Manager, Operational Excellence,Claims

Reposted 13 Days Ago
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Cambridge, ON
Senior level
Fintech • Insurance • Payments • Financial Services
The Role
The Manager of Claims Operational Excellence leads initiatives in Learning & Development, Quality Assurance, and Customer Experience within the Claims Department. Responsibilities include overseeing training programs, maintaining quality assurance standards, enhancing customer satisfaction, managing the workforce strategy, and driving continuous process improvements for superior service delivery.
Summary Generated by Built In

Next Horizon is here. Fueled by investments in talent and technology, our bold strategy to transform is nearly complete.  

At Gore Mutual, we’ve always set ourselves apart as a modern mutual that does good. Now, we’re proudly building on that legacy to transform our company—and our industry—for the better. 

Our path forward sharpens our focus on business performance, driven by leading technology, innovation and an agile, high-performing culture. With Gore Mutual and Beneva announcing their intent to merge in 2026, we’ll be uniting two well-established, financially strong, and trusted brands to become the strongest mutual insurer in Canada, ensuring Canadians have purpose-driven insurance options for generations to come. Come join us. 

The Manager, Claims Operational Excellence role plays a key role in the performance of the Claims Department at Gore Mutual. This role exists to lead and oversee Learning & Development, Quality Assurance Programs, Customer Experience programs, and Claims Communication. The objectives are to drive continuous improvement, ensure high-quality service delivery, and enhance customer satisfaction. The expected end results include a well-trained and efficient claims team, improved claims processes, and a superior customer experience, all contributing to the company's overall success.

What will you do?

Leading Learning & Development Initiatives

  • Guiding the team in designing and implementing training programs for the claims department.
  • Overseeing the assessment of training needs and development of relevant content.
  • Leading the monitoring and evaluation of the effectiveness of training programs.

Overseeing Quality Assurance Programs

  • Directing the team in developing and maintaining quality assurance standards.
  • Ensuring adherence to regulations, privacy, and compliance standards.
  • Supervising regular audits and reviews of claims processes.
  • Leading the identification of areas for improvement and implementation of corrective actions.

 Enhancing Customer Experience Programs

  • Steering the team in developing strategies to improve customer satisfaction.
  • Overseeing the monitoring of customer feedback and identification of trends.
  • Leading the implementation of initiatives to address customer concerns and improve service delivery.

Overseeing Workforce Management

  • Leading and providing direction on creating and optimizing the workforce management strategy for the claims department.
  • Analysing volumes, trends, forecasting and determining optimal headcount requirements for the claims department in all functions and roles.
  • Oversee compliance with scheduling, phone SLAs and vacation and time off practices.
  • Optimize the use of resources including flexibility of resources based on seasonality, hiring plan, need for coverage focusing on productivity and customer service excellence.
  • Partner and collaborate with Operations WFM resources on enterprise-wide strategy and approach.

Managing Claims Communication

  • Ensuring the team maintains clear and consistent communication within the claims department.
  • Overseeing the development of communication materials and guidelines.
  • Facilitating effective communication between the claims team and other departments.

Driving Continuous Improvement

Leading the team in identifying opportunities for process improvements. · Monitoring performance metrics and adjusting strategies as needed.

What will you need to succeed in this role?

  • Bachelor's degree in relevant field and CIP designation desirable.
  •  5-7 years of experience in the insurance industry, with a focus on claims management.
  • Leadership Experience: Proven experience in leading and managing teams.
  • Project Management: Experience in managing cross-functional projects and initiatives.
  • Analytical Skills: Strong ability to analyze data and metrics to drive performance improvements.
  • Communication Skills: Excellent verbal and written communication skills for effective interaction with internal and external stakeholders.
  •  Problem-Solving Skills: Ability to identify issues and implement effective solutions.
  • Technical Skills: Proficiency in using claims management software and data analytics tools.
  • Customer Focus: Strong commitment to enhancing customer experience and satisfaction.
  • Regulatory Knowledge: Understanding of industry regulations, privacy, and compliance standards.

#LI-HYB

#IND-HP

Gore Mutual Insurance is committed to providing accommodations for people with disabilities during all phases of the recruiting process, including the application process. If you require accommodation because of a disability, we will work with you to meet your needs. If you are selected for an interview and require accommodation, please advise the HR representative who will consult with you to determine an appropriate accommodation.

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The Company
Toronto, Ontario
617 Employees
On-site Workplace
Year Founded: 1839

What We Do

Built on a foundation of financial strength for more than 180 years, Gore Mutual Insurance Company is one of Canada’s first property and casualty insurers. With offices in Cambridge, Toronto and Vancouver, Gore Mutual is a Canadian mutual company offering competitive insurance products through trusted broker partners. Every decision and investment made is anchored in the long-term benefits to customers, members and communities.

Insurance that does good – this is our Purpose. Grounded in our purpose and guided by our core values, at Gore Mutual, we believe that being good and doing good by our employees, customers and broker partners will benefit not only them but also us—which in turn allows us to spread good in our communities and reward the good we see in others. This is what is driving our work to become a purpose-driven, digitally-led national insurer

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