Vice President, Technology Strategy & Innovation

The VP, TPA Technology and Claims Modernization is a senior strategic leader responsible for setting the TPA’s technology strategy and capability roadmap to operate as an industry-leading, modern TPA.

The role strengthens foundational capabilities (client onboarding, data conversions, carrier feeds), drives claims modernization (AI, automation, cloud, analytics), and represents the TPA in the insurance company’s enterprise core systems transformation (policy, billing, claims, and enterprise content management), 1) Claims modernization and AI strategy

• Develop and own the modernization roadmap for claims
• Identify and implement responsible, phased AI and automation opportunities
• Reduce manual touches and improve adjuster efficiency
• Ensure AI initiatives are safe, compliant, and aligned with business goals

2) Client onboarding, data conversions, and carrier feeds

• Establish TPA technical standards and target-state patterns for onboarding, data conversions, and carrier feeds (formats, validation, reconciliation, error handling)
• Define a repeatable onboarding/conversion lifecycle with Shared Services IT and business owners (intake, sizing, cutover readiness, hypercare success criteria)
• Drive carrier feed reliability and timeliness through SLAs/OLAs, monitoring, and escalation to reduce downstream claim impacts
• Partner with Claims, Finance, and Operations to define data controls (reconciliation, exception queues, root-cause remediation) that protect outcomes and margin

3) Business and Shared Services IT alignment

• Serve as the single point of alignment between TPA leadership and Shared Services IT
• Translate business strategy into clear technical direction
• Ensure Shared Services understands priorities and desired outcomes
• Ensure the business understands technical realities and constraints
• Remove ambiguity and facilitate cross-functional alignment

4) Enterprise core systems transformation (TPA requirements and adoption)

• Own and maintain the TPA requirements backlog for enterprise platforms (policy, billing, claims, ECM): needs, priorities, acceptance criteria, and constraints
• Participate as a TPA representative in requirements and design workshops with TPA SMEs and Shared Services IT; approve fit-gap outcomes and ensure traceability through build and testing
• Coordinate and support TPA readiness for enterprise releases (UAT support, process updates, training impacts, cutover coordination) so changes land cleanly in operations

5) Cloud platform optimization

• Guide the cloud upgrade strategy for the claims platform
• Ensure cloud-native capabilities are adopted
• Prevent legacy workflows from being re-implemented
• Maintain clean data models and modern integration patterns
• Protect the platform from unnecessary customization and technical debt

6) Vendor oversight (strategic)

• Provide technical and strategic oversight for claims platform, onboarding, and integration vendors
• Ensure vendors follow TPA standards and modernization roadmap
• Escalate quality or alignment issues as needed

7) Data and analytics

• Define analytics requirements that support modernization and AI
• Partner with analytics teams to ensure dashboards support decision-making
• Use data to measure modernization ROI and operational improvements

8) Business efficiency and operating model

• Partner with Claims leadership to define the future claims operating model
• Identify opportunities to eliminate manual work and reduce cycle time
• Improve adjuster experience and workflow design
• Ensure technology investments directly support operational goals

9) IT spend discipline and financial alignment

• Promote reuse, standardization, and cloud-native efficiencies
• Influence Shared Services to adopt cost-efficient patterns
• Ensure vendors deliver value without inflating long-term costs
• Build a multi-year plan to flatten the TPA’s IT spend curve
• Track and report ROI for all TPA technology investments
• Ensure modernization reduces cost-per-claim and improves scalability

10) Value realization and demand shaping

• Shape and prioritize TPA technology demand to maximize value
• Prevent low-value work from consuming IT capacity
• Ensure the TPA’s ~36% IT total spend is used on the highest-impact initiatives

11) Governance TPA Technology Office (TTO)

• Chair the TPA Technology governance (TTG) forum to align TPA leadership and Shared Services IT on priorities, sequencing, standards, and escalation
• Run a predictable cadence (monthly decisions; quarterly roadmap/ROI review; annual strategic reset)
• Establish guardrails for integrations, data, and cloud configurations
• Ensure Shared Services and vendors follow standards
• Maintain alignment without adding bureaucracy

12) Benchmarking

• Benchmark technology spend, efficiency, and modernization maturity against peer TPAs
• Ensure the TPA’s technology cost structure remains competitive
• Use benchmarking to guide modernization priorities

Do you have experience in Vendor relationship management?, * 10+ years of progressive experience in technology, digital transformation, or platform modernization roles within insurance, workers’ compensation, TPA, or other regulated financial services environments

• Deep understanding of claims platforms, integrations, data flows, and enterprise core systems, with experience translating business requirements into scalable, implementable solutions
• Proven ability to influence without authority in a Shared Services or matrixed IT operating model, partnering effectively with enterprise IT, vendors, and business leaders
• Strong financial and value-orientation, with experience shaping demand, prioritizing investments, tracking ROI, and enforcing cost discipline across technology portfolios
• Demonstrated executive communication and governance capabilities, including facilitating cross-functional forums, resolving priority conflicts, and presenting clearly to senior leadership