Manager Major Claims Unit

ICW Group • Philadelphia, PA

9d • $104,125 - $175,600 • Hybrid

About The Position

The Manager of the Major Claims Unit leads a team of Major Claims professionals responsible for handling complex, high-value, and catastrophic claims. This role ensures operational excellence, delivery of optimal claim outcomes and reduction of financial exposure. The manager drives strategic resolution plans, ensures compliance with Workers’ Compensation regulations, and leverages data-driven strategies aligned with company values and objectives.

Requirements

• Bachelor's degree in Business, Insurance, Risk Management or related field required. Additional experience may be considered in lieu of degree.
• Minimum 7 years of related experience in claims required.
• Minimum 5 years of experience in claims negotiation, strategic decision-making and litigation related to major loss claims.
• Minimum of 2 years of experience leading a team.
• Required to receive certification that meets the minimum standards of training, experience and skill.
• Maintain state Workers’ Compensation License, as required.
• Advanced understanding of Workers’ Compensation claims principles and application.
• Ability to apply statistical & graphical techniques to data to discover useful information.
• Understanding of data sources and how data is collected & distributed within our organization.
• E xcellent verbal and written communication skills, time management and organizational skills.
• Technical expertise and insurance industry experience in the management of highly complex workers’ compensation claims.
• Ability to lead, manage and mentor claims team with strong understanding of personnel and performance strategies .
• Ability to effectively present information to colleagues and the Leadership Team.
• Advanced skills in negotiation, critical thinking, and decision making related to team management and claims.
• Strong attention to detail required.

Nice To Haves

• Continuing education designations (CPCU, AIC, etc.) or other industry licensing and training programs are preferred.

Responsibilities

• Lead a high-performing Major Claims team, fostering engagement, development, and retention to achieve operational excellence.
• Ensure performance and outcomes; strive for excellence in delivery and customer experience while working in close partnership with department leadership.
• Ensure the team is engaged and that leadership practices encourage development, recognition, and retention.
• Oversee the performance management and development process for the team and completes performance management duties, development planning and coaching for direct reports.
• Act as a resource for team members and leaders to answer questions and solve complex problems.
• Ensure adherence with all company policies and procedures and compliance responsibilities
• Provide technical expertise in the analysis, negotiation, and strategic resolution of claims .
• Mentor and develop team members to further their skills, knowledge, and professional practice.
• Set performance expectations, individual goals and timelines in alignment with organizational goals .
• Organize team workload, assign projects, and manage resources and results.
• Approve expense reports and travel for hearings, settlement conferences, training presentations, etc.
• Manage team members located in various branches or remote locations.
• Oversee claims to ensure company and jurisdictional requirements are met while achieving optimal outcomes.
• Ensure timely and accurate adjudication of major claims in compliance with company policies and state regulations.
• Ensure fact and data-based analyses are conducted, and appropriate resources are utilized, to formulate potential resolution strategies and estimate most probable exposures .
• Review and analyze claim strategies driven by case law, new and existing WC Rules and Regulations for multiple jurisdictions.
• Maintain oversight of claims to ensure that appropriate strategies are in place and reserves adequately reflect the most probable outcome of the claim .
• Approve reserves and payments within designated authority limits and submit recommendations for those exceeding Manager authority.
• Ensure work quality, adherence to company guidelines, b est practices, and applicable state laws.
• Serve as a point of escalation for complex claim issues.
• Participate in the creation and implementation of claims handling strategies.
• Recommend and implement plans and programs specific to major claims management.
• Effectively evaluate processes and procedures and make recommendations for continuous improvements.
• Act as a financial steward of the Company within assigned authority levels.
• Communicate professionally with both internal and external partners including senior leadership.
• Responsible for establishing and maintaining the Company’s philosophy and technical practices through effective leadership and communication.
• Delivers accurate, actionable data insights to guide claim strategies, identify trends, and drive continuous improvement for better outcomes and profitability.
• Proactively utilize reports to identify trends and drive continuous improvement, seek positive claim outcomes and maximize customer value.
• Participate in the development of metrics and data to monitor and analyze organizational performance.
• Identify strategies to reduce total claim costs relevant to major claim management and optimize profitability.
• Ensures data quality, adherence to IT security guidelines, profitability and other risk-related metrics for self and members of the team.
• Collaborate with senior leadership and cross functional teams to establish unit objectives and align with organizational goals.

Benefits

• We offer a competitive benefits package, with generous medical, dental, and vision plans as well as 401K retirement plans and company match
• Bonus potential for all positions
• Paid Time Off with an accrual rate of 5.23 hours per pay period (equal to 17 days per year)
• 11 paid holidays throughout the calendar year
• Want to continue learning? We’ll support you 100%

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1,001-5,000 employees