VP, Claims Adjudication in Abbeyville, Colorado at Jobgether

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a VP, Claims Adjudication based in the United States.

This executive leadership role offers the opportunity to shape and scale a high-performing claims adjudication organization within a fast-growing, technology-driven insurance environment. You will oversee end-to-end workers' compensation claims operations while driving strategic initiatives that improve claim outcomes, operational excellence, and customer experience. Working closely with executive leadership and cross-functional teams, you will influence company-wide decisions related to claims, underwriting, technology, and risk management. This role combines operational leadership, organizational development, and innovation, making it ideal for a seasoned claims executive who thrives in a collaborative, data-driven, and transformation-focused environment. If you're passionate about building exceptional teams and modernizing claims operations, this is an opportunity to make a lasting impact.

• Lead the overall claims adjudication function across multiple jurisdictions, ensuring efficient, compliant, and customer-focused claims operations.
• Develop and execute claims adjudication strategies aligned with broader business objectives and workers' compensation programs.
• Establish policies, procedures, and best practices that improve claim investigations, evaluations, settlements, and operational consistency.
• Oversee the management of complex, litigated, catastrophic, and high-value claims while ensuring optimal financial and customer outcomes.
• Build, lead, and develop a high-performing organization of Directors, Senior Managers, and claims professionals through coaching, succession planning, and performance management.
• Define organizational structures, KPIs, workforce planning, and operational goals that support long-term business growth.
• Manage departmental budgets, financial planning, operational expenses, and performance metrics to drive profitability and continuous improvement.
• Partner with technology, product, and engineering teams to modernize claims operations through automation, digital transformation, and process innovation.
• Collaborate with underwriting, actuarial, finance, legal, compliance, product, and executive leadership on strategic initiatives and enterprise decision-making.
• Ensure compliance with regulatory requirements, oversee risk management practices, and maintain strong relationships with regulatory agencies and industry partners.
• Represent the organization externally as a senior claims expert at industry events, client engagements, and strategic partnerships.

• 15+ years of experience in workers' compensation claims, claims adjudication, and field claims operations.
• 10+ years of progressive leadership experience managing large claims organizations and developing senior leaders.
• Demonstrated success managing second-line leaders, including Directors and Senior Managers.
• Deep expertise in workers' compensation regulations, disputed and litigated claims, and multi-jurisdictional claims management.
• Proven ability to design and execute strategic claims initiatives that improve operational performance, financial outcomes, and customer satisfaction.
• Strong understanding of claims analytics, KPIs, budgeting, forecasting, and performance management.
• Experience leading organizational growth, transformation initiatives, and technology-driven process improvements.
• Exceptional leadership, coaching, and talent development skills with a focus on building inclusive, high-performing teams.
• Strong executive presence with outstanding communication, presentation, negotiation, and stakeholder management abilities.
• Proven ability to collaborate across cross-functional executive teams and influence strategic business decisions.
• Experience representing an organization externally as an industry thought leader is highly desirable.
• Bachelor's degree or equivalent professional experience in insurance, business, or a related field is preferred.

• Salary: $200,000–$260,000 USD annually.
• Performance-based discretionary bonus opportunities.
• Comprehensive medical, dental, and vision healthcare coverage.
• 401(k) retirement plan with company matching.
• Generous paid time off.
• Paid parental and caregiver leave.
• Fully remote opportunity within the United States.
• Competitive compensation package based on experience, skills, and location.
• Career growth opportunities within a rapidly scaling organization.
• Collaborative, innovative, and mission-driven work culture.