting things done right. Proven ability to consistently produce and deliver expected results to all stakeholders by:
Finding a way to achieve success through adversity.
Being solution (not problem) focused
Thinking with a global mindset first.
Successful traits (flexibility, ability to thrive in change, being resourceful on your own) necessary to work in a fast paced environment that is evolving constantly.
Must work independently and demonstrate the ability to exercise sound judgment.
Exhibit natural and intellectual curiosity. Consistently considers all options and is not governed by conventional thinking.
Proficient in MS Office Suite and other business-related software.
The ability to read and write English fluently is required.
Must demonstrate a desire for continued professional development through continuing education and self-development opportunities.

Nice To Haves

JD, advanced degree, CPCU, AIC, SCLA, Six Sigma/Lean, PMP, Prosci, Guidewire certification, or similar insurance, claims, audit, process improvement, project management, or change management credential preferred.

Responsibilities

Manage a team of Quality Assurance professionals (currently referred to as the Quality Improvement team) to administer the Quality Assurance Program at Farm Family.
Create and maintain a positive working relationship with all direct reports, peers, and other department managers to ensure the Quality Assurance Team adds value and meets or exceeds the needs of internal stakeholders and are compliant with set expectations.
Support the Quality Assurance selection process to retain Quality Assurance professionals that consistently demonstrate exceptional customer service and appropriate technical expertise, maturity and a professional commitment to excellence.
Conduct Development Reviews and engage direct reports in developmental and skill building opportunities.
Train and mentor staff.
Act as a role model demonstrating belief in, and commitment to, the aspiration values of Clearbrook, continuing to build and lead a value-based organization committed to long-term success.
Partner with the Farm Family’s Chief Claims Officer and Clearbrook enterprise QA leadership to align Farm Family’s QA program with enterprise standards.
Design and implement QA audit methodology, scoring models, and sampling strategies.
Evaluate claim handling quality, including coverage, reserving, documentation, and claim strategy.
Develop structured feedback loops to claims handlers and leadership.
Ensure QA supports compliance, governance, and audit readiness requirements.
Partner with leadership to define and align claims KPIs.
Build reporting and analytics that use QA results as the foundation for evaluating claim quality, operational effectiveness, and KPI performance.
Serve as a key claims performance intelligence link for senior leadership by connecting QA audit results, claims data, KPI reporting, and process assessment findings.
Translate audit findings into training, process improvements, performance actions, and leadership decision-making support.
Deliver executive-level reporting on claim quality, claim adjuster performance, operational trends, and overall Farm Family business performance indicators.
Oversee Guidewire system utilization audits and data integrity assessments.
Identify operational inefficiencies and recommend corrective actions.
Lead integration of AI-enabled QA tools and automation solutions.
Drive continuous improvement through enhanced audit processes, technology-enabled insights, and operational effectiveness initiatives.