Claims Communication and Process Enablement Lead

Role Overview

• Responsible for translating Claims strategy, system changes, and workflow design into clear, consistent, and executable practices across the Claims organization.
• Establishes and maintains disciplined standards for workflow documentation, job-level execution, and practical job aids, ensuring that leadership intent is understood, adopted, and executed consistently along frontline teams.
• Partners closely with Claims leadership, Transformation, and Technology to ensure change is implemented with clarity, consistency, and accountability.
• Monitors execution consistency across teams and identifies gaps between defined standards and actual practice.
• Utilizes data, audits, and frontline feedback to prioritize improvements.
• Drives continuous refinement of workflows, job aids, and communication practices.
• Owns end-to-end documentation of critical Claims workflows across Adjusting, Medical Management, and operational support functions.
• Translates complex workflows into clear, structured process maps and execution standards.
• Ensures a singular, consistent voice across all Claims communication related to workflow and execution changes.
• Establishes a repeatable model for change rollout, including sequencing, reinforcement, and adoption tracking. Identifies breakdowns in adoption and drives correction actions.

Requirements

• Bachelor's degree from an accredited four-year college or university.
• Licensed to adjust workers compensation claims in one or more jurisdictions.
• Prosci Change Management Certification or Certified Change Management Professional (CCMP).
• Project Management Professional (PMP).
• A minimum of seven (7) years of experience in workers compensation claims management, claims operations, or closely related functions.
• Demonstrated experience translating complex processes into clear, structured, and actionable guidance.
• Proven experience with Claims Management Systems (CMS).
• Experience supporting or leading operational change initiatives, including system implementations or workflow designs; experience driving adoption, not just awareness.
• Deep understanding of end-to-end Claims workflows, including Adjusting, Medical Management, and regulatory considerations.
• Strong process orientation with ability to simplify complexity without losing substance.
• Ability to convert strategy and system design into practical execution.
• Strong ability to influence without direct authority across multiple levels of the organization.
• Proven ability to bring structure, discipline, and clarity to ambiguous or evolving environments.
• Demonstrated proficiency in Microsoft Office suite of applications, Power BI, and currently adopted proprietary and vendor software programs.
• Ability to master and become proficient in additional proprietary and vendor software programs.
• Ability to think critically and adapt quickly in a flexible and dynamic environment.
• Ability to read, analyze, and interpret Claims laws and regulations, medical documentation, general business periodicals, professional journals, technical procedures, and data from various sources.
• Ability to develop clear, actionable workflows/SOPs maintaining strict adherence to regulations, and effectively communicate them to stakeholders/users both in individual conversations and presentations to groups.
• Ability to solve practical problems and deal with a variety of variables in situations where only limited standardization exists.

Tech Stack

• PMP

Benefits

• Hybrid Work Schedule (up to 2 days work from home upon eligibility)
• Paid Time Off
• Paid Holidays
• Immediate Vesting of Retirement Savings + Company Match
• Group Health Insurance (Medical, Dental, and Vision)
• Life and AD&D Insurance
• Long Term Disability Insurance
• Hospital Indemnity Insurance
• Accident and Critical Illness Insurance
• Flexible Savings Accounts
• Paid Community Volunteer Day
• Employee Assistance Program
• Tuition Reimbursement Program
• Employee Referral Program
• Diversity, Equity and Inclusion Program