Claims Director-EMC Claims Solutions

About the role

As the Claims Director at EMC Claims Solutions, you will lead the strategic direction and day-to-day operations of the TPA claims organization. You will develop high-performing claims leaders and teams, oversee complex commercial claims, and ensure exceptional service for clients while driving operational excellence.

Responsibilities

• Lead, coach, and develop Claims Solutions supervisors and staff, including performance management, succession planning, hiring, and employee development.
• Establish team goals aligned with KPIs and business objectives while fostering a collaborative, inclusive, and innovative culture.
• Manage staffing, workload distribution, budgets, and resource planning to ensure operational efficiency and fiscal responsibility.
• Provide leadership and technical oversight across General Liability, Workers Compensation, Auto Liability, Auto PD, and Professional Liability claims programs.
• Serve as the subject matter expert for complex coverage, liability, reserving, and claim valuation issues.
• Review high-exposure, litigated, and escalated claims; provide settlement authority and resolution guidance.
• Audit claim files, monitor reserve adequacy, and ensure adherence to claims best practices, client handling instructions, and regulatory requirements.
• Build and maintain relationships with clients, agents, vendors, and internal stakeholders while delivering exceptional service.
• Communicate significant claim developments, reserve changes, coverage matters, and account activity to key stakeholders.
• Analyze loss trends, claim performance, and operational data to develop strategic recommendations and customized client reporting.
• Partner with clients to understand business needs and enhance claims processes, reporting capabilities, and service delivery.
• Develop and implement claims strategies, operational goals, policies, and staffing recommendations to support business growth.
• Oversee compliance, licensing requirements, litigation management, defense counsel performance, and multi-state regulatory matters.
• Support business development efforts through client presentations, new account opportunities, vendor evaluations, and innovative service solutions.
• Participate in depositions, hearings, settlement conferences, audits, and Department of Insurance matters as needed.

Requirements

Essential Functions:

• Lead, coach, and develop Claims Solutions supervisors and staff, including performance management, succession planning, hiring, and employee development.
• Establish team goals aligned with KPIs and business objectives while fostering a collaborative, inclusive, and innovative culture.
• Manage staffing, workload distribution, budgets, and resource planning to ensure operational efficiency and fiscal responsibility.
• Provide leadership and technical oversight across General Liability, Workers Compensation, Auto Liability, Auto PD, and Professional Liability claims programs.
• Serve as the subject matter expert for complex coverage, liability, reserving, and claim valuation issues.
• Review high-exposure, litigated, and escalated claims; provide settlement authority and resolution guidance.
• Audit claim files, monitor reserve adequacy, and ensure adherence to claims best practices, client handling instructions, and regulatory requirements.
• Build and maintain relationships with clients, agents, vendors, and internal stakeholders while delivering exceptional service.
• Communicate significant claim developments, reserve changes, coverage matters, and account activity to key stakeholders.
• Analyze loss trends, claim performance, and operational data to develop strategic recommendations and customized client reporting.
• Partner with clients to understand business needs and enhance claims processes, reporting capabilities, and service delivery.
• Develop and implement claims strategies, operational goals, policies, and staffing recommendations to support business growth.
• Oversee compliance, licensing requirements, litigation management, defense counsel performance, and multi-state regulatory matters.
• Support business development efforts through client presentations, new account opportunities, vendor evaluations, and innovative service solutions.
• Participate in depositions, hearings, settlement conferences, audits, and Department of Insurance matters as needed.

Qualifications

• Bachelor’s degree, preferably in a business or insurance related field, or equivalent relevant experience.
• Ten years of claims handling experience in progressively responsible roles.
• Prior management experience.
• Prior experience handling commercial and workers’ compensation claims.
• Insurance designations, such as CPCU, AIM, AIC, preferred.

Skills & Abilities

• Superior knowledge of the theory and practice of the claim function coupled with analytical ability and demonstrated experience of good judgment with legal liability and coverage.
• Excellent leadership qualities with ability to motivate staff in the handling and disposition of claims.
• Excellent knowledge of insurance contracts, medical terminology and legal aspects of court procedures affecting legal liability.
• Excellent ability to make decisions under challenging circumstances.
• Excellent ability to translate technical ideas into more general terms for business customers.
• Superior organizational and written and verbal communication skills.
• Superior investigative, relationship-building, and problem-solving abilities.

Benefits

Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws. All of our locations are tobacco free including in company vehicles.