Job Type:Permanent
Position: Quality Assurance Manager
Business Unit/Function: Group Claims
Location: Atlanta or Chicago
Reporting to: Head of Claims Quality Assurance & Governance
Type: Permanent - Full time
The Role:The Claims Quality Assurance Manager leads the claims quality assurance program across internal and third-party administrator operations. This role is accountable for the quality framework, risk-based review strategy, team performance, stakeholder reporting, and delivery of sustainable improvements
The manager partners with Claims Leadership, Compliance, Legal, Operations, and business units to ensure regulatory requirements and Hiscox Claims Best Practices are consistently applied.
Key Responsibilities:- Set the annual claims quality assurance strategy, review plan, methodology, and risk-based priorities across internal and TPA claims operations.
- Lead, coach, and develop the Claims Quality Assurance team; establish objectives, allocate work, calibrate assessments, and maintain consistent, high-quality output.
- Own the quality assurance framework and governance standards, ensuring alignment with Hiscox Claims Best Practices, TPA Claim Handling Guidelines, regulatory obligations, and operational risk requirements.
- Oversee monthly and thematic claim reviews, ensuring appropriate coverage, timely completion, sound evidence, and defensible conclusions.
- Deliver concise management information and executive reporting that identifies trends, root causes, emerging risks, and priorities for corrective action.
- Present findings and recommendations to Claims Leadership and key stakeholders, clearly communicating risk, business impact, ownership, and required decisions.
- Partner with business leaders to establish corrective action plans, assign accountability, monitor delivery, and verify that remediation produces sustainable improvement.
- Drive calibration, training, and continuous improvement initiatives based on review outcomes, regulatory developments, complaints, litigation, and other quality indicators.
- Maintain effective governance, documentation, issue escalation, and quality controls across the end-to-end review process.
- Serve as the senior point of contact for claims quality assurance matters and provide practical, commercially balanced advice to leaders and stakeholders.
- Monitor program effectiveness through meaningful performance and risk indicators, and adjust priorities, resources, and review coverage as needed.
Our Must Haves:- 10+ years of progressive multi-line claims experience, including significant responsibility for claims quality assurance, auditing, compliance, or operational risk.
- Demonstrated experience leading, coaching, and developing a team, or providing sustained functional leadership across a quality assurance program.
- Deep knowledge of claims handling practices, regulatory expectations, state DOI standards, compliance, and operational risk.
- Experience working collaboratively across multiple internal and external teams, including third-party administrators and suppliers.
- Proven ability to build effective relationships and influence stakeholders at all levels of the organization, supported by strong facilitation and written and verbal communication skills.
- Proven ability to analyze complex review findings and data and translate them into clear executive-level insights, risk assessments, and actionable recommendations.
- Sound judgment, strong organization, and change leadership, with the ability to balance competing priorities, respond to emerging risks, and apply a pragmatic, commercial, customer-focused, and solution-oriented approach.
- A strong track record of driving corrective action, improving processes, and reducing repeat quality deficiencies.
Desirable Experience and Qualifications:- Demonstrable subject-matter expertise in claims quality, technical claims handling, or regulatory compliance.
- Experience designing or enhancing quality frameworks, audit methodologies, governance arrangements, or management reporting.
- Experience overseeing TPA quality, vendor performance, or delegated claims arrangements.
- Experience in General Liability, Professional Liability, Property/Inland Marine, or other specialty lines.
- A relevant professional designation in insurance, claims, audit, or compliance.
Salary Range: $100-$130kThe actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment
**Please note that this position is hybrid and requires two (2) days in our office weekly** What Hiscox USA Offers:- Competitive salary and bonus (based on personal & company performance)
- 401(k) with competitive company matching
- Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care)
- Company paid group term life, short- term disability and long-term disability coverage
- Paid parental leave
- 4-week paid sabbatical after every 5 years of service
- Financial Adoption Assistance and Medical Travel Reimbursement Programs
- Annual reimbursement up to $600 for health club membership or fees associated with any fitness program
- Recipient of 2024 Cigna's Well-Being Award for having a best-in-class health and wellness program
- Dynamic, creative and values-driven culture
- Modern and open office spaces, complimentary drinks
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