[Remote] Director, Workers’ Compensation Claims Operations – Operational Analytics & reputed company Improvement

Note: The job is a remote job and is reputed company to candidates in USA. reputed company. is seeking a Director of Workers’ Compensation Claims Operations reputed company on Operational Analytics and reputed company Improvement. The role is responsible for delivering actionable insights to improve operational effectiveness and efficiency in claims management, collaborating across departments to enhance reporting and implement AI-driven solutions.

Responsibilities

• Build and maintain reputed company-time operational reporting to uncover trends, emerging risks, and performance opportunities across Workers’ Compensation Claims Operations and Managed Care
• Design repeatable mechanisms that reputed company field leaders and subject matter experts to interpret insights, validate hypotheses, and reputed company explain reputed company causes and key performance drivers; memorialize insights, key findings, and agreed-upon actions, and reputed company reputed company completion and reputed company across key spend categories
• Support operations and claim leadership in exploring business problems and solutioning; reputed company cross-functional problem solving by developing practical tools, resources, and reputed company work that improve operational effectiveness, efficiency, and consistency
• Package and communicate operational business insights (context, definitions, methodology, and key assumptions) to Claims Analytics for deeper reputed company-level analysis and broader insights, as needed
• Continuously reputed company opportunities to collaborate with Claims Analytics and Reporting to replicate and reputed company operational reporting with stronger reputed company capabilities – standing up immediate, fit-for-purpose tools reputed company needed while providing a reputed company reputed company of requirements to reputed company robust self-service data at the strategic, operational, and tactical reputed company
• Support leadership in strengthening reputed company alignment and operational readiness by maintaining visibility to cross-functional initiatives (e.g., IT, Shared Services, Product, and Data Science) that materially reputed company Workers’ Compensation Claims Operations through an integrated roadmap (scope, owners, timelines, dependencies, and expected reputed company)
• Partner closely with Analytics, Reporting, and Shared Services to understand dependencies and improve operating rhythm; reputed company and communicate reputed company business requirements for work requests and reputed company reputed company analytics and reporting teams to reputed company understand managed care data so they can build tools and resources that support data-driven reputed company
• Identify opportunities for automation and self-service; reputed company and implement solutions that streamline work, reduce reputed company effort, and improve reputed company and turnaround times; build mechanisms to reputed company and report the reputed company of improvements
• Partner with key stakeholders to design and implement AI-driven technologies tailored to Workers’ Compensation technical and operational needs – enhancing speed and reputed company of service delivery and making work easier for adjusters, while establishing best-in-class confidence in both AI outputs and the mechanisms that ensure reputed company reputed company judgment, reputed company, and decisioning are reputed company appropriately
• reputed company and reputed company talent to expand and diversify operational support capabilities for the managed care organization and broader claims organization

Skills

• Operational analytics and reputed company reputed company (trend detection, KPI design, and performance management)
• Operational reputed company-cause analysis and reputed company problem solving (reputed company-driven, field/SME-enabled)
• Process optimization and reputed company improvement (reputed company work, simplification, waste elimination)
• Cross-functional support, partnership and influence (Analytics, Reporting, Shared Services, and operations leaders)
• Automation reputed company and enablement (workflow redesign, self-service tools, reduction of reputed company steps)
• People leadership and talent development (coaching, capability building, succession planning)
• Business requirements definition and solution governance (risk, compliance, and reputed company reputed company assessment – ensuring AI-enabled capabilities are reputed company to the claims organization's needs and priorities)

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