Job Title: Claims Manager - Partner Programs
Location: Austin, TX / Dallas, TX / Morristown, NJ
Reports To: Senior Claims Program Manager / Head of Claims, Spinnaker (Director, Claims-Partner Programs)
About You:The
Claims Manager - Partner Programs is responsible for the day-to-day oversight and performance management of assigned programs and Third-Party Administrators (TPAs). This role ensures claims are handled in accordance with established guidelines, regulatory requirements, and service expectations while supporting strong claim outcomes and partner relationships.
What You'll Do:Program Oversight & Execution
- Oversee claims handling for assigned programs to ensure compliance with claims guidelines, coverage intent, and regulatory requirements
- Monitor TPA performance including timeliness, reserving accuracy, and overall claim quality
- Conduct file reviews and QA audits to identify trends and improvement opportunities
- Assist in implementation and maintenance of claims guidelines and best practices
- Support onboarding of new programs including TPA setup, workflows, and reporting requirements
Operational Support & Reporting
- Analyze claims data and KPIs to identify emerging trends and performance issues
- Prepare stewardship and performance reports for internal stakeholders and program partners
- Track and follow up on corrective action plans
- Support reinsurance reporting and documentation requirements
- Assist with regulatory audits, data calls, and compliance reviews
Stakeholder Collaboration
- Serve as a primary point of contact for TPAs on routine matters
- Partner with underwriting, actuarial, finance, and legal teams
- Participate in program-level meetings and continuous improvement initiatives
Professional Development
- Build expertise in coverage analysis, reserving, litigation management, and regulatory compliance
- Support senior team members on complex claims
- Participate in training and development opportunities
Must Haves:- 5-8 years of claims handling or program oversight experience
- Experience working with TPAs, MGAs, or delegated authority programs preferred
- Strong understanding of claims fundamentals
- Familiarity with multi-state regulatory environments
- Strong analytical, organizational, and communication skills
- Proficiency in Microsoft Excel and claims systems
Nice to Have:- Experience in program business or fronting carrier environment
- Exposure to reinsurance reporting
- Industry designations such as AIC, CPCU, or ARM preferred
Benefits and PerksHippo treats its team members with the same level of dedication and care as we do our customers, which is why we're fortunate to provide all of our Hippos with:
- Healthy Hippos Benefits - Multiple medical plans to choose from and 100% employer covered dental & vision plans for our team members and their families. We also offer a 401(k)-retirement plan, short & long-term disability, employer-paid life insurance, Flexible Spending Accounts (FSA) for health and dependent care, and an Employee Assistance Program (EAP)
- Equity -This position is eligible for equity compensation
- Training and Career Growth - Training and internal career growth opportunities
- Flexible Time Off - You know when and how you should recharge
- Little Hippos Program - We offer 12 weeks of parental leave for primary and secondary caregivers
- Hippo Habitat - Snacks and drinks available for onsite employees
The Morristown, NJ base pay range for this role is $120,000 - $150,250. Exact compensation may vary based on several job-related factors that are unique to each candidate, including but not limited to: skill set, experience, education/training, location, business needs and market demands.
