Health Plan Claims Operations Manager Jobs (NOW HIRING)

Location:London; New York or Remote U.S

On-Site/Remote| Full-time

Compensation:$150K – $200K • Offers Equity • £110K - £150K

Our client is an AI-native Third-Party Administrator (TPA) that is redefining how claims operations are managed globally. Backed by some of the world's most prestigious investment funds—including Y Combinator, Atomico, and Eurazeo—our client manages claims operations across the US, UK, and Europe for leading MGAs, publicly traded companies, and household insurer names.

By combining elite claims talent with proprietary AI systems, our client delivers drastically faster resolutions, lower leakage, and a fundamentally superior, empathetic customer experience across multiple lines of business (including auto, property, travel, gadget, pet, renters, and liability).

Our client is seeking an ambitious, hands‑on Head of Claims to lead, redesign, and scale their global claims function. This is not a traditional insurance leadership role. This position is designed for an operational and technical strategist who views claims as a product, technical, and operational challenge rather than just a people‑management task. The successful candidate will rebuild claims processes from first principles, establish global standards, and work closely with the founding, product, and engineering teams to integrate cutting‑edge AI workflows.

• Location: This is a full‑time, in‑person (5 days a week) role based out of our client's office in London (UK), New York (US), or their upcoming Dallas (US) location.

Key ResponsibilitiesRebuild Claims Operations from First Principles

• Redesign workflows, escalation structures, QA systems, and claims governance to eliminate unnecessary complexity and operational bottlenecks.
• Build highly scalable claims standards across multiple lines of business and diverse geographic regions.
• Collaborate directly with product and engineering teams to automate workflows and continuously improve operations using AI.

Own Technical Claims Excellence

• Define and maintain technical claims handling standards across auto, property, liability, travel, renters, and other specialized products.
• Establish and oversee governance frameworks for complex, high‑risk, litigated, or precedent‑setting claims.
• Personally review difficult or high‑value cases, making final technical decisions where required.
• Drive continuous improvement across core metrics, including leakage, fraud prevention, recoveries, and audit performance.

Build and Scale Elite Claims Teams

• Recruit, develop, and mentor exceptional Claims Handlers, Team Leads, and QA specialists.
• Elevate the organization's technical capabilities by creating coaching systems, calibration frameworks, and structured technical training.
• Foster an internal culture centered on high standards, extreme ownership, and urgency.

Manage Key Partner and Customer Relationships

• Serve as the senior claims subject matter expert during strategic partner, customer, and carrier meetings.
• Support client launches, external audits, high‑level escalations, and executive‑level insurer discussions.
• Cultivate deep trust with carriers, MGAs, brokers, and key enterprise partners.

Core Outcomes You Will Own

• Overall claims quality, technical accuracy, and claims governance across all active client accounts.
• Leakage reduction, fraud detection, and litigation outcomes.
• SLA performance, backlog management, and low complaint rates.
• QA and external audit scores, as well as recovery performance.
• Team quality, talent development, and high retention rates.

Professional Experience & Background

• 7 to 15 years of claims experience with deep technical expertise across auto, property, and liability lines of business.
• Proven track record of working within a fast‑paced startup or scale‑up environment.
• Extensive experience leading claims operations, managing technical governance, and leading Team Leads or Claims Managers.
• Strong understanding of leakage control, fraud detection, litigation exposure, recoveries, and robust QA frameworks.
• Solid knowledge of regulatory and compliance requirements, with a demonstrated ability to integrate these smoothly into daily operational workflows.
• A legal background is strongly preferred.

Ideal Profile & Cultural Fit

• Driven by a desire to rebuild inefficient, legacy systems rather than managing them from a distance.
• Deeply committed to operational excellence and comfortable making difficult decisions under pressure.
• Enthusiastic about staying close to the day‑to‑day work, including personally reviewing claims when necessary.
• Operates with high intensity, speed, and a strong sense of urgency.
• Prefers clear ownership and action over administrative bureaucracy.

Benefits

• Compensation: Competitive salary positioned beyond the standard industry average.
• Equity: Generous and transparent equity participation, allowing you to share in the company's long‑term success.
• Visa Support: Skilled Worker visa sponsorship is available for qualified candidates in the UK.
• Paid Time Off: 28 days of annual leave plus bank holidays in the UK (20 days of annual leave in the US).
• Flexibility: 30 days of remote work permitted annually.
• Health & Wellness: Comprehensive private health insurance.
• Retirement: Pension contributions provided in line with UK auto‑enrolment requirements (or regional equivalents).
• Culture: Regular company offsites and the opportunity to build a category‑defining company alongside exceptional colleagues.

Commitment to Equality and Accessibility

At MLabs, we are committed to offer equal opportunities to all candidates. We ensure no discrimination, accessible job adverts, and providing information in accessible formats. Our goal is to foster a diverse, inclusive workplace with equal opportunities for all. If you need any reasonable adjustments during any part of the hiring process or you would like to see the job‑advert in an accessible format please let us know at the earliest opportunity by emailing human-resources@mlabs.city.