Title:
Head of Claims Third-Party Administrators (Continental Europe & Latin America)
Company:
Everest Insurance (Ireland) Spain
Job Category:
Claims
Job Description:
About Everest:
Everest is a global leader in risk management, rooted in a rich, 50+ year heritage of enabling businesses to survive and thrive, and economies to function and flourish. We are underwriters of risk, growth, progress and opportunity. We are a global team focused on disciplined capital allocation and long-term value creation for all stakeholders, who care deeply about our impact on communities and the wider world.
Purpose
Everest is seeking an experienced and strategic leader to join our team in Madrid as Head of Claims – Third-Party Administrators (TPA) for Continental Europe and Latin America. This pivotal role will oversee the governance, selection, and management of all A&H and P&C TPAs servicing our markets across these regions.
The successful candidate will be responsible for the full lifecycle of TPA relationships, including onboarding, due diligence (for both new and existing partners), and ownership of all commercial aspects. You will act as the key point of contact for internal stakeholders, ensuring seamless day-to-day operations and swift resolution of any issues.
A core part of this role will be to establish and maintain a robust performance management framework, driving transparency and ensuring all TPAs consistently meet Everest’s high standards.
Scope
- All Claims Vendors that hold a delegation of authority. This includes Third-Party Administrators (TPA) and any other third-party providers to whom Everest delegates a claims handling authority.
Key Accountabilities
- Responsible for the development, implementation, due diligence, risk management, and performance of all Continental European & Latin American Claims Third-Party Administrators, to meet business goals and objectives.
- Contribute towards the long-term strategy of Claims TPAs.
- Managing vendor relationships, performing root cause analysis and resolutions, developing, and monitoring vendor improvement plans.
- Establishes a strong network and foster collaboration with customers, vendors, key stakeholders, and team members. (See Key stakeholder section below).
- Risk Management of all Claims TPAs and other Vendors within scope of this role.
- Focus on owning, facilitating, and resolving any issue linked with a Claims TPA.
- To continuously seek Process Improvement / Efficiencies in the utilization of Claims TPAs.
- Responsible for the management of contracts including the management of cost, service schedules, and performance parameters. Developing contract service specifications, work statements, and terms & conditions, working closely with Everest Legal.
- Present reports to the Claims LOB management team highlighting any trends or issues.
- Develop and own the profile of all Claims TPAs and maintain a central overview of their services, pricing and strengths and weaknesses accessible for all internal stakeholders.
- Maintain an accurate record of all TPA arrangements, documents, and contracts in the Global Claims Vendor Management SharePoint site.
- Ensure the Global Claims Database is up to date and accurate at all times.
Key Stakeholder Relationships
- Underwriters & Client Services - Regular meetings with the various underwriting divisions to support all TPA initiatives and provide expert insights to achieve practical decisions on choosing the right TPA and managing all TPA issues.
- Claims - Regular meetings with claims leaders for liaison over service, customer satisfaction and the auditing of TPAs (QA Team).
- Legal - Work with Associate General Counsel on contracts on legal issues.
- Claims QA - Liaise with Global Claims QA Lead to agree annual audit regime for TPAs.
- Brokers – Liaise with Brokers to manage concerns over TPA performance, but also to promote our TPA Service proposition in securing new business.
- Third Party Administrators – Regular meetings with all TPA account managers (see below), to ensure accounts are running as expected. Quarterly Relationship with our ‘strategic’ TPAs along with the Global Claims Vendor Lead.
- Risk/ Compliance – As it relates to Sanctions, Financial crime and Conduct risk. This will include attendance at Product Oversight Committee (POG) and when required the Conduct Oversight Committee (CoCo). For Continental Europe.
- Finance – As it relates to evaluating the financial stability of all new and existing TPAs.
- Policyholders – manage request for policyholders to self-administer claims.
Skills and competences
- Customer Focus: Ensuring that the internal or external customer’s perspective is a driving force behind strategic priorities, business decisions, organizational processes, and individual activities, crafting and implementing service practices that meet customers’ and own organization’s needs; promoting and operationalizing customer service as a value.
- Decision Making: Identifying and understanding problems and opportunities by gathering, analysing, and interpreting quantitative and qualitative information; choosing the best course of action by establishing clear decision criteria, generating, and evaluating alternatives, and making timely decisions; taking action that is consistent with available facts and constraints and optimizes probable consequences.
- Driving for Results: Setting high goals for personal and group accomplishment; using measurement methods to monitor progress toward goals; tenaciously working to meet or exceed goals while deriving satisfaction from that achievement and continuous improvement.
- Driving Innovation: Creating an environment (culture) that inspires people to generate novel solutions with measurable value for existing and potential customers (internal or external) ; encouraging experimentation with new ways to solve work problems and seize opportunities that result in unique and differentiated solutions.
- Emotional Intelligence Essentials: Establishing and sustaining trusting relationships by accurately perceiving and interpreting own and others’ emotions and behaviour; leveraging insights to effectively manage own responses so that one’s behaviour matches one’s values and delivers intended results.
- Problem Solving: The ability to work with other key stakeholders to identify a problem, take ownership of that problem and provide a recommended solution to the business.
- Supply Chain Management: Ability to think strategically, to initiate and embrace change based on supply chain management first principles. Ability to negotiate professionally and effectively. An understanding of claims supply chain management and claims operations.
Knowledge
- Expert knowledge of the Continental & LATAM TPA market.
- Awareness of Contract and commercial law.
- Knowledge of supply chain/ vendor management.
- A good knowledge of claims processes.
- Market, risk and business awareness.
- Strong problem-solving skills and ability to prioritize multiple projects.
- Requires advanced customer service skills.
- Knowledge and computer literacy of Business software is essential. (Power BI, Qlik Sense)
- Requires expertise in operating Microsoft Office programs.
Qualifications
- Degree & Charted Institute of purchasing & Supply (CIPS)/ Institute of Supply Management (ISM) qualified or another equivalent is preferred.
- At of least 7 years at managing Claims TPAs.
- Claims qualification preferred.
Languages
- English
- Spanish
What if I don’t meet every requirement? At Everest we are dedicated to building an inclusive and authentic workplace. So, if you are excited about this role but your past experience doesn’t align perfectly with every element in the job description, we still encourage you to apply. You may be just the right candidate for this or other roles. Please let us know if you need any accommodations throughout the application or interview process.
Our Culture
At Everest, our purpose is to provide the world with protection. We help clients and businesses thrive, fuel global economies, and create sustainable value for our colleagues, shareholders and the communities that we serve. We also pride ourselves on having a unique and inclusive culture which is driven by a unified set of values and behaviors. Click
here
to learn more about our culture.- Our Values are the guiding principles that inform our decisions, actions and behaviors. They are an expression of our culture and an integral part of how we work: Talent. Thoughtful assumption of risk. Execution. Efficiency. Humility. Leadership. Collaboration. Inclusion and Belonging.
- Our Colleague Behaviors define how we operate and interact with each other no matter our location, level or function: Respect everyone. Pursue better. Lead by example. Own our outcomes. Win together.
All colleagues are held accountable to upholding and supporting our values and behaviors across the company. This includes day to day interactions with fellow colleagues, and the global communities we serve.
Type:
Regular
Time Type:
Full time
Primary Location:
Madrid, Spain
Additional Locations:
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