Manager, Carrier Operations Quality Management

Accountabilities:

Quality assurance and audit leadership: Lead quality management, auditing, testing, and oversight programs across delegated insurance operations. Develop and maintain a risk-based quality assurance framework that supports compliance, consistency, and operational effectiveness.
Operational audits and performance monitoring: Oversee audits and reviews covering claims, policy administration, licensing, appeals, customer service, fulfillment, and related activities. Monitor quality metrics, identify trends, assess operational risks, and recommend improvements based on audit findings.
Reporting and regulatory oversight: Prepare and present clear reports on audit outcomes, emerging risks, performance trends, and remediation progress. Support regulatory reviews, market conduct examinations, compliance assessments, and other carrier oversight initiatives.
Compliance and risk management: Partner with business leaders and delegated administrators to ensure adherence to regulatory requirements, contractual commitments, carrier standards, and internal policies. Act as an escalation point for significant quality, compliance, and operational risk issues.
Corrective actions and continuous improvement: Oversee the development, implementation, and validation of corrective action plans. Evaluate processes, workflows, internal controls, and system enhancements to identify improvement opportunities and strengthen operational effectiveness.
Policy and process development: Maintain quality management policies, procedures, audit standards, and training materials. Support the testing and validation of new processes, technologies, and regulatory changes to ensure continued compliance.
Team leadership and development: Lead, coach, and develop a high-performing Quality Management team. Manage priorities, workloads, and performance to ensure timely completion of audits and reviews while supporting recruitment, onboarding, professional development, and succession planning.
Cross-functional collaboration: Build strong relationships with internal stakeholders, third-party administrators, vendors, and external business partners to promote accountability, resolve issues, and embed a culture of continuous improvement.
Requirements:
At least 7 years of professional experience in insurance operations, quality assurance, auditing, compliance, claims, policy administration, or a related field.
Demonstrated experience leading, managing, and developing teams, including setting priorities, monitoring performance, and supporting employee growth.
Proven experience managing quality assurance programs, operational audits, compliance monitoring, or operational testing initiatives.
Strong understanding of insurance operations, delegated authority arrangements, carrier oversight, and applicable regulatory requirements.
Experience evaluating operational controls, identifying risks, developing corrective actions, and implementing sustainable process improvements.
Strong analytical and problem-solving skills, with the ability to interpret operational data, identify trends, assess complex issues, and provide actionable recommendations to senior leadership.
Excellent written, verbal, and interpersonal communication skills, including the ability to present audit findings clearly and influence stakeholders to implement corrective actions.
Strong organizational and project management capabilities, with the ability to manage multiple priorities, coordinate audits, and meet deadlines in a fast-paced environment.
High attention to detail, sound judgment, and a commitment to compliance, accountability, and operational excellence.
A bachelor's degree in Business, Insurance, Risk Management, Compliance, Finance, or a related discipline is preferred. Equivalent combinations of education and relevant professional experience will also be considered.
Preferred qualifications:
Experience supporting insurance carrier operations and delegated authority programs.
Familiarity with third-party administrators, vendors, and external business partners in regulated insurance environments.
Experience managing remediation initiatives, corrective action plans, and operational risk improvement programs.
Previous involvement in regulatory examinations, external audits, market conduct reviews, or compliance assessments.
Professional certifications in auditing, compliance, quality management, insurance, or a related discipline.
Benefits:
Remote work: Fully remote position with travel requirements of up to eight trips per year to office locations across the United States and Canada.
Comprehensive healthcare: Medical, dental, and vision insurance coverage.
Life insurance: Basic life insurance provided at no cost to employees.
Disability coverage: Company-paid short-term and long-term disability benefits.
Paid parental leave: 12 weeks of parental leave at 100% pay.
Health and spending accounts: Access to Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA).
Retirement savings: Access to a retirement savings plan.
Paid time off: Personal paid time off, paid holidays, and a company-wide Wellness Day.
Volunteer opportunities: Paid time off to volunteer with nonprofit organizations.
Pet-related benefits: Group pet insurance and access to a pet-friendly office environment.
Commuter benefits: Available where applicable based on work location.
Professional development: On-the-job training, skills development, and opportunities for career advancement.
Employee well-being: Access to an Employee Assistance Program (EAP).
Inclusive workplace: A commitment to accessibility, equal opportunity, and reasonable accommodations throughout the recruitment and employment process.