Manager, Claims Optimization

Manager, Claims Optimization

Job Overview

The Manager, Claims Optimization provides leadership and strategic oversight for Claims transformation, AI enablement, automation, and continuous improvement initiatives.

This role is accountable for identifying opportunities to enhance operational effectiveness, customer outcomes, and employee experience through process optimization, technology enablement, and change initiatives. Leading a team of analysts, the Manager partners closely with operational leaders and key stakeholders to prioritize, govern, and deliver strategic initiatives that achieve measurable business outcomes.

Job Responsibilities

• Develops and leads a team of analysts responsible for business analysis, initiative planning, process improvement, implementation support, and the execution of Claims and EPMO initiatives.
• Manages a portfolio of Claims optimization, transformation, AI, and automation initiatives, ensuring alignment with business strategy, capacity, risks, dependencies, and measurable outcomes.
• Supports the responsible enablement of AI and automation solutions by defining business requirements, validating outcomes, and partnering with technology, data, risk, privacy, and operational stakeholders to ensure appropriate governance and oversight.
• Partners with Claims leaders and stakeholders to identify improvement opportunities, define requirements and outcomes, remove delivery barriers, and support implementation and adoption of Claims optimization initiatives.
• Partners with Claims Operations, Quality Assurance, and other stakeholders translate quality results and performance trends into prioritized improvement, coaching, training, process, and capability-development actions.
• Leads the design and continuous improvement of Claims processes and workflows to support compliance and improve operational effectiveness.
• Lead change initiatives by engaging stakeholders seeking and responding to feedback, addressing barriers to adoption, and reinforcing the behaviours and practices required to sustain outcomes.
• Champions adoption and benefits realization by establishing measurement and reporting approaches, monitoring portfolio performance and outcomes against approved business cases and forecasts, identifying variances and emerging risks, and coordinating corrective actions and recommendations to support informed leadership decisions.
• Contributes to the analysis of operational, financial, quality, member, employee, and initiative-performance trends to identify emerging opportunities and risks, evaluate potential business impacts, and recommend evidence-based actions.

Qualifications

• 5+ years of progressive experience in Claims, operational excellence, business transformation, continuous improvement, or strategic initiatives, including people leadership experience

• Strong proficiency with Microsoft 365 applications and the ability to leverage data, reporting, and analytics tools to support decision-making

• Experience leading cross-functional transformation initiatives involving business, operations, technology, and change management stakeholders, including AI enablement, automation, process improvement, and adoption activities.

• Demonstrated leadership, communication, facilitation, and influencing skills, with the ability to build partnerships, gain credibility, and effectively communicate complex concepts across all levels of the organization.

• Strong business acumen with exceptional analytical, critical thinking, problem-solving, and decision-making skills.

• Post-secondary education in business, insurance, technology, process improvement, or a related discipline.

• Professional designation, certification, or experience in areas such as CIP, Lean, Change Management, Project Management, portfolio governance, business-case development, outcome measurement, or benefits realization is considered an asset.

• LI-hybrid

• Diversity Equity, Inclusion & Belonging

• At Wawanesa, we are committed to Diversity, Equity, Inclusion and Belonging (DEIB) and believe that our strength lies in the diversity of our people – this is supported by having a representative workforce.

• We welcome applications from all qualified candidates, including racialized persons, women, Indigenous Peoples, persons with disabilities, members of the 2SLGBTQIA+ community, gender-diverse and neurodiverse individuals, and anyone who can contribute to the further diversification of thought and ideas.

• We aim to ensure our recruitment process is accessible to all candidates. If you require accommodations during any stage of the recruitment process, please reach out in confidence to [email protected].

• All Wawanesa job applicants are subject to Wawanesa's Privacy Policy.

• Please note that the recruitment process for this position may involve the use of AI tools to screen, assess, or select applicants. All final decisions are taken or reviewed by human recruiters and human hiring leaders in compliance with all applicable legislation.