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Manager, TPA Oversight

Ae05a1c1 9966 4cfe B9bb 641045c5f183 19000101 000001 · Remote, US, Remote · Remote · Active · ADP Workforce Now Recruiting

Job facts

FieldValue
CompanyAe05a1c1 9966 4cfe B9bb 641045c5f183 19000101 000001
TitleManager, TPA Oversight
Normalized title-
Department / team-
LocationUnited States
Work modelRemote / Remote
Employment typeFull Time
Salary-
Statusactive
ATS providerADP Workforce Now Recruiting
Posted / first seen2026-04-13 / 2026-05-31
Changed / last seen2026-06-06 / 2026-06-06

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Linked records

CompanyAe05a1c1 9966 4cfe B9bb 641045c5f183 19000101 000001
Sourceac459f40-3220-49cf-9eae-ab6a8b756405
ATS providerADP Workforce Now Recruiting

Description

This role will be responsible for monitoring, reviewing, and coordinating the activities of TPAs handling multi-line commercial cases with an emphasis on worker’s compensation claims including analyzing coverage issues, establishing accurate reserves, and resolution of cases on behalf of affiliate insurers. Oversight also includes TPA selection, audit and review of compliance with contractual, legal obligations and other internal controls, assistance with TPA contract drafting and placement, preparation of special handling instructions, TPA fraud reporting, training and compliance, preparation of workflows to ensure accurate information exchange with TPA partners, and preparation and analysis of reports reflective of TPAs meeting key performance indicators, benchmarks and other obligations. Essential Functions Coordinates TPA selection, review of compliance with contractual, legal obligations and other internal controls. Assists with TPA contract drafting and placement, preparation of handling instructions, TPA fraud reporting, training and compliance, preparation of workflows to ensure accurate information exchange with TPA partners. Responsible for all results of all assigned TPA oversight Coordinates with TPA to develop KPI reports and other operational reports to manage the TPA towards those priorities. Reviews loss notices; confirms and interprets policy coverage; establishes accurate reserves; investigates and handles claims involving multi-line commercial cases; reviews reimbursement requests and initiates payment as appropriate. Consistently delivers superior customer service to both internal and external business partners. Develops creative ideas and solutions to real time business problems and /or business opportunities; Takes reasonable, calculated risks even if failure is possible. Ensures proper file setup, file documentation, reserving, general handling and application of company procedure and coverage interpretation. Conducts audits of TPAs; assesses claim handling performance of the TPAs and remedies issues as they arise; directs TPA activities. Participates in development of claim-handling techniques, including TPA oversight, defense coordination, expense control, and strategy. Reports on the results of TPA managed business and provides other claims information to senior management for selected losses and maintains specific financial and reporting metrics for reporting to management. Maintains diary control of reported cases to ensure maintenance of proper reserves to reflect the company's exposure and adequate notice to reinsurers, and recovery of specific amounts owed to the company, where applicable. Seeks continuous development by identifying areas for growth and improvement. Works with the continuous improvement team to implement process and technical improvements. Experience · Minimum of 7 years’ experience of adjusting multi-line claims and worker’s compensation claims, including large losses, preferably in multiple jurisdictions. · Claims technical supervisory or management experience preferred. · Experience analyzing statistical reports of multi-line claims and a proven ability to identify trends. Required Education Four-year college degree required or equivalent work experience. Preferred Education or Certification JD, CPCU, SCLA, CCLA Travel Minimal to moderate, based upon business needs. Work Environment / Physical Demands This position operates in a professional, collaborative environment and must have the ability to timely produce thorough, accurate work with many competing demands, deadlines, and distractions. The position uses standard equipment such as phones, computers, copiers/printers and filing cabinets. Noise level is moderate. Other Duties (Disclaimer Statement): RiverStone retains the right to change or assign other duties to this position as needed, or other duties or responsibilities may change or be assigned as needed. Diversity, Equity, Inclusion & Belonging RiverStone Resources, LLC is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, LGBTQ+, national origin, gender identity, disability, protected veteran status, or any other characteristic protected by law. Privacy Notice for California Residents https://www.trg.com/california-consumer-privacy-notice/

Full job record

Job ID729cbc8cd62336adbb6a6735f46adeb4a7f87d24
Org ID0c5e1c2e-b5c6-46cf-a8af-7b0c4bf5c7b5
Source IDac459f40-3220-49cf-9eae-ab6a8b756405
Board IDac459f40-3220-49cf-9eae-ab6a8b756405
Provideradp_workforcenow
Provider Job Key462833
TitleManager, TPA Oversight
Normalized Title—
Statusactive
Activeyes
Location TextRemote, US, Remote
Department—
Team—
Employment Typefull_time
Workplace Typeremote
Remote Policyremote
CountryUnited States
Region—
City—
Salary Raw—
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Source URLhttps://workforcenow.adp.com/mascsr/default/mdf/recruitment/recruitment.html?cid=ae05a1c1-9966-4cfe-b9bb-641045c5f183&ccId=19000101_000001&lang=en_US&type=JS&jobId=462833&jwId=9200545871921_1
Apply URLhttps://workforcenow.adp.com/mascsr/default/mdf/recruitment/recruitment.html?cid=ae05a1c1-9966-4cfe-b9bb-641045c5f183&ccId=19000101_000001&lang=en_US&type=JS&jobId=462833&jwId=9200545871921_1
First Seen At2026-05-31 18:48:26Z
Last Seen At2026-06-06 13:19:43Z
Last Checked At2026-06-06 13:19:43Z
Last Changed At2026-06-06 13:19:43Z
Inactive At—
Source Posted At2026-04-13 20:43:00Z
Source Updated At—
Raw Payload Uris3://job-postings-prod-raw-590183727216/raw/provider=adp_workforcenow/board=ae05a1c1-9966-4cfe-b9bb-641045c5f183|19000101_000001/date=2026-06-06/2026-06-06T13-19-42-940Z-62423ed7e7ae755744825707bf011c27cd4813f3c8a0e64676809e6545526a24.json
Event Fields
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Extensions
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    "requisitionDescription": "<div><div><div><div><div><div><div><div><div><div><div align=\"center\" style='margin-top:3.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;' data-pasted=\"true\"><table border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"659\" style=\"border-collapse: collapse; border: none; width: 659px; height: 1621px;\"><colgroup><col style=\"width: 16.7149%;\"><col style=\"width: 83.2851%;\"></colgroup><tbody><tr><td colspan=\"2\" valign=\"top\" style=\"border: 1pt solid windowtext; padding: 0in 5.4pt; height: 0.5in; vertical-align: top;\"><p style='margin-top:2.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;color:#262626;font-weight:bold;'><span style='font-size:15px;font-family:\"Times New Roman\";color:black;'><span style='font-size:16px;font-family:\"Times New Roman\";color:black;font-weight:normal;'>This role will be responsible for monitoring, reviewing, and coordinating the activities of TPAs handling multi-line commercial cases with an emphasis on worker&rsquo;s compensation claims including analyzing coverage issues, establishing accurate reserves, and resolution of cases on behalf of affiliate insurers. Oversight also includes TPA selection, audit and review of compliance with contractual, legal obligations and other internal controls, assistance with TPA contract drafting and placement, preparation of special handling instructions, TPA fraud reporting, training and compliance, preparation of workflows to ensure accurate information exchange with TPA partners, and preparation and analysis of reports reflective of TPAs meeting key performance indicators, benchmarks and other obligations.</span></span></p></td></tr><tr><td colspan=\"2\" valign=\"top\" style=\"border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-image: initial; border-top: none; background: rgb(219, 219, 219); padding: 0in 5.4pt; height: 0.25in; vertical-align: top;\"><p style='margin-top:2.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;color:#262626;font-weight:bold;'>Essential Functions</p></td></tr><tr style=\"height: 834px;\"><td colspan=\"2\" valign=\"top\" style=\"border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-image: initial; border-top: none; padding: 0in 5.4pt; height: 0.5in; vertical-align: top;\"><div style='margin-top:3.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;'><ul style=\"margin-bottom:0in;list-style-type: disc;margin-left: 0.09999999999999998in;\"><li style='margin-top:3.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;'><span style=\"color:black;\">Coordinates TPA selection, review of compliance with contractual, legal obligations and other internal controls.</span></li><li style='margin-top:3.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;'><span style=\"color:black;\">Assists with TPA contract drafting and placement, preparation of handling instructions, TPA fraud reporting, training and compliance, preparation of workflows to ensure accurate information exchange with TPA partners.</span></li><li style='margin-top:3.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;'><span style=\"color:black;\">Responsible for all results of all assigned TPA oversight</span></li><li style='margin-top:3.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;'><span style=\"color:black;\">Coordinates with TPA to develop KPI reports and other operational reports to manage the TPA towards those priorities.</span></li><li style='margin-top:3.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;'><span style=\"color:black;\">Reviews loss notices; confirms and interprets policy coverage; establishes accurate reserves; investigates and handles claims involving multi-line commercial cases; reviews reimbursement requests and initiates payment as appropriate.</span></li><li style='margin-top:3.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;'><span style=\"color:black;\">Consistently delivers superior customer service to both internal and external business partners.</span></li><li style='margin-top:3.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;'><span style=\"color:black;\">Develops creative ideas and solutions to real time business problems and /or business opportunities; Takes reasonable, calculated risks even if failure is possible.</span></li><li style='margin-top:3.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;'><span style=\"color:black;\">Ensures proper file setup, file documentation, reserving, general handling and application of company procedure and coverage interpretation.</span></li><li style='margin-top:3.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;'><span style=\"color:black;\">Conducts audits of TPAs; assesses claim handling performance of the TPAs and remedies issues as they arise; directs TPA activities.</span></li><li style='margin-top:3.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;'><span style=\"color:black;\">Participates in development of claim-handling techniques, including TPA oversight, defense coordination, expense control, and strategy.</span></li><li style='margin-top:3.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;'><span style=\"color:black;\">Reports on the results of TPA managed business and provides other claims information to senior management for selected losses and maintains specific financial and reporting metrics for reporting to management.</span></li><li style='margin-top:3.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;'><span style=\"color:black;\">Maintains diary control of reported cases to ensure maintenance of proper reserves to reflect the company&#39;s exposure and adequate notice to reinsurers, and recovery of specific amounts owed to the company, where applicable.</span></li><li style='margin-top:3.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;'><span style=\"color:black;\">Seeks continuous development by identifying areas for growth and improvement. Works with the continuous improvement team to implement process and technical improvements.</span></li></ul></div></td></tr><tr><td colspan=\"2\" style=\"border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-image: initial; border-top: none; background: rgb(186, 178, 173); padding: 0in 5.4pt; height: 2.4pt;\"><p style='margin-top:2.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;color:#262626;font-weight:bold;'>Experience</p></td></tr><tr><td colspan=\"2\" style=\"border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-image: initial; border-top: none; padding: 0in 5.4pt; height: 2.4pt;\"><p class=\"MsoNormal\" style=\"margin-top:3.3pt;margin-right:16.2pt;margin-bottom:   0in;margin-left:.6in;text-align:justify;text-indent:-.25in;line-height:14.65pt;vertical-align:baseline;\"><!--[if !supportLists]--><span style=\"font-family:Symbol;color:black;\">&middot;&nbsp;</span><!--[endif]--><span style=\"color:black;\">Minimum of 7 years&rsquo; experience of adjusting multi-line claims and worker&rsquo;s compensation claims, including large losses, preferably in multiple jurisdictions.</span></p><p class=\"MsoNormal\" style=\"margin-top:5.65pt;margin-right:0in;margin-bottom:   0in;margin-left:.6in;text-indent:-.25in;line-height:12.6pt;vertical-align:baseline;\"><!--[if !supportLists]--><span style=\"font-family:Symbol;color:black;\">&middot; &nbsp;&nbsp;</span><!--[endif]--><span style=\"color:black;\">Claims technical supervisory or management experience preferred.</span></p><p class=\"MsoNormal\" style=\"margin-top:5.65pt;margin-right:0in;margin-bottom:   0in;margin-left:.6in;text-indent:-.25in;line-height:12.6pt;vertical-align:baseline;\"><!--[if !supportLists]--><span style=\"font-family:Symbol;color:black;\">&middot; &nbsp;&nbsp;</span><!--[endif]--><span style=\"color:black;\">Experience analyzing statistical reports of multi-line claims and a proven ability to identify trends.</span></p></td></tr><tr><td style=\"border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-image: initial; border-top: none; background: rgb(219, 219, 219); padding: 0in 5.4pt;\"><p style='margin-top:2.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;color:#262626;font-weight:bold;'>Required Education</p></td><td style=\"border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; padding: 0in 5.4pt;\"><p style='margin-top:2.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;color:#262626;font-weight:bold;'><span style=\"color:black;font-weight:normal;\">Four-year college degree required or equivalent work experience.</span></p></td></tr><tr><td style=\"border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-image: initial; border-top: none; background: rgb(219, 219, 219); padding: 0in 5.4pt;\"><p style='margin-top:2.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;color:#262626;font-weight:bold;'>Preferred Education or Certification</p></td><td style=\"border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; padding: 0in 5.4pt;\"><p style='margin-top:2.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;color:#262626;font-weight:bold;'><span style='font-size:15px;font-family:\"Times New Roman\";color:black;font-weight:normal;'><span style='font-size:16px;font-family:\"Times New Roman\";color:black;'>JD, CPCU, SCLA, CCLA</span></span></p></td></tr><tr><td style=\"border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-image: initial; border-top: none; background: rgb(219, 219, 219); padding: 0in 5.4pt;\"><p style='margin-top:2.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;color:#262626;font-weight:bold;'>Travel</p></td><td style=\"border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; padding: 0in 5.4pt;\"><p style='margin-top:2.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;color:#262626;font-weight:bold;'><span style='font-size:15px;font-family:\"Times New Roman\";color:black;font-weight:normal;'><span style='font-size:16px;font-family:\"Times New Roman\";color:black;'>Minimal to moderate, based upon business needs.</span></span></p></td></tr><tr><td valign=\"top\" style=\"border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-image: initial; border-top: none; background: rgb(219, 219, 219); padding: 0in 5.4pt; vertical-align: top;\"><p style='margin-top:2.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;color:#262626;font-weight:bold;'>Work Environment / Physical Demands</p></td><td style=\"border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; padding: 0in 5.4pt;\"><p style='margin-top:2.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;color:#262626;font-weight:bold;'><span style=\"font-weight:normal;\">This position operates in a professional, collaborative environment and must have the ability to timely produce thorough, accurate work with many competing demands, deadlines, and distractions. The position uses standard equipment such as phones, computers, copiers/printers and filing cabinets. Noise level is moderate. Other Duties (Disclaimer Statement): RiverStone retains the right to change or assign other duties to this position as needed, or other duties or responsibilities may change or be assigned as needed.</span></p></td></tr><tr style=\"height: 94px;\"><td valign=\"top\" style=\"border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-image: initial; border-top: none; background: rgb(219, 219, 219); padding: 0in 5.4pt; vertical-align: top;\"><p style='margin-top:2.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;color:#262626;font-weight:bold;'>Diversity, Equity, Inclusion &amp; Belonging</p></td><td style=\"border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; padding: 0in 5.4pt;\"><p style='margin-top:2.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;color:#262626;font-weight:bold;'><span style=\"font-weight:normal;\">RiverStone Resources, LLC is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, LGBTQ+, national origin, gender identity, disability, protected veteran status, or any other characteristic protected by law.</span></p></td></tr><tr><td valign=\"top\" style=\"border-right: 1pt solid windowtext; border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-image: initial; border-top: none; background: rgb(219, 219, 219); padding: 0in 5.4pt; vertical-align: top;\"><p style='margin-top:2.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;color:#262626;font-weight:bold;'>Privacy Notice for California Residents</p></td><td style=\"border-top: none; border-left: none; border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; padding: 0in 5.4pt;\"><p style='margin-top:2.0pt;margin-right:0in;margin-bottom:1.0pt;margin-left:0in;font-size:16px;font-family:\"Calibri\",sans-serif;color:#262626;font-weight:bold;'><a href=\"https://www.trg.com/california-consumer-privacy-notice/\" target=\"_blank\">https://www.trg.com/california-consumer-privacy-notice/</a></p></td></tr></tbody></table></div></div></div></div></div></div></div></div></div></div></div>\n",
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