Senior Quality Improvement Specialist

Brookfield Wealth Solutions, Ltd•Omaha, NE

4d•Onsite

About The Position

Farm Family is seeking a highly effective Senior Quality Improvement Specialist to join their team. This role involves conducting data-driven quality claim audits to evaluate claims handling and outcomes against enterprise standards, consistent processes, governance, and quality levels. The specialist will provide feedback to the claims management team and recommend improvements, which may include process enhancements, training, or performance management. This is a 100% in-office position, requiring candidates to work on-site at a designated company office during standard business hours.

Requirements

A broad theoretical knowledge of general liability claims as well as an exceptional customer service focus.
Minimum of two years of direct auto, bodily injury, liability, or PIP handling experience, with emphasis on complex, high-severity commercial losses coverage, reserving, litigation management, and claim strategy expertise.
Bachelor’s degree from an accredited university required. (Two or more insurance designations or four additional years of related experience adjudicating claims beyond the minimum experience required above may be substituted in lieu of a degree.)
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).
Demonstrated ability to translate Quality Audit findings into measurable claim quality improvements, operational changes, training priorities, and performance management actions.
Experience using structured feedback loops to claims management and claim handlers to ensure Quality Audit findings result in timely corrective action and sustained improvement.
Excellent written and verbal communication skills, including the ability to prepare clear summaries, findings reports, and 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-focused, and thinking with a global mindset first.
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 consider all options and not be 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

Experience working with Guidewire and Athenium auditing platforms and CCC.
Experience developing and presenting training materials based on Quality Audit results, claim handling trends, system utilization gaps, and identified performance opportunities.

Responsibilities

Conduct and document data-driven claim audits in the designated audit system within established timelines, having a direct impact on department results.
Evaluate claim files for adherence to enterprise standards and gaps between actual and optimal claims outcomes, including coverage analysis, liability, estimates, reserving, documentation, and compliance with internal standards, regulatory requirements, and quality expectations.
Analyze audit results and perform focused audits on specific trends to identify gaps and opportunities for improvement.
Translate audit findings into training, process improvements, and performance actions for claims staff and leadership.
Escalate critical findings and provide immediate feedback to leadership when urgent action is needed on a claim.
Participate in internal calibration activities within the Quality team to ensure scoring consistency.
Partner with leadership to support training initiatives and process improvements.
Consistently demonstrate exceptional customer service and appropriate technical expertise, maturity, and a professional commitment to excellence.
Demonstrate an appreciation and passion for data analysis, process improvement, and training that elevates strong claim management throughout the department.