Sr. Manager, Major Claims Unit

Are you looking to make an impactful difference in your work, yourself, and your community? Why settle for just a job when you can land a career? At ICW Group, we are hiring team members who are ready to use their skills, curiosity, and drive to be part of our  journey as we strive to transform the insurance  carrier space. We're proud to be in business for over 50 years, and its change agents like yourself that will help us continue to deliver our mission to create the best insurance experience possible.

Headquartered in San Diego with regional offices located throughout the United States, ICW Group has been named for ten consecutive years as a Top 50 performing P&C organization offering the stability of a large, profitable and growing company combined with a focus on all things people. It's our team members who make us an employer of choice and the vibrant company we are today. We strive to make both our  internal and external communities better everyday! Learn more about why you want to be here!

The Senior Manager Major Claims Unit (MCU) leads a team of specialized complex claims professionals focused on managing and resolving catastrophic, high-dollar workers’ compensation injury claims. This role is responsible for driving claims closure initiatives, ensuring regulatory compliance, and optimizing financial outcomes through expert oversight and innovative resolution strategies. This role directly contributes to enterprise risk reduction by ensuring timely resolution of high-cost claims and influencing best practices in litigation management. The Major Claims Unit works collaboratively with and receives support from dedicated in-house counsel for litigation strategy and nurse case managers for medical management.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Strategic Claims Management

• Manages all aspects of high exposure claims including coverage determinations, investigations, and resolution strategies which may include pursuit of risk transfer, extensive negotiations and complex litigation management.

• Identifies and provides potential solutions for emerging exposures and claims trends.

• Develops and implements strategic plans to accelerate closure of high-cost, long-duration claims.

• Collaborates with legal, medical, and financial experts to evaluate exposure and resolution pathways.

• Leverages predictive analytics and severity modeling tools to proactively identify claims requiring escalation, closure strategy shifts, or risk transfer.

• Partners with Underwriting and Risk Management to inform account level-strategies and employer engagement.

Stakeholder Engagement

• Presents high exposure claim strategies, trends, and outcomes to executive leadership and enterprise risk stakeholders.

• Builds strong partnerships with panel defense counsel, and medical management vendors to drive optimal outcomes.

• Acts as a critical Subject Matter Expert in high exposure claims reviews across all jurisdictions providing strategic insight and resolution recommendations.  

• Ensures compliance with state/local regulatory requirements by following company guidelines and staying current on insurance laws and regulations.

Operational Excellence

• Ensures reserve accuracy to support appropriate financial forecasting, reinsurance reporting and risk scoring.

• Oversees quality assurance processes and conducts regular audits of complex claims.

• Utilizes data analytics to track performance metrics, analyzes operations/system issues, and drive decision-making.

Team Leadership

• Coaches and mentors a team of MCU claims examiners to build judgment and capabilities to effective manager complex and catastrophic cases from early intervention to mitigate exposure to claims closure.

• Provides guidance on claim strategy, litigation management, and settlement negotiations.

• Drives a high-performing culture focused on engagement, accountability, development, and results.

• Establishes and maintains overall work cadence, ensuring excellent performance and outcomes in delivery and customer service.

SUPERVISORY RESPONISBILITIES

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