VP, Claims Operations

Posted Yesterday
Be an Early Applicant
La Jolla, Placentia, CA, USA
In-Office
150K-215K Annually
Senior level
Insurance
Reimagining specialty property and casualty insurance with creative solutions that provide better protection.
The Role
The VP of Claims Operations will lead and enhance claims performance through KPIs, governance programs, and quality assurance, focusing on operational excellence and vendor accountability.
Summary Generated by Built In

Why choose Palomar?

Palomar is a rapidly growing and innovative insurer focused on providing specialty insurance to residential and commercial customers. Palomar welcomes the best and brightest to our thriving team. Guided by an entrepreneurial spirit, Palomar is building a dynamic and diverse team.

Join a company built on a culture of agility, innovation and authenticity that delivers peace of mind and protection to individuals and businesses impacted by adversity.

Want to learn more about our exciting journey? https://ir.plmr.com/corporate-profile/default.aspx

We are Hiring!

Location: La Jolla, CA; Edina, MN; Remote


The Details:

We are seeking a strategic and hands-on Vice President, Claims Operations to join our specialty property and casualty insurance claims leadership team. This executive will strengthen claims operating discipline by building key performance indicator driven reporting, defining claims analytics requirements, and leading internal and third-party administrator file review/quality assurance programs. The Vice President will translate operational insight into meaningful process improvement, stronger vendor accountability, and scalable claims excellence - improving consistency, compliance, reserving discipline, and overall claim outcomes.

 

What will you do:

  • Drive claims operations performance by governing and benchmarking TPAs, strengthening vendor accountability, and translating analytics into clear operational and financial strategy.
  • Build and lead KPI-driven reporting by defining analytical requirements and tracking claims KPIs, dashboards, and metrics to measure effectiveness and drive continuous improvement.
  • Partner with TPAs on corrective actions to address performance gaps, emerging trends, and control issues.
  • Establish a formal TPA governance and Quality Assurance program - scorecards, performance reviews, operating cadence/escalations, and standardized file review criteria, scoring, and reporting - to ensure consistent claims quality.
  • Conduct regular operational reviews with TPAs to evaluate results against service expectations, contractual standards, KPIs, and claim-handling requirements.
  • Lead internal and TPA claims file reviews to assess handling quality and discipline, including coverage analysis, investigations, reserving, documentation, litigation and vendor management, and compliance with company standards.


What we are looking for:

  • 10+ years of progressive claims experience, preferably within an insurer overseeing TPAs in Property & Casualty lines. Experience with Specialty lines of business is a plus.
  • Bachelor's degree required.
  • Strong knowledge of claims processes, regulatory compliance, and industry best practices.
  • Deep understanding of claims life cycle, reserving practices, LAE drivers, and claims financial metrics.
  • Experience defining analytical requirements for claims-related reports, KPIs and metrics to drive operational performance.
  • Experience designing and conducting TPA or claims file reviews, or quality assurance assessments across internal claim teams and/or TPAs.
  • Strong analytical skills with the ability to translate data into operational and financial strategy.
  • Excellent negotiation, communication, and executive presentation skills.
  • Proficiency in claims management systems and data reporting tools.


We love people who want to: 

  • Build strong relationships through transparency, trust, and respect for each other.
  • Work in an agile environment, with a resilient mindset to find creative solutions to challenges.
  • Collaborate and celebrate diverse perspectives, promoting inclusivity and equality.
  • Do the right thing with strong conviction and integrity.
  • Be bold and innovative to help make an impact.
  • Demonstrable track record of working autonomously and driving progress
  • Be intellectually curious, think creatively, and pragmatic

 

If you thrive in a dynamic environment, and like working with happy, authentic, talented people, you'll enjoy a career with Palomar!

 

  • What will you get in return?
  • Full Suite of Medical Benefits 
  • Long Term Financial Incentives – STOCK! 
  • 401k with 3.5% Automatic Fully Vested Employer Contributions 
  • Competitive PTO + Holiday Program
  • Lifestyle Spending Allowance
  • Professional Development Assistance  
  • Career Exploration Opportunities
  • Regular company-wide social events (even virtually!)
  • To learn more visit us at www.plmr.com

 

Diversity at Palomar

At Palomar, we are committed to diversity, equality and inclusion in all facets of the organization. We have built an open culture that celebrates the diversity of our workforce, while actively championing equality and inclusion practices that make us a company people want to work with and work for.

We believe that diversity, equality and inclusion yields greater organizational creativity and productivity, which helps us serve our customers and partners more effectively.  Delivering on our diversity commitment returns greater value to our shareholders and ultimately makes a positive impact to the communities in which we do business and to the people who live in them

 

#PalomarPride #Insurancejobs #hiring

Accommodations:

Palomar will consider reasonable accommodations to ensure a qualified applicant with a disability can be considered for the position. Palomar will also consider necessary modifications to the physical work environment, or to the way a job is usually performed, so an individual with a disability can perform the essential functions of the position. Additional accommodations will be considered that enable an employee with a disability to enjoy equal benefits and privileges of employment like those that are enjoyed by other employees without disabilities.

For more information about our company, visit us at www.plmr.com. Palomar is an Equal Opportunity Employer.

No phone calls or agency solicitation please

 

CCPA Job Applicant:

 

Pay Range: $$150,000 - $215,000 + Bonus Potential & Participation in our Competitive Long-Term Incentive (LTI) Program.

 

The above pay range is for all US-based roles based on function and level, benchmarked against companies of similar size and scope. To be compliant with local legislation as well as provide greater transparency to candidates, we disclose salary ranges on all job postings regardless of the desired job location. We also offer a competitive annual discretionary bonus program and the opportunity for annual long-term incentive stock grants. In addition, we offer a highly competitive benefits package. Final offer amounts are determined by multiple factors, including candidate experience and qualifications, and may vary from the amounts listed above

 

 

 

 

Top Skills

Claims Management Systems
Data Reporting Tools
Am I A Good Fit?
beta
Get Personalized Job Insights.
Our AI-powered fit analysis compares your resume with a job listing so you know if your skills & experience align.

The Company
HQ: La Jolla, CA
168 Employees
Year Founded: 2014

What We Do

As leaders in risk management for earthquakes, hurricanes, floods and other disasters, we take a fresh perspective on specialty property insurance. Palomar was founded in 2014 by seasoned insurance leaders with a vision for a better way to protect individuals and businesses with innovative specialty property insurance solutions. Our leadership team combines extensive insurance experience and expertise in specialty underwriting, reinsurance, program administration, distribution and analytics. Every home, every business and every neighborhood is unique so Palomar uses more accurate risk measures and an extensive partner network to write tailored, geographically differentiated policies. Our goal is to provide every customer with economic resiliency.

Similar Jobs

Tapestry - Coach and Kate Spade Logo Tapestry - Coach and Kate Spade

Sales Associate II

eCommerce • Fashion • Other • Retail • Sales • Wearables • Design
Hybrid
Valley Center, CA, USA
16000 Employees
15-24 Hourly

Tapestry - Coach and Kate Spade Logo Tapestry - Coach and Kate Spade

Seasonal Stylist

eCommerce • Fashion • Other • Retail • Sales • Wearables • Design
Hybrid
Arvin, CA, USA
16000 Employees
15-20 Hourly

Tapestry - Coach and Kate Spade Logo Tapestry - Coach and Kate Spade

Sales Associate II-3

eCommerce • Fashion • Other • Retail • Sales • Wearables • Design
Hybrid
Valley Center, CA, USA
16000 Employees
15-24 Hourly

Airwallex Logo Airwallex

Director GTM Engineering

Artificial Intelligence • Fintech • Payments • Business Intelligence • Financial Services • Generative AI
Remote or Hybrid
San Francisco, CA, USA
2000 Employees

Similar Companies Hiring

Globe Life Thumbnail
Insurance • Financial Services
McKinney, TX
3000 Employees
MassMutual India Thumbnail
Insurance • Information Technology • Fintech • Financial Services • Big Data
Hyderabad, Telangana
Granted Thumbnail
Mobile • Insurance • Healthtech • Financial Services • Artificial Intelligence
New York, New York
23 Employees

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account