Health Claims Jobs (NOW HIRING)

Corporate Title: Senior Vice President
Division: CSC - Claims Corporate Solutions - US
Department: Accident & Health Claims - Corporate Solutions
Location: Kansas City, Missouri -- or -- Windsor, Connecticut
** This role is in-office (hybrid). We are not considering teleworkers for this position. Relocation has not been budgeted for this role.
Are you ready to shape the future of Accident & Health claims within a global commercial insurance organization? Join Swiss Re Corporate Solutions as the Head of Accident & Health Claims, where you will lead a transformative stop loss and health claims organization focused on operational excellence, innovation, and superior client service.
This is an opportunity to shape a modern claims function that combines deep technical expertise with process improvement, automation, AI-driven efficiencies, and a customer-first mindset to deliver industry-leading outcomes for clients, brokers, and business partners.
About the Role
As the Head of Accident & Health Claims, you will lead the strategic direction and transformation of our employer stop loss claims organization. You will oversee a high-performing team responsible for delivering accurate, timely, and client-focused claim determinations while driving innovation across claims processes and technologies.
You will play a critical leadership role in shaping our claims processes and operations through operational redesign, automation, AI-enabled workflows, and data analytics initiatives that improve efficiency, scalability, and customer experience. This role requires a visionary leader who can balance operational discipline with creativity and innovation while building strong partnerships internally and externally.
Key Responsibilities

• Lead and develop a high-performing Accident & Health claims organization focused on transformative innovation, efficiency, accountability, collaboration, and service excellence.

• Drive innovative and transformational initiatives focused on scalable claims process improvements, automation and digital workflows.
• Evaluate and implement emerging technologies and AI-enabled capabilities that enhance claims handling, communication, and operational insights.
• Reshape and oversee the end-to-end claims lifecycle including intake, adjudication, reimbursement, escalation management, appeals, and complex claim resolution.
• Leverage data analytics and reporting to identify trends, improve decision-making, mitigate risk exposure, and enhance client outcomes.
• Develop and implement strategies that improve turnaround times, claims accuracy, operational efficiency, and client satisfaction.
• Champion a culture of innovation by encouraging creative problem-solving and introducing novel approaches to claims management and customer service.
• Serve as the senior escalation point for complex, high-dollar, and sensitive employer stop loss claims.
• Partner closely with underwriting, actuarial, legal, operations, and client management teams to align claims strategies with broader business objectives.
• Build strong relationships with brokers, clients, TPAs, vendors, and internal stakeholders while representing Swiss Re Corporate Solutions as a strategic claims leader.
• Ensure compliance with applicable state regulations, policy language, and internal governance standards.
• Lead talent development initiatives, succession planning, and coaching efforts to build a future-ready claims organization.

• Ensure compliance with Global frameworks while localizing them to the US context

About the Team
In this role, you will be part of the Swiss Re Corporate Solutions US Claims Leadership Team and work closely with leaders across underwriting, operations, and client management functions. You will lead a specialized team of Accident & Health claims professionals across multiple locations and collaborate with global and regional stakeholders to advance strategic claims initiatives.
You will serve as a key advocate for innovation and operational excellence, helping shape the future of Accident & Health claims within Corporate Solutions while ensuring exceptional service delivery for our customers and partners.
About You
You are a forward-thinking claims leader with a strong transformational mindset and a passion for innovation, client service, and organizational effectiveness. You are energized by building high-performing teams, creating efficient processes, and leveraging technology to improve outcomes for customers and business partners. You are motivated by challenging traditional approaches and introducing creative solutions that elevate the claims experience.
We are looking for candidates who meet these requirements:

• Minimum 10 years of people leadership experience managing and transforming high-performing claims teams.
• Proven track record implementing claims transformation initiatives, operational efficiencies, and process improvements and mapping.
• Experience with ERISA, HIPAA, cost-containment vendors, TPAs/Networks and applicable insurance regulations and compliance requirements.
• Experience leveraging automation, workflow technologies, and analytics to optimize claims operations and customer service delivery.
• Experience with digital claims platforms, predictive analytics, or AI-enabled claims technologies.
• Experience building scalable claims operations in a growth-oriented environment.
• Ability to translate claims insights into broader business and risk management strategies.
• Demonstrated ability to lead through change and influence cross-functional stakeholders in a matrixed organization.
• Experience managing TPAs and vendor relationships.
• Strong analytical, strategic thinking, and problem-solving capabilities.
• Exceptional communication, relationship management, and executive presence.
• Customer-centric mindset with a passion for delivering superior service experiences.

Skills that may be helpful in this role:

• Knowledge of stop loss claims administration, reimbursement methodologies, plan interpretation, and policy language.
• Background in reinsurance, self-funded health plans, or corporate Accident & Health insurance.
• Professional insurance designations or advanced degree.

Our company uses a hybrid work model requiring at least three days in the office each week, with the option of working onsite full-time if preferred. This position is not eligible for full-time telework, relocation assistance or visa sponsorship.
The estimated base salary range for this role in Kansas City, Missouri -- or --- Windsor, Connecticut is $150,000 to $250,000.
The specific salary offered for this role will consider several factors including but not limited to job location, scope of role, qualifications, complexity/specialization/scarcity of talent, experience, education, and employer budget.
At Swiss Re, we take a "total compensation approach" when making compensation decisions. This means that we consider all components of compensation in their totality (such as base pay, short- and long-term incentives, and benefits offered) in setting individual compensation.
About Swiss Re
Swiss Re is one of the world's leading providers of reinsurance, insurance and other forms of insurance-based risk transfer, working to make the world more resilient. We anticipate and manage a wide variety of risks, from natural catastrophes and climate change to cybercrime. Combining experience with creative thinking and cutting-edge expertise, we create new opportunities and solutions for our clients. This is possible thanks to the collaboration of more than 15,000 employees across the world.
Our success depends on our ability to build an inclusive culture encouraging fresh perspectives and innovative thinking. We embrace a workplace where everyone has equal opportunities to thrive and develop professionally regardless of their age, gender, race, ethnicity, gender identity and/or expression, sexual orientation, physical or mental ability, skillset, thought or other characteristics. In our inclusive and flexible environment everyone can bring their authentic selves to work and their passion for sustainability.
If you are an experienced professional returning to the workforce after a career break, we encourage you to apply for open positions that match your skills and experience.
Swiss Re is an equal opportunity employer. It is our practice to recruit, hire and promote without regard to race, religion, color, national origin, sex, disability, age, pregnancy, sexual orientations, marital status, military status, or any other characteristic protected by law. Decisions on employment are solely based on an individual's qualifications for the position being filled.
During the recruitment process, reasonable accommodations for disabilities are available upon request. If contacted for an interview, please inform the Recruiter/HR Professional of the accommodation needed.
We may use AI-powered tools to support the review and evaluation of applications for this position. These tools provide additional insights to our recruitment teams, but all hiring decisions are carefully reviewed and made by people. To learn more about how we use AI in recruitment and how we handle your personal data, please review our Data Privacy Statement before applying.
Keywords: : Claims Transformation, Claims Process Efficiency, Stop Loss Claims, Accident & Health Claims, Medi
Reference Code: 138728