Vice President, Workers' Compensation Claims Consulting

Enlyte•UNAVAILABLE, UNAVAILABLE

6d•Remote

About The Position

The Vice President of Workers’ Compensation Claims Consulting is a strategic leader responsible for partnering with clients to improve claims performance, operational effectiveness, and financial outcomes across workers’ compensation programs. This role leverages deep industry expertise, advanced data analytics, and the full breadth of company resources to identify opportunities, develop actionable recommendations, and lead consulting engagements that drive measurable results. Working closely with clients, internal subject matter experts, and cross-functional teams, the Vice President evaluates claims data, operational workflows, and program performance to uncover trends, optimize processes, reduce costs, improve return-to-work outcomes, and enhance overall claim management effectiveness. The position serves as a trusted advisor to executive stakeholders, translating complex insights into practical strategies and leading initiatives that deliver sustainable improvements in claim outcomes, customer satisfaction, and program value.

Requirements

Bachelor's in Operations Research, Risk Management, Insurance, Healthcare Administration, Business Analytics, related field or equivalent experience.
15+ years of experience, including workers' compensation consulting, managed care consulting, process reengineering, or payer/carrier leadership, with a track record of managing in a remote and matrixed environment.
Proven ability to interpret internal benchmarks against external industry trends and market dynamics to predict future workers’ compensation claims and operational challenges.
Claims operations expertise and deep understanding of the interplay between regulatory constraints, medical management strategies, return-to-work objectives, and technical data analysis using BI.
Exceptional ability to foster collaboration across siloed departments (Compliance, Marketing, Clinical, and Analytics) to deliver a unified client solution.
This is a remote position and can be located anywhere in the US. This requires ~30% travel, thus the ideal candidate will have convenient access to a major US airport.

Nice To Haves

MBA or industry certification that reinforces candidate's abilities in process reengineering, workers' compensation expertise, or analytics preferred.

Responsibilities

Serve as a trusted advisor to senior executives at workers' compensation carriers, TPAs, and self-insured employers, providing strategic guidance to improve claim outcomes, operational performance, and financial results.
Lead consulting engagements from assessment through implementation, helping clients identify opportunities and execute initiatives that deliver measurable and sustainable improvements.
Develop and present executive-level recommendations that align claims operations, medical management, return-to-work strategies, and organizational objectives.
Facilitate discussions with client leadership teams to establish priorities, define success metrics, and drive continuous improvement efforts.
Assess claims operations, workflows, staffing models, and performance metrics to identify opportunities for increased efficiency, consistency, and effectiveness.
Evaluate workers' compensation program performance and recommend operational, clinical, and process improvements that reduce claim costs and duration while improving outcomes.
Partner with clients to enhance return-to-work strategies, claims handling practices, vendor management, and overall program governance.
Support organizational change initiatives and help clients implement best practices that improve long-term program performance.
Collaborate with internal clinical, regulatory, analytics, product, and operational experts to deliver comprehensive client solutions.
Leverage the full range of company capabilities, resources, and subject matter expertise to address complex client challenges.
Coordinate multidisciplinary teams to ensure consulting recommendations are actionable, aligned, and successfully executed.
Foster strong partnerships across internal departments to provide an integrated and consistent client experience.
Analyze claims data, operational metrics, and industry benchmarks to identify trends, risks, and opportunities for improvement.
Translate analytical findings into practical business recommendations that can be implemented by claims and operational leadership.
Utilize internal and external benchmarks to evaluate program performance and support strategic decision-making.
Measure and communicate the impact of implemented initiatives through meaningful performance indicators and business outcomes.
Maintain deep expertise in workers' compensation claims management, industry trends, regulatory developments, and emerging best practices.
Provide thought leadership to clients and internal stakeholders on evolving claims management strategies and operational innovations.
Contribute to the development of consulting methodologies, tools, and service offerings that enhance client value and market differentiation.