DIRECTOR OF TPA CLAIMS

USA Managed Care Organization•West Lake Hills, TX

2d•Onsite

About The Position

Southern Premier Administrators (SPA), a subsidiary of USA Managed Care Organization (USAMCO), is a dynamic third-party administrator in the Life and Health insurance industry. SPA administers both group and individual insurance products on behalf of insurance carriers, associations, and self-insured plans. SPA is currently seeking a full-time Director Claims to join its growing team! This role reports to the VP of Southern Premier Administrators and is based in the Austin, TX, office. This is an exciting opportunity to join an expanding company with career-growth opportunities.

Requirements

Minimum 15 years in Life and Health insurance claims roles required
Minimum 5 years in a leadership role required
Experience working for one or more third-party administrators required
Experience and understanding of compliance and regulatory requirements required

Nice To Haves

Change-management leadership experience including system conversions/implementations, preferred

Responsibilities

Expand department capabilities to meet growing business needs and Service-Level Agreements (SLAs)
Lead TPA Claims departments, developing and mentoring employees
Design and maintain internal and external reporting on inventory, metrics, and SLA reporting
Drive continuous improvement to support a scalable, growing business
Work closely with Underwriting department on contestable claims and reinstatements
Maintain relationships with vendors, carriers, auditors, and reinsurers
Travel to other office(s) as necessary
All other job duties as assigned