- 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 leadershipRequirements- 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- Solid 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- 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 EnglishCore CompetenciesDemonstrates 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 ToolsHard Skills- Claims Management- Risk Assessment- Audit Experience- Medical Case Management- User Acceptance Testing- Backlog Ownership- Performance Tracking- Regulatory Compliance- Decision Making- Process ImprovementSoft Skills- Leadership- Communication- Judgment- Coaching- CollaborationIndustry Keywords- Insurance- Canadian Financial Services- Third-Party Risk- Customer Complaint Handling- Operational ReportingTools & Technologies- Excel- Power BI- AI Tools- Reporting Tools- Automation Software#J-18808-Ljbffr

📌 Accounting & Assurance Manager — Flexible Hours (Ottawa)
🏢 Baker Tilly
📍 Ottawa