Claims Manager

Job Summary

The Claims Manager will lead the claims team and serve as the subject-matter expert for our commercial insurance portfolio. Reporting to the Senior Director, Customer Relations, the role is based in Santa Ana, CA.

What You'll Do

• Lead day-to-day operations of the Claims team; set standards for training, quality, cost control, staffing, and continuous improvement
• Develop a high-performing team: recruit, hire, onboard, motivate, coach, mentor, and manage performance
• Run monthly 1:1s and formal feedback sessions; create development plans and hold the team accountable to goals
• Own annual and quarterly claims volume, severity, and expense forecasting; update outlooks based on trends and drivers
• Utilize data to inform workforce planning and site coverage, aligning schedules and staffing to meet service levels across facilities
• Define, track, and report KPIs (e.g., cycle time, accuracy, SLAs); deliver actionable trend analyses to leadership
• Maintain compliance with carrier guidelines, internal policies, and applicable laws/regulations; promptly remediate any issues that arise
• Adjudicate claims within delegated authority (approve/deny) and escalate exceptions with a clear rationale
• Partner with Underwriters to communicate claim developments and insights that inform pricing, policy language, and risk selection
• Champion process improvement (Lean/Six Sigma mindset); streamline workflows, eliminate defects, and improve employee engagement and customer experience
• Lead and support claims initiatives and cross-functional projects from scoping through implementation and change management
• Drive productive negotiations with internal and external stakeholders to advance policy, process, and system improvements

Who You Are

• 5+ years of hands-on, technical claims experience with strong insurance coverage, liability, and adjudication fundamentals required
• 4+ years of people management experience leading a claims operations team to meet internal and external stakeholder requirements required
• Proven ability to prioritize and manage multiple workflows; strong problem-solving and organizational skills
• Excellent written and verbal communication; professional interpersonal skills with the presence to lead change
• Strong negotiation and interpersonal influence skills; adept at relationship building and driving alignment with internal and external stakeholders
• Demonstrated ability to plan, delegate, and execute projects to completion, aligned to company OKRs
• Proficient with Microsoft Office and Google Workspace (Docs, Sheets, Slides); comfortable working with metrics and dashboards
• Sound judgment within delegated authority limits; escalates exceptions with clear rationale
• Able to perform the essential functions of the role, with or without reasonable accommodation

Requirements

• Bachelor’s degree in Business, Risk Management, or a related field preferred (or equivalent experience)
• CPCU, AU, or similar professional designation (completed or in progress) is an asset

Benefits

• Salary Range: $102k-$138k
• Health Insurance
• Additional Benefits: Fertility, Commuter, Educational Assistance
• 401(k) Matching Plan
• Vacation
• Holiday Pay
• Employee Discounts
• Flexible Hours
• Fun Working Environment