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TPA/Project Manager

ChrisHunt, Inc.

TPA/Project Manager

Fullerton, CA
Full Time
Paid
  • Responsibilities

    Job Description:

    The TPA/Project Manager will be responsible for supporting the general day-to- day business operations of our growing HR company with an emphasis on Project Management Implementations and Workflow.

    The TPA/Project Manager will have primary responsibility for defining, planning, tracking and managing the projects and claims that they are assigned. He/she is responsible for identifying key resources needed and providing the direction required for meeting the project objectives & achieving corporate goals. He/she is also responsible for ensuring appropriate management of project and claims outcomes

    Qualifications and skills of the Project Manager include the ability to coordinate Team efforts to reach goals, self-motivation, and the aptitude to motivate and encourage teamwork. He/she must also be able to communicate effectively with senior management, and have a clear vision of what is needed to achieve corporate goals. In addition, the TPA/Project Manager should have a technical background regarding system interfaces, and/or have knowledge sufficient enough to understand the technologies and technical issues involved with the what a TPA does, to be able to help anticipate and identify critical technical obstacles, and to make accurate decisions that affect the organization.

    The TPA/Project Manager must also be able to utilize project management tools such as tracking charts, checklists, and project scheduling software. He/she must have analytical skills to be able to manage change and take active leadership in timely decision making according to the data analyzed. The TPA/project Manager will perform and oversee a wide range of duties and ultimately create an enthusiastic, but determined moderator.

    The TPA/Project Manager will report directly to the VP of Human Resources, but will have involvement & support all areas of the company (Sales, Operations & Administration).

    Skills and Qualifications:

    • Ensure timely investigation and evaluation of events that could lead to an insured claim.
    • Ensure timely and accurate reporting of claims to legal counsel, Third Party Administrator (TPA), and insurance providers.
    • Act as liaison between operations, health and safety, finance, TPA, defense attorneys, and in-house counsel.
    • Effectively communicate recommended claim mitigation strategies to cross functional and internal leadership teams.
    • Demonstrated ability to analyze and drive the resolution of large losses and pending settlements.
    • Oversee liability claims data for large loss submissions and address insurers’ on-going questions and concerns through claims resolution.
    • Comprehensive knowledge of insurance policy provisions, practices, laws and regulations, including contracts, tort, and foreign jurisdictions.
    • Ability to interpret and apply laws and regulations, determine appropriate courses of action, including subrogation, present solutions, and resolve claims.
    • Demonstrated knowledge of claim handling principles and the application of coverage language to fact patterns.
    • Manage claims administration process for multiple jurisdictions, including foreign jurisdictions.
    • Strong knowledge of statistical claims data analysis and reporting for senior leadership and use in insurance program design.
    • Utilize and/or establish analytics, metrics and benchmarking through multiple sources to evaluate loss trends and cost of risk to prioritize resources (e.g., RMIS, actuarial reports, and broker data).
    • Provide guidance and support for loss prevention matters to cross functional partners to ensure an open, proactive, and effective risk management claims culture.
    • Conduct and attend internal and external claim reviews as required.
    • Attend settlement hearings and trial as needed.
    • Conduct claims training for internal stakeholders.
    • Provide settlement authority.
    • Working knowledge of Risk Management Information Systems (RMIS).
    • Ability to multitask in a fast-paced environment.
    • Excellent analytical, problem solving, negotiation, vendor selection, and organization skills.

     

    Minimum Requirements:

    Bachelor’s degree in Business Administration, Finance, Accounting, Entrepreneurship, Healthcare Management or similar field; however MBA is preferred.

    Experience in any aspect of the insurance industry a plus but not required.

    Proficient/Advanced knowledge of Microsoft Excel; ability to create customizable reports and analysis. Prior experience in projects at a consulting firm, financial firm, or insurance company a plus.

    Experience with evaluating and assessing internal company processes and improving them.

    Advanced problem solving skills and the ability to work collaboratively with others.

    Demonstrated ability to prioritize work load and meet project deadlines .

    Willingness to work a flexible schedule to accommodate project deadlines and travel requirements, and the ability to work remote on occasion.

    Strong organizational skills required

    Ability to plan, organize, and prioritize the actions required to accomplish day to day goals and objectives. As well as work effectively with fellow Team members to further the goals of the business.

    Must be able to multi-task & work on simultaneous projects.

    Job Type: Full-time

    Pay: $50,000.00 - $70,000.00 per year