Manager Claims Business Controls
Core
Own the end-to-end Claims Business Control Environment, driving a proactive, data-driven first-line control strategy to enhance customer outcomes, elevate quality, and optimize loss cost performance.
Role type
Manager, Claims Business Controls
Builds
QA operating system, audit programs, and control testing frameworks for Claims
Domain
Insurance (Property & Casualty), Claims Operations, Risk Management
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Claims leadership, data analytics for claims, Quality Assurance (QA) methodology, internal and external audit management, regulatory compliance (Canada), team management
Preferred skills
Experience with TFR automation, cross-line-of-business calibration, MGA/DUA audit oversight, KRI definition and monitoring
Technologies
TFR automation, corporate risk tools, privacy/compliance frameworks
Responsibilities
Own QA operating system including methodology, sampling, calibration, and reporting; Standardize QAR categories and align with automated attributes; Run cross-LOB calibration and embed phone call audits; Design and execute first-line control testing for leakage, authority, and reserves; Lead Claims audit program for MGAs/DUAs; Maintain Claims Procedures Manuals; Act as SME for external audits; Serve as lead for KRIs and monthly dashboards; Lead a small team of analysts.
Seniority
Manager, hands-on leadership
