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Jessica Claire
Montgomery Street, San Francisco, CA 94105
Home: (555) 432-1000 - Cell: - resumesample@example.com - -
Professional Summary

An extremely motivated Claims, Insurance and Risk Management professional with a results-oriented approach and extensive experience in insurance and risk management, as well as significant exposure to workers’ compensation, absence management, disability and unemployment compensation.   An astute individual with the highest ethical standards, as well as exceptional communication, interpersonal, and organizational skills, all of which contribute to exceeding both personal and organizational objectives.

Work History
03/2015 to Current
Senior Manager, Insurance/Risk Management Texas Health & Human Services Commission Sulphur Springs, TX,

03/2014 to Current
Senior Manager, Insurance/Risk Management Concentra Fraser, MI,
  • Provides oversight responsibilities of several of Raytheon's Insurance programs (domestic and international) and participates in the operational management and strategic planning of the company's Insurance/Risk Management program.
  • This includes, the procurement and administration of several insurance programs, including but not limited to Workers' Compensation, General Liability/Umbrella-Excess, Directors and Officers Liability, Professional Liability/Cyber insurance programs for Raytheon Company world-wide.
  • Participates in management oversight of Raytheon's captive insurance company in Bermuda.
  • Conducted Risk/Insurance related training sessions related to various topics, including international insurance issues.
  • Conducted insurance renewal presentations with Raytheon leadership for various insurance programs.
  • Nominated and completed "Leadership Excellence Program".
  • Corporate advisor to the Contracts and Supply Chain organization in the area of contractual insurance issues.
  • Oversaw and conducted comprehensive review of "cyber insurance" program through outside legal experts and brokers.
  • Increased 1st party coverages and total limits, while negotiated industry leading policy wording, including coordination with property insurer.
  • Assessed, analyzed and refined the certificate of insurance (COI) process for Insurance/Risk Management program.
  • Improved the interface, in an effort to improve the delivery of services through automation, refining controls and reduce touch-points.
  • Led Company-wide transformative change in the area of "additional insured", updating more favorable contractual language, policy language and endorsements and captive solutions.
  • Global Business Services - Enterprise Absence Management Program.
2007 to 2014
Manager III Raytheon Company City, STATE,
  • Held key management role with oversight responsibilities of Raytheon's disability program (STD/LTD).
  • Responsible for strategic level oversight of vendor relationship with third party administrator, including dedicated 50 person claims unit and 6 person Raytheon team.
  • In addition, provided claims/risk services regional management oversight of Raytheon's self-insured - self-administered workers' compensation program.
  • Provided regional direction and oversight of Raytheon's national workers' compensation carrier and Monopolistic state claims, which included litigation management, settlement authority and adherence to special claims instructions.
  • Led corporate level oversight of the unemployment claims program (administrator/vendor) and the unemployment claims process.
  • Designated as "high potential" and nominated for high potential leadership program.
  • Drove down Experience Modification Rate (EMR) of insured WC program to industry low of .39.
  • Developed and implemented cutting edge, dashboard style disability claims review list for medical review meetings with individual duration benchmarks for each case.
  • Lowered average Self Insured WC lost time claims cost to 20% below industry average.
  • In under a year, reduced the average duration of a disability claim by 1 day, resulting in 4.5 million of savings and 109 FTE's saved over disability carrier's book of business.
  • Led high level Absence Management project (6Sigma), which included process improvements to the way Raytheon manages non-occupational absences.
  • Process flows, playbook and other resources developed.
  • The project developed a common/consistent process with a tiered structure to elevate issues.
  • Highlighted key players/ roles and responsibilities in the Absence Management process.
  • Developed comprehensive workers' compensation bill review process that cut bill pay cycle time 50% to an average of 15 days and significantly reduced duplication bill receipts and tasks.
  • Lowered self-insured claims durations to 26 days; which is 38% lower than insured operations.
  • Implemented state of the art unemployment HR contact process and nationwide unemployment training for HR professionals.
  • Improved overall compliance to 99% resulting in $800,000 savings the first year and $2,843,618 overall UI tax savings.
  • As well as industry leading 93% overall win rate.
10/2001 to 2007
Sr. Claims Analyst/Principal Claims Analyst Raytheon Company City, STATE,
  • Effectively and aggressively negotiated rates with vendors for services and products, investigated injury reports, determined compensability, and managed workers' compensation claims for Raytheon employees in Massachusetts and Rhode Island under the self-insured/self-administered program.
  • Provided excellent customer service deliverables by mitigating costs through performing detailed analysis, in addition to understanding and administering benefits per the law.
  • Lead "Lost Time Intervention Team" (LTIT) meetings at site locations, which included consulting on STD, LTD and workers' compensation claims.
  • Developed and maintained network of occupational medicine clinics and preferred orthopedic clinics for injured workers as well as a preferred provider network (PPN) in Rhode Island.
  • Provided selection and oversight of outside counsel to ensure proper litigation track.
04/1999 to 09/2001
Claims Case Manager III LIBERTY MUTUAL INSURANCE City, STATE,
  • Managed, investigated, litigated, and resolved workers' compensation claims in multiple jurisdictions.
  • Facilitated excellent customer service by maintaining regular and effective communication with employees and customers; policyholders included large-deductible bearing, nationwide companies.
  • Controlled claims costs and provided reserving and financial analysis and recommendations to customers.
  • Managed caseloads of up to 150-200 MA and RI workers' compensation claims.
  • Office leader in structured settlements.
  • Investigated and handled multiple high exposure medical and lost time claims.
  • Directly handled multiple claims with reserves in excess of $1,000,000.
1994 to 1999
Emergency Medical Technician AMERICAN MEDICAL RESPONSE AMR City, STATE,
  • Provided pre-hospital and emergency room advanced life support care for patients.
  • Key responsibilities included
Education
Expected in
Bachelor of Arts: Sociology/Criminal Justice Biology
University of New Hampshire - Durham, NH
GPA:
Sociology/Criminal Justice Biology
Expected in
MBA: Risk Management
Salve Regina University - Newport, RI
GPA:
4.0
Expected in
Associate: Claims
- ,
GPA:
Claims
Expected in
Associate: Risk Management
- ,
GPA:
Risk Management Chartered Property Casualty Underwriter (CPCU) American Institute for Chartered Property Casualty Underwriters/Insurance Institute of America
Skills
  • Guest services
  • Inventory control procedures
  • Merchandising expertise
  • Loss prevention
  • Cash register operations
  • Product promotions

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Resume Overview

School Attended

  • University of New Hampshire
  • Salve Regina University

Job Titles Held:

  • Senior Manager, Insurance/Risk Management
  • Senior Manager, Insurance/Risk Management
  • Manager III
  • Sr. Claims Analyst/Principal Claims Analyst
  • Claims Case Manager III
  • Emergency Medical Technician

Degrees

  • Bachelor of Arts
  • MBA
  • Associate
  • Associate

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