Jobs · Project Management

US MGA Claims Program Manager

Simply Business · Massachusetts, United States · 1 wk ago
RemoteRemoteProject Management$86k–$141k/yrFull-time

What Is the Opportunity?

As the Claims Program Manager, you will be the guardian of our claims integrity and the primary driver of program profitability through robust claims management and outcomes. This role is responsible for the complete collaboration, oversight, and management of our Third-Party Administrator (TPA) program(s) to ensure they are compliant, effective, and cost efficient. You will act as the crucial technical bridge between our MGA, TPA partners, and Fronting Carriers/Reinsurers, ensuring our claims process maintains rigorous technical control to protect loss ratios, litigation spend, and carrier relationships.

What Will You Do?

  • Guide TPA partners as the primary technical point of contact to ensure claims excellence and accurate dispositions.
  • Establish and monitor KPIs, such as settlement accuracy and lifecycle duration, while keeping a close eye on aged inventory.
  • Conduct deep-dive audits and technical file reviews to score TPA quality, efficiency, and adherence to best practices.
  • Maintain reserve integrity by tracking increases of $25K or more to ensure accuracy aligns with long-term book profitability.
  • Strategic ownership by providing expert second opinions on complex coverage letters and pushing for aggressive, early resolution of claims.
  • Drive data intelligence by analyzing loss trends to identify specific trade risks and feeding those insights back to our Underwriting and Product teams.
  • Partner with stakeholders to lead roundtable discussions on complex claims and produce high-quality performance scorecards for leadership.
  • Perform other duties as assigned.

What Will Our Ideal Candidate Have?

  • Professional designations such as CPCU, ARM, AIC, or SCLA.
  • Ability to influence and persuade partners through technical expertise and relationship building.
  • Leverage a data-driven mindset and analytical curiosity to deeply understand litigation and loss ratio drivers, identifying financial trends that protect the bottom line.
  • A self-motivated problem-solver who thrives in fast-paced environments and isn't afraid to "fix broken processes".

Must Have

  • Bachelor’s Degree.
  • A minimum of 5+ years of professional experience in claims or risk management, with a specific focus on Commercial Lines General Liability.
  • Expertise in handling litigated commercial bodily injury or product liability claims.
  • Deep understanding and application of coverage throughout the claims lifecycle, including compliance with regulatory requirements.

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