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The Director of Client Experience sets the strategy for client engagement and service delivery across the third-party administration (TPA) portfolio. This role builds trusted partnerships with clients, brokers, carriers, and internal executives; translates client priorities into coordinated action; and holds teams accountable for delivering measurable results. The Director leads retention, renewals, implementations, executive reporting, and continuous improvement while identifying opportunities to strengthen partnerships and expand revenue. Success requires executive presence, sound knowledge of claims and TPA operations, disciplined execution, and the ability to influence outcomes across complex, cross-functional environments.
Essential Duties and Responsibilities
Support and lead a high-performing Client Experience team, setting clear expectations, developing talent, and fostering accountability for client and business outcomes.
Serve as the relationship leader for clients, brokers, consultants, carriers, vendors, and other stakeholders, aligning expectations, contractual commitments, and program priorities.
Own end-to-end client service delivery for TPA claims programs, including account management, issue resolution, reporting, contract administration, renewals, implementations, and ongoing communication.
Manage contract administration and renewal activities, including contract profiles, key dates, pricing changes, required approvals, authorized signatures, and coordination with finance, legal, compliance, and leadership.
Own the development, approval, maintenance, and distribution of client-specific service instructions, including contacts, authority levels, reporting schedules, service standards, escalation protocols, and special handling requirements.
Act as the senior escalation point for complex client concerns, service issues, claim handling inquiries, compliance-related matters, and operational challenges.
Partner with claims operations to monitor claim performance, claim quality, closing ratios, reserves, litigation trends, turnaround times, diary compliance, responsiveness, and adherence to service level agreements.
Coordinate with carriers, excess insurers, medical management vendors, bill review providers, legal partners, loss control resources, and technology vendors to support client program objectives.
Develop and implement standardized TPA client service procedures, workflows, communication standards, claim review protocols, stewardship processes, and escalation practices.
Analyze client feedback, claim trends, loss data, service metrics, and performance reports to identify improvement opportunities and recommend practical solutions.
Shape retention and growth strategy in partnership with sales, business development, and executive leadership; to support, qualify opportunities, strengthen proposals and prepare RFP and RFI responses, contribute to pricing strategy, identify organic growth and cross-selling opportunities within existing client and broker relationships.
Lead full cycle onboarding and implementation of new TPA clients, including service calendars, trust-account or prefunding coordination, invoicing setup, data conversion, system configuration, client access, reporting, coding, regulatory reporting setup, staffing assignments, kickoff meetings, operational readiness, and post-implementation follow-up.
Coordinate client technology and reporting needs, including claims-system access and training, custom reports, scheduled reporting, data feeds, conversions, reconciliations, and data-quality validation.
Establish account service calendars and governance routines; document decisions, owners, and deadlines; monitor aging items and service commitments; and escalate missed deliverables or unresolved risks.
Coordinate staffing transitions that affect clients, including communication plans, required client approvals, candidate qualifications and interviews, interim coverage, and continuity of service.
Partner with finance and operations on trust accounts, prefunding, invoicing, fee schedules, contract pricing, payment reporting, and resolution of related client financial inquiries.
Coordinate client, carrier, broker, and internal audits; track corrective actions; and confirm that reporting, compliance, and claim-handling commitments are completed.
Prepare and deliver client business reviews, claim review materials, stewardship reports, performance dashboards, renewal support summaries, and executive presentations.
Ensure client service practices align with applicable laws, insurance regulations, contractual requirements, privacy obligations, carrier guidelines, and internal TPA policies.
Operate within, and escalate, technical claim issues while respecting delegated authority and established; do not independently direct claim outcomes, waive defenses, provide legal, regulatory, and claim-handling protocols, directing appropriate escalation of matters that require technical, legal advice, or exercise settlement authority unless expressly authorized.
Set departmental priorities and direct staffing, resources, performance standards, service commitments, budget stewardship responsibilities, and client satisfaction objectives to achieve portfolio and organizational goals, as assigned.
Establish performance standards and metrics for team members, including client satisfaction, renewals, new client onboarding, client change requests, implementations, escalations handling and resolution, reporting accuracy, service-level compliance; intervene decisively when results fall below expectations with corrective actions.
Champion a culture of ownership, responsiveness, professional judgment, claims advocacy, and continuous improvement.
Measurable Success Metrics
Maintain annual client retention at or above 95%, excluding planned exits or accounts outside the role’s control.
Achieve an average client satisfaction score of at least 4.5 out of 5, or an equivalent established benchmark, with documented action plans for scores below target.
Complete at least 95% of renewals, contract amendments, and required approvals by the established due date.
Deliver at least 90% of new-client implementations by the agreed launch date, with no material unresolved operational, financial, reporting, or system issues at go-live.
Acknowledge urgent client escalations within one business day and resolve or establish a documented action plan for at least 90% within five business days.
Deliver at least 98% of scheduled client reports, stewardship materials, and business-review deliverables accurately and on time.
Maintain at least 95% compliance with contractual service levels, client-specific instructions, reporting schedules, and documented follow-up commitments.
Close at least 90% of audit findings and corrective actions by the agreed deadline, with no repeat material findings attributable to client service oversight.
Maintain complete and current client profiles, service instructions, contract records, and account calendars for 100% of assigned accounts, reviewed at least annually and after material changes.
Identify, document, and advance qualified retention, cross-selling, or organic growth opportunities in alignment with annual revenue goals established by leadership.
Required Qualifications
Bachelor’s degree in Business Administration, Risk Management, Insurance, Healthcare Administration, Human Resources, or a related field; equivalent experience may be considered.
Minimum of 8 years of progressive experience in client services, account management, claims administration, third-party administration, insurance brokerage, carrier operations, risk management, or a related service environment.
Minimum of 3 years of leadership experience managing client-facing teams in a TPA, claims, insurance, or risk management setting.
Demonstrated experience managing complex employer, broker, carrier, or consultant relationships and resolving escalated service or claims-related issues.
Deep understanding of TPA operations, claims administration, contractual service levels, executive reporting, stewardship, claim review practices, compliance expectations, and client communication standards.
Working knowledge of one or more claims lines, such as workers’ compensation, general liability, property, auto, disability, leave administration, or employee benefits.
Excellent verbal, written, presentation, and executive communication skills, including the ability to explain claims and service issues clearly to clients and internal stakeholders.
Proven ability to analyze loss data, claim trends, service metrics, and operational performance to develop practical recommendations.
Strong organizational, problem-solving, project management, and cross-functional leadership skills.
Proficiency with Microsoft Office applications and experience using claims management, RMIS, CRM, or client service platforms.
Preferred Qualifications
Experience working for a third-party administrator, claims management organization, insurance brokerage, carrier, self-insured employer program, or risk management services firm.
Experience supporting self-insured, high-deductible, loss-sensitive, or administratively serviced insurance programs.
Experience supporting municipalities, public agencies, or other public-sector entities, including public contracting, statutory claim requirements, governing board or council processes, and coordination with public counsel.
Knowledge of workers’ compensation, general liability, auto liability, property, professional liability, disability, leave administration, employee benefits, or other applicable claims lines.
Experience leading claim reviews, client stewardship meetings, quarterly business reviews, renewal strategy meetings, or executive-level client presentations.
Professional designation or certification related to claims, insurance, risk management, benefits, or project management is a plus, such as ARM, AIC, CPCU, WCP, SHRM, CEBS, or PMP.
Key Competencies
TPA client relationship management and executive presence
Claims advocacy and operational service orientation
Leadership, coaching, and team development
Claims administration knowledge and sound technical judgment
Service excellence, client retention, and renewal support
Strategic thinking, workflow design, and process improvement
Problem-solving, negotiation, and conflict resolution
Data-driven claims and service performance management
Executive influence and cross-functional leadership across claims, sales, compliance, finance, technology, carriers, brokers, and vendors
Decisive prioritization and disciplined execution in a fast-paced, client-focused TPA environment
Work Environment and Expectations
Travel as needed to strengthen client partnerships, lead stewardship and executive presentations, support industry engagement, and align internal teams.
Exercise sound judgment and discretion in managing sensitive client, financial, contractual, and claims-related information.
Provide leadership outside standard business hours when significant client or operational matters require timely executive attention.
