Manager, Claims QA CL

Nationwide Columbus , OH 43216

Posted 2 months ago

If you're passionate about helping people protect what matters most to them, as well as innovating and simplifying processes and operations to provide the best customer value, then Nationwide's Property and Casualty team could be the place for you!

Compensation Grade: G4 (Manager)

  • Claim technical experience in General Liability, Transportation, Employment Practice Liability, Professional programs, Surety, Financial products, Business Management Risk, E&O, D&O, and continuing torts claims, SIR or program claims experience a plus. With emphasis on Business Management Risk to include Employment Practice Liability and New York Labor Law.

  • Seeking candidate who demonstrates: professionalism and poise; confidence; leadership skills (either formal or informal); conflict management ability; clear and concise articulation; ability to learn quickly and "on the fly" (systems and applications)

  • This position requires claims handling background, however, it is an auditing role (no direct claims handling involved)

  • 5-7 years E&S experience preferred

  • This position will involve travel

Job Description Summary

Manages, organizes, and leads the Claims Quality Assurance process for various commercial lines claims zone operations and other functional areas as directed. Measures performance opportunities through use of file reviews/re-inspections, calibrations and/or audit processes and promotes On Your Side Service. Performance results and improvement opportunities are regularly communicated to various levels of senior and state/claims leadership.

Job Description

RELATIONSHIP: Reports to Director/Associate Director

DIRECT REPORTS: Directly manages claims quality assurance consultants/specialists

1.Completes special projects and reviews as needed.
2.Supports claims performance improvement via participation in special claims initiatives, as identified by leadership.
3.Identifies and develops action items based on performance reviews.
4.As requested, collaborates with claims leadership and training to ensure that necessary training is developed and implemented in response to trends identified by the quality assurance process.
5.Provides assistance to other managers and claims managers with the utilization of performance review computer/data programs and reports.
6.Analyzes performance data for credibility and accuracy; creates and prepares relevant narrative and analysis reports regarding performance findings and trends. Ensures the proper identification of performance opportunities.
7.Ensures and measures calibration skills among file reviewers. (Is this direct reports or reviewers that do not report to this position)
8.Coordinates and confers with claims management to address and resolve inquiries and concerns.
9.Acts as an advisor to provide input to claims management and leadership regarding claims technical performance. Provides input to the development of methodologies and practices to improve loss results.
10. Delivers a positive On-Your-Side customer service experience to internal, external, current and prospective Nationwide customers.
11. Participates in the development of salary budgets. Is accountable for adhering to the operating budget of assigned team.
12. Manages and assumes the leadership role for the quality assurance process in multiple operations. Manages, directs and oversees the successful completion of claims performance reviews to ensure accurate and quality data. Ensures the accuracy and quality of the findings.
13. Identifies, develops and retains high potential/high performing associates who have the potential for or are ready to fill critical roles in the organization.
14. Responsible for the management of associates including performance management, salary planning and administration, training and development, workflow planning, hiring and placement, and disciplinary actions.
15. Other duties as assigned.


Education: Undergraduate degree or equivalent experience. Successful completion of required claims certification schools/courses preferred.

Licenses/Designations: State licensing where required. Studies toward professional designations, such as ARE, CPCU, IIA, and/or AEI preferred.

Experience: Eight to ten years of progressive experience in commercial lines property, casualty and/or material damage claims.

Claims management/supervisory experience preferred. Claims consulting experience preferred.

Requires advanced knowledge of claims best practices, technical claims operations, procedures and claims performance strategies, day-to-day claims operations, as well as Claims Best Practices.

Requires advanced knowledge of claims operating practices, and claims litigation laws and regulations. Requires in-depth knowledge of Nationwide's commercial lines product offerings, underwriting practices, and pricing strategies.

Skills/Competencies: Proven ability to meet customer needs and provide exemplary service by informing customers of the claims process and ensuring a positive customer experience.

Proven presentation skills and demonstrated ability to analyze and evaluate data relative to claims technical performance reviews. Ability to assess and make determinations regarding problematic areas and advise leadership of action plans. Proven ability to make independent decisions regarding claims file performance.

Demonstrated problem solving skills including the ability to diagnose and recommend solutions. Demonstrates strong but flexible standards and can be perceived as balanced based on the conflicting demands of the position. Ability to be flexible and handle multiple projects.

Excellent oral and written communication skills used to interact with all levels of associates and excellent conflict management skills. Ability to coordinate, delegate and lead training for all levels of claims associates and management. Proven organizational skills to effectively prioritize work and act in a consulting role. Computer skills required.

Values: Regularly and consistently demonstrates the Nationwide Values and Guiding Behaviors. Staffing Exceptions to the above Minimum Job Requirements must be approved by Business Unit Executive and Human Resources.


Working Conditions: Normal office environment or remote office environment.

May require ability to sit and operate telephone and personal computer for extended periods of time. Representatives may be required to operate an automobile and have a valid driver's license with a safe driving record. Must be willing to work irregular hours and to travel with possible overnight requirements.

Must be available to work catastrophes (CAT) requiring travel to CAT sites with multiple on-site responsibilities and/or for extended periods of time. Ability to work extended hours as required.

ADA: The above statements cover what are generally believed to be principal and essential functions of this job. Specific circumstances may allow or require some people assigned to the job to perform a somewhat different combination of duties.

Overtime Eligibility: Exempt

Job Evaluation Activity: 8/2012 KLG


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Manager, Claims QA CL