Job Details

Job Description:
The Head of Claims is a senior leadership role responsible for designing, building and continuously enhancing the claims function within a growing specialty insurance organization. This individual will oversee claims strategy, governance, operational performance, third-party administrator (TPA) relationships and claims technology initiatives. The role requires a balance of technical claims expertise, operational leadership and strategic vision to ensure efficient claims management, strong partner oversight, regulatory compliance and exceptional service delivery. The successful candidate will thrive in a fast-paced, entrepreneurial environment and play a key role in shaping the organization's long-term claims strategy and operational framework.

Responsibilities:

• Develop and execute the overall claims strategy in alignment with corporate objectives.

• Build and scale a high-performing claims function designed to support long-term growth.

• Establish performance metrics and key performance indicators (KPIs) to monitor operational effectiveness and service quality.

• Drive continuous improvement initiatives that enhance efficiency, scalability and partner experience.

• Oversee claims performance across delegated claims partners and third-party administrators.

• Establish controls to ensure compliance with delegated authority guidelines, claims handling standards and escalation protocols.

• Provide oversight of reserving practices, litigation management, complex claims and large-loss events.

• Implement systems to identify emerging claims trends, risks and performance issues.

• Lead claims transformation initiatives focused on automation, workflow optimization and operational efficiency.

• Collaborate with technology and data teams to improve claims systems, analytics, and reporting capabilities.

• Standardize claims processes and governance practices across the organization.

• Evaluate and implement technologies that enhance productivity, transparency, and customer experience.

• Lead the selection, onboarding and ongoing management of third-party claims partners.

• Develop oversight programs including audits, performance reviews, due diligence and issue resolution processes.

• Monitor partner performance against established service levels, KPIs, reporting standards and contractual obligations.

• Manage corrective action plans when performance expectations are not met.

• Develop and maintain a comprehensive claims governance framework.

• Define reporting requirements and enhance claims data quality, consistency, and transparency.

• Oversee claims authority structures, reserving governance, referral protocols and reinsurance recovery processes.

• Prepare executive-level reporting on claims performance, trends, risks and operational effectiveness.

• Ensure claims operations and outsourced claims arrangements comply with all applicable regulatory and governance requirements.

• Lead claims audits and partner reviews, including remediation and follow-up activities.

• Promote fair customer outcomes, operational resilience and adherence to claims best practices.

• Maintain strong controls around documentation, compliance and claims handling standards.

Requirements:

• 10+ years of claims experience within specialty insurance, program business, delegated authority environments, MGAs, fronting carriers, reinsurance or related sectors

• Proven leadership experience managing claims operations and external claims partners

• Strong understanding of delegated claims authority, claims governance, reserving oversight, claims reporting and outsourced claims models

• Experience utilizing data and analytics to identify trends, risks, and performance opportunities

• Demonstrated ability to manage and influence external partners while maintaining productive business relationships

• Strong analytical, organizational and problem-solving skills

• Excellent communication and stakeholder management abilities

• Commercially minded with a practical, solutions-oriented approach

• Collaborative leadership style with the ability to operate effectively in a growing organization

• Entrepreneurial mindset and comfort working in a scaling or start-up environment

• Experience building claims functions, processes or governance frameworks from the ground up (preferred)

• Passion for operational excellence, innovation and continuous improvement

• Strong attention to detail and commitment to delivering high-quality outcomes

Compensation:
The anticipated compensation for this position is $175k plus bonus and benefits. We understand salary is an important factor in a job search, and we encourage you to apply even if you feel that your desired compensation may fall outside of the listed range. The final pay for this position is determined based on several factors including but not limited to, relevant experience, skills and certifications, education and training, geographic location, market conditions, and internal equity. We are committed to finding the right candidate for this role and are open to discussing how your unique qualifications align with our needs.

Contact:
Janet Foor
jfoor@jacobsongroup.com
+1 (312) 884-0421