Lead the Travel Claims Risk Management Team of eight covering high-risk medical and non-medical claims, denials, appeals, sensitive and escalated files, legal and media threats, regulatory inquiries, and large-loss oversight Lead review of high-value and complex travel claims and make or endorse financially, regulatorily, or reputationally significant decisions Set standards for written decision reasoning and manage work based on age and claim value Act as escalation point for claimant complaints, legal and media threats, and regulator enquiries Partner with Audit and Operations on monthly audits across Affinity and Group Perks travel business Convert audit findings into process changes, training, administrator handling standards, and automation backlog improvements Establish the recovery baseline and connect audit findings with recoveries Build and maintain live operational reporting on intake, assignment wait time, review time, open work, overturn rates, and audit findings Own the Travel Claims scope of the transformation programme, including backlog prioritization, process definitions, planning, demonstrations, testing, go-live, and stabilization Assess automation tools, including medical-record summarization, and define appropriate automation and human decision boundaries Own risk and control oversight of the third-party administrator handling travel claims Own the vendor issue and corrective-action pipeline and maintain an accurate vendor risk position Build team capability with data and AI tools, set performance expectations, and develop succession depth Report to the Director, Affinity Claims, Canada Segment, and collaborate with Audit and Operations, risk, compliance, vendor management, transformation, and Affinity Operations leadership Post-secondary education in a business, health, analytics, or insurance discipline, or an equivalent combination of education and experience Five or more years leading a claims, risk,



or audit team Strong technical grounding in travel or health claims and medical case management Demonstrated use of data to run an operation Confidence with Excel and a reporting tool such as Power BI Backlog ownership, user acceptance testing, and go-live decision experience Understanding of controls, error tolerance, and human decision points in automation Proven vendor relationship management experience with material outsourced or third-party relationships Experience with performance conversations, remediation, and maintaining vendor relationships Risk, control, and audit experience, including defining and testing controls, evidencing failures, documenting findings, and completing remediation Experience working with first- and second-line risk partners and internal and external audit Strong vendor governance experience, including service levels, scorecards, issue and corrective action tracking, and upward risk reporting Strong written and verbal communication skills, including presenting results and recommendations to senior leaders Preferred: experience automating manual processes while maintaining or improving quality Preferred: familiarity with fair treatment of customers, complaint handling, and regulator enquiries in a Canadian insurance setting Preferred: familiarity with Canadian financial-services outsourcing and third-party-risk expectations Nice to have: bilingual French and English Demonstrates strong leadership in managing a Travel Claims Risk Management Team, with expertise in high-value claims, regulatory compliance, and vendor relationship management. Proficient in utilizing data and automation tools to enhance operational efficiency and decision‑making processes.

Travel Claims Management Risk Management Data

Analysis Claims Management Risk Assessment Audit Experience Medical Case Management User Acceptance Testing Performance Tracking Regulatory Compliance Process Improvement Coaching Canadian Financial Services Third-Party Risk Customer Complaint Handling Excel Power BI Automation Software #

📌 Manager, Travel Claims Vendor Risk - Oversight (Ontario)
🏢 Jobtailor
📍 Ontario