Head of Accident & Health Claims / US - Corporate Solutions

Swiss Re•Windsor, CT

12d•$150,000 - $250,000•Hybrid

About The Position

Join Swiss Re Corporate Solutions as the Head of Accident & Health Claims, where you will lead a transformative stop loss and health claims organization focused on operational excellence, innovation, and superior client service. This is an opportunity to shape a modern claims function that combines deep technical expertise with process improvement, automation, AI-driven efficiencies, and a customer-first mindset to deliver industry-leading outcomes for clients, brokers, and business partners. As the Head of Accident & Health Claims, you will lead the strategic direction and transformation of our employer stop loss claims organization. You will oversee a high-performing team responsible for delivering accurate, timely, and client-focused claim determinations while driving innovation across claims processes and technologies. You will play a critical leadership role in shaping our claims processes and operations through operational redesign, automation, AI-enabled workflows, and data analytics initiatives that improve efficiency, scalability, and customer experience. This role requires a visionary leader who can balance operational discipline with creativity and innovation while building strong partnerships internally and externally.

Requirements

Minimum 10 years of people leadership experience managing and transforming high-performing claims teams.
Proven track record implementing claims transformation initiatives, operational efficiencies, and process improvements and mapping.
Experience leveraging automation, workflow technologies, and analytics to optimize claims operations and customer service delivery.
Experience with digital claims platforms, predictive analytics, or AI-enabled claims technologies.
Experience building scalable claims operations in a growth-oriented environment.
Ability to translate claims insights into broader business and risk management strategies.
Demonstrated ability to lead through change and influence cross-functional stakeholders in a matrixed organization.
Experience managing TPAs and vendor relationships.
Strong analytical, strategic thinking, and problem-solving capabilities.
Exceptional communication, relationship management, and executive presence.
Customer-centric mindset with a passion for delivering superior service experiences.

Nice To Haves

Knowledge of stop loss claims administration, reimbursement methodologies, plan interpretation, and policy language.
General understanding of ERISA, HIPAA, and applicable insurance regulations and compliance requirements.
Background in reinsurance, self-funded health plans, or corporate Accident & Health insurance.
Professional insurance designations or advanced degree.

Responsibilities

Drive innovative and transformational initiatives focused on scalable claims process improvements, automation and digital workflows.
Evaluate and implement emerging technologies and AI-enabled capabilities that enhance claims handling, communication, and operational insights.
Reshape and oversee the end-to-end claims lifecycle including intake, adjudication, reimbursement, escalation management, appeals, and complex claim resolution.
Lead and develop a high-performing Accident & Health claims organization focused on transformative innovation, efficiency, accountability, collaboration, and service excellence.
Leverage data analytics and reporting to identify trends, improve decision-making, mitigate risk exposure, and enhance client outcomes.
Develop and implement strategies that improve turnaround times, claims accuracy, operational efficiency, and client satisfaction.
Champion a culture of innovation by encouraging creative problem-solving and introducing novel approaches to claims management and customer service.
Serve as the senior escalation point for complex, high-dollar, and sensitive employer stop loss claims.
Partner closely with underwriting, actuarial, legal, operations, and client management teams to align claims strategies with broader business objectives.
Build strong relationships with brokers, clients, TPAs, vendors, and internal stakeholders while representing Swiss Re Corporate Solutions as a strategic claims leader.
Ensure compliance with applicable state regulations, policy language, and internal governance standards.
Lead talent development initiatives, succession planning, and coaching efforts to build a future-ready claims organization.
Ensure compliance with Global frameworks while localizing them to the US context.