Job Description

Title:
Claims TPA Technical Oversight Lead
Company:
Everest Advisors (Uk), Ltd.
Job Category:
Claims
:
Everest is a global leader in risk management, rooted in a rich, 50+ year heritage of enabling businesses to survive and thrive, and economies to function and flourish. We are underwriters of risk, growth, progress and opportunity. We are a global team focused on disciplined capital allocation and long-term value creation for all stakeholders, who care deeply about our impact on communities and the wider world.
Role Purpose
As the Claims TPA Technical Oversight Lead, you will be responsible for overseeing the performance and providing technical assurance of Third-Party Administrators (TPAs) handling both Accident & Health (A&H) and Property & Casualty (P&C) claims on behalf of the company. You will ensure that outsourced claims operations consistently deliver accurate, timely, and fair outcomes in accordance with regulatory expectations, internal policies, and customer commitments.
In this role, you'll drive technical excellence, operational efficiency, and continuous improvement across a diverse TPA panel within Everest's International Claims operations. You'll also be tasked with maintaining robust oversight frameworks that effectively manage risk.
Key Responsibilities:
Technical Oversight & Quality AssuranceYou will establish and maintain technical claims handling oversight frameworks for both A&H and P&C lines, ensuring compliance with internal standards. You'll conduct deep-dive file reviews, quality assurance assessments, and root-cause analyses of claims handling issues. You'll provide technical guidance to TPAs on complex claims, including policy interpretation, liability, and indemnity decisions. You will monitor reserving accuracy and indemnity spend, escalating material trends and anomalies as needed. You'll ensure that TPAs operate within their delegated authorities, escalating any breaches promptly.

TPA Performance & Relationship ManagementYou'll support the Global Claims Vendor Management team in conducting performance reviews, maintaining scorecards, and running governance meetings for a panel of A&H and P&C TPAs. You will ensure claims are handled efficiently, empathetically, and in line with customer service standards. You'll identify performance gaps, help define corrective actions, and assist the Claims Vendor Management team in tracking improvements. You'll support the onboarding, transitioning, and offboarding of TPAs, as required.

Data, MI & ReportingYou will analyze claims MI across the A&H and P&C portfolios to identify risks, performance trends, and leakage. You'll report on oversight activities, technical reviews, and audit outcomes to senior stakeholders, coordinating with the Global Claims QA team where appropriate.

Stakeholder & Cross-Functional CollaborationYou'll work closely with underwriting, claims vendor management, legal, actuarial, and finance teams to align claims strategies and inform business decisions. You will act as the escalation point for disputes, complaints, or technical challenges related to TPA-managed claims. You'll participate in QA audit reviews and respond to internal/external audit requests related to TPA oversight.

Skills, Experience & Competencies
Essential:You bring solid claims experience across A&H and P&C lines (minimum 7 years PQE), ideally gained within both insurer and TPA environments. You have a strong track record in technical claims oversight, performance management, and audits. You're adept at managing stakeholders and influencing outcomes. You are comfortable interpreting data and producing insightful performance reports.

Desirable:You've worked with international TPA networks or managed cross-border claims oversight. You're familiar with Lloyd's or London Market operating models. You've led or contributed to process improvement or project delivery initiatives. You have experience with claims platforms like Guidewire, ECF, IMR, Trax, etc.

QualificationsA professional insurance qualification (e.g., Dip CII or ACII) is preferred. You hold a degree or possess equivalent experience in insurance, legal, or risk-related disciplines.

Core CompetenciesTechnical Mastery: You bring deep claims expertise across both A&H and P&C products. Governance-Oriented: You have a strong understanding of risk controls and operational assurance. Analytical Thinking: You can translate data into meaningful action. Collaborative: You work well with both internal and external stakeholders. Decisive: You're confident making sound, defensible technical decisions. Customer-Centric: You consistently advocate for fair and positive customer outcomes.

#LI-HYBRIDWhat if I don't meet every requirement? At Everest we are dedicated to building an inclusive and authentic workplace. So, if you are excited about this role but your past experience doesn't align perfectly with every element in the job description, we still encourage you to apply. You may be just the right candidate for this or other roles. Please let us know if you need any accommodations throughout the application or interview process.

Our Culture
At Everest, our purpose is to provide the world with protection. We help clients and businesses thrive, fuel global economies, and create sustainable value for our colleagues, shareholders and the communities that we serve. We also pride ourselves on having a unique and inclusive culture which is driven by a unified set of values and behaviors. Click here to learn more about our culture.Our Values are the guiding principles that inform our decisions, actions and behaviors. They are an expression of our culture and an integral part of how we work: Talent. Thoughtful assumption of risk. Execution. Efficiency. Humility. Leadership. Collaboration. Inclusion and Belonging. Our Colleague Behaviors define how we operate and interact with each other no matter our location, level or function: Respect everyone. Pursue better. Lead by example. Own our outcomes. Win together.


All colleagues are held accountable to upholding and supporting our values and behaviors across the company. This includes day to day interactions with fellow colleagues, and the global communities we serve.
Type:
Regular
Time Type:
Full time
Primary Location:
London
Additional Locations:
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