Pie Insurance is seeking a Claims Manager to manage our workers' compensation TPA and in-house claims program(s). This position will report to Pie's VP of Claims, and work closely with Pie's TPA as well as our internal claims, legal and compliance, underwriting, and customer success teams to understand, review, and guide decisions regarding claims statutory, regulatory, and quality compliance. As Manager, Claims you will be accountable for the operational results of your assigned region and will utilize operational reports, metrics, and data to analyze program performance to achieve Pie's Claims Department objectives and to drive for exceptional results. You will partner with our TPA leadership and internal claims teams to ensure injured workers are receiving prompt and appropriate medical care, returning to work as effectively as possible, and receiving the very best claims experience. The Manager, Claims is also responsible for leading a group of Team Leads and/or Claims Specialists by providing oversight for regional claim activities, and providing technical and jurisdictional direction on claims adjudication to ensure Pie is providing optimal claim outcomes and experiences for our clients. Additionally, this role is responsible for performance management and development of direct reports. The Manager, Claims will need to be able to pivot quickly in a fast growing company and department.

This role can work in our Denver or DC office or can work in a remote location.

How You'll Do It

• Managing expectations within and outside Pie around the overall Workers Compensation (WC) claims program and/or other small business insurance claims by conducting recurring claims reviews, developing investigation and closure strategies, and ensuring compliance with TPA Service Instructions as well as internal procedures and guidelines.
• Performing monthly analysis to identify key drivers of claim severity and develop mitigating strategies.
• Partnering with our internal teams (Engineering, UX, Finance, Legal, Customer Care, Product, Underwriting) and TPA in order to facilitate diversity in thought and drive to deliver results.
• Completing all monthly, quarterly, and annual State Reporting requirements on time and ensuring compliance.
• Create a humanized claims process and manage the relationship with our TPA.
• Preparing analysis and business case justification for settlements requiring executive approval.
• This is an experienced hire role. As a leader at Pie, you will be as comfortable and content managing projects and programs as you are managing people.
• Team building and leadership are important in this role. You will manage our claims Team Leads and/or Specialists who are focused on providing a top notch claims experience through their daily interactions with all of the important stakeholders in a claim's overall success

The Right Stuff

• High School diploma or equivalent is required.
• 8+ years of workers' compensation experience with a minimum of 3 years of experience managing a TPA or in-house WC claims program directly.
• 3+ years of people management required, and experience leading leaders is preferred.
• Advanced attention to detail, experience and analytical competencies.
• Strong understanding of complexity of WC claims and why our relationship with a TPA is vital to our success.
• Demonstrated Collaboration: Strong ability to articulate issues, questions, and requirements. Must be able to communicate openly, freely, and frequently with colleagues, customers, vendors, and insurance partners. Must confidently and actively participate, listen, and share.
• Demonstrated ability to establish goals and empower your team to achieve them.
• Strong multitasking and organization of work skills, must be able to set priorities by using data, your knowledge and experience to figure things out.
• Keen focus on customer experience, we are looking to provide a first class claims experience. Ability to share perspective to come up with the best possible solutions, whether it's through TPA partnership or on our own.
• Advanced knowledge of workers' compensation, with ability to quickly and readily identify new opportunities for Pie.
• The ability to innovate is a must. Expect to constantly challenge the insurance industry status quo.

Compensation range for position: $110,000 - $150,000

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