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Director of Claims Management
2 months ago
The Director of Claims Management will provide strategic leadership and oversight for the Claims Management department, ensuring compliance with auditing standards and accurate, timely processing of financial claims as part of WCG's Funding Model Guidelines. This role will also be responsible for the management and implementation of the Quality Improvement Framework to ensure the effective delivery and quality of employment services delivered by Service Provider Partners and WCG direct delivery team(s).
Key Responsibilities- Monitor and evaluate the performance of the Claims Management function, analyzing key metrics and trends to identify areas for improvement
- Monitor workflows to ensure Service Level Agreements (SLAs) are maintained, particularly through periods of peak demand
- Provide direction and leadership for the claims management function, aligning objectives with the program's goals and priorities
- Lead and manage the department, fostering a collaborative and high-performance culture. Provide guidance, coaching, and support to ensure team effectiveness and individual development
- Ensure that partners' expectations are exceeded with the quality of service received and that quality of contract delivery consistently conforms to expectations
- Ensure effective monitoring and compliance of service delivery within the department, working in collaboration with other leaders to drive key performance measures
- Support the continuous evaluation of programs through the collection and analysis of statistics and program data
- In consultation with the Director, Service Design and Quality, develop, implement, monitor, and evaluate a risk management plan for the department
- Drive a continuous improvement mindset, leading program management to develop and monitor action plans which improve and optimize performance; ensuring lessons are learned from challenges
- Oversee the development of budgets for the department, and lead the development and implementation of strategies ensuring responsible financial performance in line with operational effectiveness and efficiency
- Monitor financial performance closely and works with program management to develop strategies and contingency plans to ensure attainment of financial goals
- Bachelor's Degree in Business, Finance, Administration, or a related discipline or equivalent work experience
- A minimum of ten (10) years' cumulative experience in a claims, financial, and/or auditing environment, with a minimum of five (5) years' experience in a leadership role in this capacity
- Proven ability to drive strategic initiatives and deliver results in a complex organizational setting
- Experience with oversight of performance measurement and quality management of an employment services program
- Extensive experience in developing and coaching staff to maximize their potential and performance
- Must successfully pass a Criminal Record Check
- Proven ability to adapt seamlessly to changing circumstances, priorities, and environments. Resilient and resourceful in navigating ambiguity and uncertainty, with a track record of driving positive outcomes amid evolving business landscapes
- Deep understanding of the importance of confidentiality and integrity in handling sensitive information and operating within highly confidential environments. Adherence to ethical principles and compliance standards to safeguard organizational interests and collaborator trust
- Bilingual (French and English)
