Self-Funded Director, Claims

Reports directly to the Vice President of Claims and provides operational and strategic leadership to the Amwins Self-Funded Claims Department. This is an in-office position with the option to work from home up to two days per week after an initial training period.

Benefits

• Hybrid environment (up to two remote days per week after training)
• Competitive benefits package from day one, including generous Paid Time Off (PTO) and paid holidays
• Annual bonus program based on leadership impact and business objectives
• Continuous leadership development and education-focused environment

Responsibilities

• Drive exceptional client service and service-level agreement performance while strengthening relationships with internal teams, senior leadership, carriers, brokers, consultants, and administrators
• Represent Claims in key forums with clear, actionable updates on performance, initiatives, and industry trends
• Partner with senior leadership to set priorities, performance targets, and strategies that advance growth, profitability, service quality, and scalable claims operations
• Execute process, policy, and technology improvements that strengthen consistency across the department
• Lead, coach, and develop Claims Managers, Claims Leads, and Analysts to build capability, strengthen performance, and support career growth
• Oversee training, performance management, talent decisions, and QA alignment to ensure effective execution
• Oversee assigned Claims teams to ensure productivity, quality, inventory, staffing, and service performance meet expectations
• Use metrics, reporting, and workload insights to improve efficiency, accuracy, compliance, and client satisfaction
• Serve as a trusted subject matter expert on complex claims, emerging regulations, escalations, and department processes
• Provide technical guidance and represent Claims in meetings, trainings, and cross-functional initiatives that improve workflows and strengthen best practices
• Lead quality, compliance, and continuous improvement efforts that protect service standards, PHI, and regulatory requirements
• Translate performance trends into corrective actions that strengthen consistency, mitigate risk, and improve departmental outcomes
• Support additional duties and projects as business needs evolve

Requirements

• 7+ years of progressive responsibility in a leadership role, managing direct and indirect reports, with demonstrated experience coaching and developing managers or large teams
• 10+ years of experience in Group Benefits Claims; Stop Loss experience strongly preferred
• Strong understanding of Stop Loss policy terms, claims handling best practices, and applicable regulations (e.g., HIPAA, PHI, COBRA, ACA)
• Proven experience managing complex claims portfolios, including high-dollar reimbursement requests and escalated case reviews
• Experience improving or maintaining departmental workflows, production standards, and quality measures
• Strong ability to communicate clearly, collaborate across teams, and build trust with internal and external partners
• Bachelor's degree strongly preferred
• Strong technical aptitude with experience in Microsoft Office programs (Excel, Outlook, SharePoint, Teams) and data reporting tools