Workers' Compensation Third Party Administrator (TPA) Claims Manager

This is a Full Remote job, available from anywhere.

The Claims Manager, Workers’ Compensation TPA Claims, oversees a team responsible for managing third-party administrator performance across multiple Workers’ Compensation programs. This fully remote leadership role within the BHDIC Claims Department requires deep expertise in workers’ compensation claims handling and regulatory requirements. The position is accountable for TPA performance outcomes, operational oversight, and escalation management.

The role involves guiding TPAs to consistently follow claims service level agreements and monitoring compliance with established policies, procedures, and standards to ensure strong oversight and control.

Key Responsibilities:

• Oversee assigned TPA relationships and ensure consistent execution of oversight and control measures.
• Lead and develop a team of Workers’ Compensation TPA Liaisons, establishing priorities to ensure tasks and performance goals are met.
• Authorize reserve/settlement requests within authority and prepare requests that exceed authority for internal senior leadership roundtable.
• Provide technical expertise and oversight through regular file reviews, audits, and authority approvals to ensure TPAs follow best practices and internal standards.
• Oversee team resolving TPA data feed errors to ensure accurate financial reporting.
• Build and maintain strong relationships with cross-functional teams, TPAs, vendors, brokers, policyholders, and legal partners.
• Participate in internal and external meetings, including weekly TPA client meetings and quarterly claim reviews.

• Deep expertise in workers’ compensation claims handling and regulatory requirements.
• Leadership experience in a similar role.
• Strong analytical and problem-solving skills.
• Excellent communication and interpersonal skills.
• Ability to work in a remote environment.