CBCS
Director,ClaimsSolutions
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“Director, Claims Solutions at CBCS. Skills: Claims solutions, Vendor management, Financial performance. Select, negotiate, and manage relationships with solution providers. Monitor vendor performance using KPIs and service standards”
What You'll Achieve.
Improve claim outcomes; Support organizational growth; Strengthen client value; Drive adoption across the organization
Industry & Context.
Data insights; Client feedback
Travel approximately 25–30%
What They're Looking For.
Must Have
Bachelor's degree in Business, Risk Management, Insurance, Healthcare Administration, or related field, 10+ years of progressive experience in Property & Casualty claims, Deep knowledge of managed care, litigation support, investigation, and Medicare compliance solutions, Proven vendor management and contract negotiation experience, Experience driving solution utilization and financial performance, Financial analysis and P&L experience
Nice to Have
Master's degree or designations (ARM, CPCU, AIC, CCM, etc.), Experience in a TPA environment, Advanced knowledge of Medicare compliance, Background in program implementation or change management, Familiarity with claims technology platforms
What You'll Do.
and manage relationships with solution providers
Monitor vendor performance using KPIs and service standards
Lead continuous improvement based on data insights and
Maintain SLAs and overall service quality
Develop go-to-market strategies and positioning for claim solutions
Identify emerging trends and technologies to enhance offerings
Partner with sales and marketing to create value
high-value solution packages for clients
Oversee profitability and financial performance of all solution
Develop pricing strategies
and cost-benefit models
Manage budgets and report results to senior leadership
Drive increased utilization
and standardization across clients
Partner with claims leadership to embed solutions into
Identify cross-sell and up-sell opportunities
Lead change management efforts to support internal adoption
Serve as subject matter expert for CBCS claim
Deliver training for claims
Develop best-practice resources and solution documentation
Foster cross-functional collaboration
How You'll Work.
Team & Collaboration
Partner with claims operations; Partner with sales; Partner with marketing; Partner with finance; Partner with executive leadership; Cross-functional collaboration
Full Job Description
The Claims Solution Leader is a senior-level role responsible for the strategy, performance, and growth of CBCS’s ancillary claim solutions portfolio. This leader oversees vendor partnerships, solution design, financial performance, and go‑to‑market execution. The role ensures that CBCS delivers high‑value, best‑in‑class solutions that improve claim outcomes and support organizational growth. This position partners closely with claims operations, sales, marketing, finance, and executive leadership to embed solutions into workflows, strengthen client value, and drive adoption across the organization. Key Responsibilities: Vendor & Solution Management Select, negotiate, and manage relationships with solution providers. Monitor vendor performance using KPIs and service standards. Lead continuous improvement based on data insights and client feedback. Maintain strong SLAs and overall service quality. Strategy & Market Positioning Develop go‑to‑market strategies and positioning for claim solutions. Identify emerging trends and technologies to enhance offerings. Partner with sales and marketing to create value propositions and materials. Build integrated, high‑value solution packages for clients. Financial Leadership Oversee profitability and financial performance of all solution lines. Develop pricing strategies, ROI analyses, and cost‑benefit models. Manage budgets and report results to senior leadership. Utilization & Adoption Drive increased utilization, penetration, and standardization across clients. Partner with claims leadership to embed solutions into workflows. Identify cross‑sell and up‑sell opportunities. Lead change management efforts to support internal adoption. Training & Collaboration Serve as subject matter expert for CBCS claim solutions. Deliver training for claims, account management, and client service teams. Develop best-practice resources and solution documentation. Foster strong cross-functional collaboration. Qualifications: Required Bachelor’s d
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