Claims Excellence Leader, Employee Benefits

At Equitable, our power is in our people. We're individuals from different cultures and backgrounds. Those differences make us stronger as a team and a force for good in our communities. Here, you'll work with dynamic individuals, build your skills, and unleash new ways of working and thinking. Are you ready to join an organization that will help unlock your potential?

Equitable is looking for an influential and dynamic leader to join our team! The Claims Excellence Leader will own and lead critical aspects of our Employee Benefits Claims organization, including Quality Assurance, Vendor/TPA Engagements, Training, and Policies and Procedures. Reporting directly to the Head of Claims, this role is pivotal in ensuring efficient and effective processing of claims, compliance with regulatory standards, and meeting the diverse needs of our clients.

This individual must be able to translate Employee Benefits' "Powerfully Simple" vision into actionable, quantitative, and innovative plans, including leading the design, ideation and build of a Claims Excellence framework for Employee Benefit Claims.

Key Job Responsibilities

• Strategy: Creates and executes on Employee Benefit's Claims Excellence strategy, including ownership for Quality, Training, Vendor/TPA Engagements, and Policies & Procedures.
• Implementation: Ensures the timely deployment of talent and processes in support of both the initial build of the EB Claims Excellence organization and ongoing execution of the strategy.
• Quality Assurance: Responsible for overseeing the quality assurance of claims processing, ensuring accuracy, timeliness, and compliance with policies and regulations.
• Vendor/TPA Engagements: Responsible for oversight of new and existing TPA and vendor relationships, ensuring they meet contractual obligations and service level agreements (SLAs).
• Training: Oversees the design, development, and execution of an EB Claims training program, encompassing both new hire training and ongoing learning and development needs.
• Policies & Procedures: Leads a robust policies and procedures framework, to ensure processes and expectations are clearly defined, well-documented, and accessible to all applicable parties.
• Leadership: Leads and manages a robust organization, including attracting and retaining top industry talent and fostering a culture of collaboration, innovation, and continuous improvement.
• Stakeholder Management: Collaborates with internal departments, external partners, and other key stakeholders to execute a market-leading strategy.
• Performs other duties as assigned.

The base salary range for this position is $119,000-$170,000. Actual base salaries vary based on skills, experience, and geographical location. In addition to base pay, Equitable provides compensation to reward performance with base salary increases, spot bonuses, and short-term incentive compensation opportunities. Eligibility for these programs depends on level and functional area of responsibility.

For eligible employees, Equitable provides a full range of benefits. This includes medical, dental, vision, a 401(k) plan, and paid time off. For detailed descriptions of these benefits, please reference the link below.

Equitable Pay and Benefits : Equitable Total Rewards Program

Required Qualifications

• 10 years of experience in Employee Benefits or Group Insurance Claims
• 5 years of people leadership experience with excellent team management abilities
• Professional work experience with one or more of the following Claims functions: Quality Assurance, Training, Vendor/TPA Engagements, and Policies/Procedures

Preferred Qualifications

• Strong analytical, strategic thinking and problem-solving skills
• Strong understanding of technology and industry trends
• Proven track record of innovative problem solving
• Strong verbal, written communication, and presentation skills
• Comfortable dealing with complexity and ambiguity and able to explore multiple solutions
• Strategic visionary who develops, communicates, and executes a compelling vision

Skills

Claims Excellence: Knowledge of building and deploying a total quality framework, with the ability to implement strategies and techniques used to ensure that claims processing meets the highest standards of accuracy and compliance.

Effective Communications: Understanding of effective communication concepts, tools, and techniques; ability to effectively transmit, receive, and accurately interpret ideas, information, a