- 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 Benefits 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 - Bring traceable analysis to monthly operating reviews and executive discussions - 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 - Set, document, and test vendor control expectations, approval authorities, and escalation rules - Run weekly and monthly operational forums, quarterly and mid-year scorecards, and annual licensing, case-fee, and recovery reviews - Own the vendor issue and corrective-action pipeline and maintain an accurate vendor risk position - Lead, coach,



and develop a team of eight through role changes and automation-driven changes in work - 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 Requirements - 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 - Experience leading people through a significant change to how work is done - Strong technical grounding in travel or health claims and medical case management - Sound judgment on high-value and complex decisions - Demonstrated use of data to run an operation - Confidence with Excel and a reporting tool such as Power BI - Experience as a business owner, product owner, or equivalent on a delivery programme - Backlog ownership, user acceptance testing, and go-live decision experience - Practical experience applying AI or automation tools to operational work - 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 - Solid 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 Core Competencies 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. Highest-signal resume keywords - Travel Claims Management - Risk Management - Vendor Relationship Management - Data Analysis - Automation Tools Hard Skills - Claims Management - Risk Assessment - Audit Experience - Medical Case Management - User Acceptance Testing - Backlog Ownership - Performance Tracking - Regulatory Compliance - Decision Making - Process Improvement Soft Skills - Leadership - Communication - Judgment - Coaching - Collaboration Industry Keywords - Insurance - Canadian Financial Services - Third-Party Risk - Customer Complaint Handling - Operational Reporting Tools & Technologies - Excel - Power BI - AI Tools - Reporting Tools - Automation Software

📌 Manager, Travel Claims Vendor Risk – Oversight (Toronto)
🏢 Jobtailor
📍 Toronto