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Great Eastern Sun

Vice President, Claims and Network

10-12 Years
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  • Posted 15 days ago
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Job Description

This role exists to lead and deliver high‑quality, reliable, and customer‑centric service across Claims, Network, and Customer Service functions. The role is accountable for end‑to‑end service delivery to policyholders and insured members by ensuring effective claims processing, Third Party Administrators (TPAs) performance, and responsive customer support that builds trust and confidence in the organisation.

  • Provide strategic and operational leadership over Claims, TPA, and Customer Service, ensuring consistent, timely, and high quality service delivery to policyholders and insured members.
  • Oversee claims processing operations to ensure accuracy, turnaround time, cost discipline, and compliance with policy terms, medical guidelines, and regulatory requirements.
  • Manage and govern TPA, setting clear service standards, KPIs, controls, and performance management mechanisms to ensure contracted outcomes are met such as service quality, escalation handling, and alignment to cost and utilisation strategies.
  • Oversee customer service operations to ensure clear communication, effective issue resolution, and a positive end to end customer experience across all touchpoints.
  • Drive continuous improvement initiatives to simplify claims and service processes, improve turnaround time, and enhance customer and provider satisfaction.
  • Build, develop, and lead high‑performing teams, establishing clear accountability, capability development, and succession planning
  • Have 10+ years of experience in insurance or healthcare operations, with strong exposure to claims processing, customer service, and TPA management.
  • Possess deep understanding of claims adjudication, medical billing, provider network operations, and service delivery models.
  • Demonstrate proven experience managing outsourced vendors or TPAs, including contract governance and performance management.
  • Have a strong grasp of risk, controls, fraud management, and regulatory requirements related to claims and customer operations
  • Are skilled at stakeholder management, balancing customer expectations, cost, service quality, and operational discipline.
  • Hold a degree in business, healthcare, insurance, or a related field; professional or service excellence certifications are an advantage

To All Recruitment Agencies

Great Eastern does not accept unsolicited agency resumes. Please do not forward resumes to our email or our employees. We will not be responsible for any fees related to unsolicited resumes.

Work Locations

SG-GE Centre

Job

Group Insurance

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About Company

Job ID: 147810461

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