Claims Operations Compliance and Data Manager

Argo Group is a leader in specialty insurance with a vibrant culture built on respect, equality, wellness and opportunity. We’re an innovative organization that’s small enough to be agile and big enough to make a difference in our industry.  

Our hybrid workplace is continuously evolving to ensure all employees feel: 

• Comfortable bringing their whole selves to work. 
• Confident that they will be treated respectfully. 
• Recognized for their performance and provided with equal opportunities to succeed. 

At Argo, skill meets opportunity. If you’re wired to raise your hand and ask, “Where can I help?”, you’ll thrive with us. 

We are looking for a highly capable Claims Operations Compliance and Data Manager to join our Claims Operations Compliance and Data team and work from any US Argo office or remotely as a home-based employee anywhere in the United States.  This role will manage a team of Claims Data Analysts. The team’s mission includes but is not limited to building and distributing claims reports and visualization.

The primary duties and responsibilities of the role are:

• Working under limited technical direction and within broad limits and authority, to build and distribute claims reports and visualization reports on assignments potentially with significant impact on departmental results.
• Solving difficult problems that requires an understanding of a broader set of issues.
• Act as the internal Claims liaison for CMS Medicare. The role will include a focus on cleanup, education, ongoing claim data lineage and the development of a business glossary.
• Drive continuous improvement through CMS focused initiatives involving our employees, processes and technology.
• Ensure 100% claims compliance with regulatory changes/ updates and develop a centralized repository for claims best practices
• Implement process related solutions to maintain and enhance regional regulatory compliance and reduce fines & penalties
• Work with the VP, National Claims Operations and key Claims personnel to quantify all Data Quality initiatives
• Design a Data and Analytics Road map and strategy for Claims Operations Compliance and Data in line with Claims Leadership
• Provide business input on data lineage and data governance to ensure consistency in reporting across systems
• Support the delivery of regional plans within the framework established by the Claims Leadership Team
• Successfully supervise and provide training, mentoring, and technical oversight to a small team of Claims Data Analysts. The team primarily consists of individuals with advance knowledge and experience that build and distribute claims reports and visualization Management of the team includes:

• • Ensuring performance objectives and metrics are in place and being met to support and meet department goals.
  • Providing direction, leadership and training.
  • Providing advice and oversight.
  • Managing expenditures for the team to budget / plan.

• Supporting the selection process to hire and retain professionals that consistently demonstrate appropriate technical expertise, maturity and a professional commitment to excellence and customer service.

Core qualifications and requirements for this position include:

• Must have good business acumen (i.e. understand how an insurance company works and makes money, including how this role impacts both Argo Group and our customers’ ability to be profitable).
• A working knowledge of the claims business environment in order to effectively discuss and prioritize reporting needs though:
  • Minimum 5 years claims experience in a Regulatory/ Compliance capacity, including Medicare compliance experience.  Prior experience with data profiling software is required, specifically:

• Ability to read, understand and develop SQL code
• Experience with data mining and profiling along with an ability to perform analysis across data groups

• Experience supporting specialty programs and partnering with TPAs, MGAs, or other outside vendors preferred.
• Bachelor’s degree from an accredited university strongly preferred.  Two or more related designations or four additional years of related experience focused on data and compliance or other equivalent experience working with data gathering and analysis.
• Proficient in MS Office Suite (particularly Access and Excel) and other business-related software.
• Prior experience with data profiling software is required, specifically:

• • Ability to read, understand and develop SQL code / MS SQL Server / Oracle.
  • Experience with data mining and profiling along with an ability to perform analysis across data groups.
  • Understanding of claims compliance reporting and analysis.
  • Familiarity with ISO and NCCI or any other statistical agent preferred.
• Ability to ability to build consensus.
• A strong focus on execution in getting things done right.  Proven ability to consistently produce and deliver expected results to all stakeholders by:
• Finding a way to achieve success through adversity.
• Being solution (not problem) focused
• Thinking with a global mindset first.
• Strong focus on selection – determined to have the right people who do the best job. 
• Successful traits (flexibility, ability to thrive in change, being resourceful on your own) necessary to work in a fast-paced environment that is evolving constantly.
• A team builder, someone who understands that success is dependent upon the performance of the team and not individual team members.  Creates strong morale and spirit within the team: shares wins and celebrates success as a team
• Dedicated to developing talent.  Understands and is committed to teaching technical skills and developing people so that they realize their full potential.
• Ability to establish mentoring relationships with key employees and participates in the development of succession and training plans for all positions.  Empowers others by driving decision-making, authority, and resources to trusted employees and providing stretch assignments.
• Ability to identify and resolve conflicts in a timely, objective manner, using sound judgment to reach a solution.
• Independent decision maker – takes full responsibility for making decisions keeping risk and compliance at the center of the process.  Makes decisions with data driven tools and information.
• Shows care and concern by expressing curiosity authentically, being self-aware, constantly engaging input from others, and collaborating with ease.
• Ability to build rapport and foster collaborative, productive relationships with business partners and organizational peers with a focus on timely and meaningful exchanges of information and providing value-added solutions.
• The courage to offer and support others to express different opinions and ideas, regardless of popularity or immediate acceptable.
• Demonstrated ability to prioritize workload and handle multiple projects simultaneously.
• Strong customer focus – with the ability to work directly with internal and external partners
• Must have excellent communication skills and the ability to build lasting relationships.
• Exhibit natural curiosity.
• Desire to work in a fast-paced environment.
• Excellent evaluation and strategic skills required.
• Must possess a strong customer focus.
• Effective time management skills and ability to prioritize workload while handling multiple tasks and deadlines.
• Must work independently and demonstrate the ability to exercise sound judgment.
• Demonstrates inner strength.  Has the courage to do the right thing and demonstrates it on a daily basis.
• Intellectual curiosity.  Consistently considers all options and is not governed by conventional thinking.
• The ability to read and write English fluently is required.
• Must demonstrate a desire for continued professional development through continuing education and self-development opportunities.

About Working in US Claims at Argo Group

• Argo Group does not treat our claims or our claims professionals as a commodity. The work we offer is challenging, diverse, and impactful.
• Our Adjusters and Managers are empowered to exercise their independent discretion and, within broad limits and authority, be creative in developing solutions and treat each case as the unique situation it is. 
• We have a very flat organizational structure, enabling our employees have more interaction with our senior management team, especially when it relates to reviewing large losses. 
• Our entire claims team works in a collaborative nature to expeditiously resolve claims.  We offer a work environment that inspires innovation and is open to employee suggestions. We even offer rewards for creative and innovative ideas. 
• We believe in building an inclusive and diverse team, and we strive to make our office a welcoming space for everyone. We encourage talented people from all backgrounds to apply.

PLEASE NOTE:  At this time, Argo Group will not sponsor an applicant for employment authorization for this position.

If you have a disability under the Americans with Disabilities Act or a similar law and you wish to discuss potential accommodations related to applying for employment at Argo Group, please contact our Benefits Department at 210-321-8400. 

To all recruitment agencies:  Unless you have been requested to work on this position, or other positions with Argo Group, please do not forward any resumes to Argo Group employees.   Argo Group is not responsible for any fees related to unsolicited resumes. 

Argo Group International Holdings, Ltd. (NYSE: ARGO) is a global multiline underwriter of specialty insurance and reinsurance products in the property and casualty market. We help power the businesses that drive the world economy, offering a comprehensive line of high-quality products and services designed to meet the unique coverage and claims-handling needs of our clients. We foster an inclusive culture that embraces diversity and design thinking, relies on innovation and agility, promotes collaborative service delivery, offers frequent, integrated communication and values authentic recognition of excellence. View our 2022 Environmental, Social & Governance Report to learn more about Argo.    

We are an Equal Opportunity Employer. We do not discriminate on the basis of age, ancestry, color, gender, gender expression, gender identity, genetic information, marital status, national origin or citizenship (including language use restrictions), denial of family and medical care leave, disability (mental and physical) , including HIV and AIDS, medical condition (including cancer and genetic characteristics), race, religious creed (including religious dress and grooming practices), sex (including pregnancy, child birth, breastfeeding, and medical conditions related to pregnancy, child birth or breastfeeding), sexual orientation, military or veteran status, or other status protected by laws or regulations in the locations where we operate. We do not tolerate discrimination or harassment based on any of these characteristics. 

Our Benefits

Developing our employees professionally and personally strengthens our organization.
Argo Group offers an attractive Total Rewards package that includes:

• A culture that recognizes performance and empowers employees to excel, offering competitive compensation and merit driven profit sharing.
  
  
• Flexible workplace policies that support employee well-being include compressed hours, flex-time, job-sharing, remote work, sabbatical leave, holiday and summer hours.
  
  
• Comprehensive health, wellness, and financial planning options that employees can tailor to meet their personal and family needs.   In addition to traditional health and wellness plans, benefits include retirement savings, matching 401K (US-based employees), generous paid time off (PTO), paid caregiver and parental leave, employee assistance program (EAP), an employee stock purchase plan (ESPP) offering a 15% discount, and an array of voluntary benefits.  
  
  
• Argo Academy, a digital and instructor-led platform that offers continuous learning and professional development – Training magazine lists Argo among the Training "Top 125" Companies.   Argo encourages career mobility and continuing education to pursue and maintain professional and industry designations, in addition to traditional university and higher education programs.
  
  
• An inclusive culture that develops and sponsors diverse teams, encourages cross-functional engagement and collaboration, builds community through employee resource groups (ERGs), and provides an environment that welcomes ongoing dialogue, creative innovation, professional and personal development.
  
  
• Active community outreach and volunteer programs in addition to matching charitable gifts by 100%.
  
  
• A generous Employee Referral program that has resulted in 25% of all new hires this year.