Technical Director, TPA Workers' Compensation Oversight
On-siteAtlanta, Georgia, United States or Philadelphia, Pennsylvania, United States
Job Summary
Lead Workers' Compensation Third-Party Administrator (TPA) Oversight operations by partnering with Claims, Legal, Finance, and Regulatory stakeholders to improve claim outcomes, control costs, and ensure reserve adequacy. Drive financial performance through oversight of indemnity, medical, and legal expenses while monitoring claim trends and payment activity. Serve as a subject matter expert on claims systems, reporting, and data integrity to support account closeouts, special projects, and stakeholder reporting. Provide litigation oversight via legal trend analysis and counsel management, and lead process improvement initiatives to enhance operational effectiveness. Identify fraud indicators and emerging risks to support mitigation efforts. Manage onboarding, training, and technical development for analysts, and build strong relationships with TPAs, clients, brokers, and internal teams.
Required Qualifications
- Extensive Workers' Compensation claims and TPA oversight experience
- Strong knowledge of reserving, litigation management, claims operations, and analytics
- Proven leadership, stakeholder management, and process improvement skills
- Strong analytical, communication, and project management capabilities
- Experience with claims management systems, RMIS platforms, and reporting tools
- Must be primarily in the office
Hiring someone like this?
Get your role in front of qualified candidates on Sorce.