Director, Client Service Delivery - TPA Facility

The Role

This role sits within the Health & Benefits Middle Office team and is responsible for leading the operational implementation, governance and service delivery oversight of WTW’s TPA facility programme.In addition to serving as the primary coordination and escalation point among WTW, insurers and TPAs, the role will drive the programme’s success by ensuring smooth client onboarding and insurer transitions, effective vendor governance, high-quality service delivery, and consistent client and member experiences.The successful candidate will play a pivotal role in building a scalable, well-controlled operating framework for the delivery, governance and ongoing management of WTW’s TPA facility programme, while partnering with TPAs, insurers and WTW Front Office (FO) teams to support client onboarding and programme expansion.

Programme Implementation & Client Transition Management

• Partner with the FO and Advisory & Wellbeing teams to identify new and existing clients for onboarding to the TPA facility, across insured, self-funded and auxiliary healthcare programmes.
• Lead the client implementation framework for onboarding, insurer transitions, renewals and the ongoing rollout of the facility programme.
• Develop implementation plans, checklists, workflows and operational documentation to ensure consistent onboarding and clear communication with TPAs and insurers.
• Monitor implementation and renewal milestones, including census submission, policy changes, blackout periods, client-specific requirements and operational readiness
• Ensure client-specific arrangements are implemented accurately, including dedicated service hotlines, special service requirements, escalation protocols, reporting and communication needs.
• Manage implementation risks, dependencies and stakeholder communications to ensure smooth client transitions with minimal disruption to members and HR teams.

TPA, Insurer & Vendor Governance

• Serve as the primary operational relationship manager for appointed TPAs and key coordination point with insurer partners.
• Establish and manage a structured governance framework across TPAs and insurers, including operational reviews, performance reviews and quarterly business reviews.
• Ensure governance meetings are documented with clear actions, owners, target completion dates and follow-up.
• Drive accountability for service performance, issue resolution, agreed deliverables and operational standards.
• Maintain consistency of standards across appointed TPAs to preserve flexibility in switching or rebalancing volume between providers, where required.

Service Performance, SLA & Escalation Management

• Establish, monitor and report on agreed SLAs, turnaround times, service quality indicators and operational performance metrics.
• Review TPA operational reports, including claims turnaround times, hotline responsiveness, member enquiry volumes, provider network utilisation, complaints and escalation trends.
• Conduct regular service performance reviews to identify trends, operational gaps and improvement opportunities.
• Coordinate investigation and resolution of complex service delivery issues, member escalation sand critical incidents
• Ensure corrective action plans are implemented and monitored where service standards are not achieved.
• Produce governance reports, KPI scorecards, dashboards and management updates on operational performance and service outcomes.

Operational Risk, Compliance & FWA Oversight

• Monitor TPA fraud, waste and abuse (FWA) frameworks, reporting processes, investigation protocols and control measures
• Review FWA reports, trends and significant incidents with TPAs, insurers and relevant internal stakeholders
• Support periodic reviews of fraud prevention, detection and escalation measures.
• Work with Compliance, Legal and Risk teams on incident reporting, contractual adherence and operational controls.
• Ensure operational processes remain aligned with contractual, regulatory, risk and client requirements.
• Oversee adherence to data protection, confidentiality and information-security requirements, including appropriate handling, access, retention and escalation of member and client data.
• Support audit and assurance activities by maintaining complete governance records, control evidence, issue logs and remediation tracking.
• Ensure business continuity, disaster recovery and critical-incident arrangements are documented, tested periodically and aligned across TPAs.

ContinuousImprovement,Technology&ServiceEnablement

• PartnerwithTPAsandinsurerstoidentifyopportunitiesforoperational,serviceandtechnology improvements.
• TrackenhancementroadmapsandimplementationprogressacrossTPAsandinsurers.
• Supportimplementationofdigitalservicingsolutions,automationinitiatives,reporting enhancements and member engagement capabilities.
• Recommendprocessimprovementstoenhanceefficiency,scalability,servicequalityand operational effectiveness.
• Maintaindocumentationofworkflows,operatingproceduresandgovernanceframeworks.

StakeholderManagement&ProgrammeExpansion

• PartnerwithFOconsultantstosupportclientonboarding,programmeexpansionandadoptionof the TPA facility.
• ServeastheprimaryescalationcontactforFOcolleaguesonfacility-relatedoperationalmatters.
• CoordinatewithMOClaims,Advisory&Wellbeing,Technology,DataAnalytics,Compliance, Legal and Risk teams to support effective service delivery.
• Supportimplementationofnewserviceofferings,wellbeingservices,ancillaryhealthcareservices and strategic initiatives where required.
• CoordinatewithTPAsandtheAdvisory&Advisoryleadtovalidateutilisationreportsandsupport the timely and accurate billing of referral or marketing fees.
• Monitor commercial and contractual obligations, including fee arrangements, invoicing dependencies,servicecreditsandrenewalorterminationrequirements,inpartnershipwith relevant internal stakeholders.
• Ensureprocess,workflowandcommunicationchangesareclearlycommunicatedtorelevant stakeholders.
• Define and track programme outcomes, including implementation timeliness, SLA attainment, issue-resolutioneffectiveness,stakeholdersatisfaction,operationalriskreductionandadoption of the TPA facility.

The Requirements

Education&ProfessionalQualifications

Bachelor’sdegreeinanydiscipline.

Professionalinsurance,healthcareoremployeebenefits-relatedqualificationswouldbe advantageous.

Experience

• Minimum6–10yearsofrelevantexperienceinemployeebenefits,healthinsurance,healthcare administration, TPA management, insurer operations or service delivery management.
• Provenexperiencemanagingthird-partyserviceproviders,insurersoroutsourcedoperational vendors.
• Demonstratedexperienceleadingonboarding,implementation,transitionoroperationalchange programmes.
• Strongtrackrecordinvendorgovernance,SLAmanagement,performancereviewcadenceand remediation.
• Experiencehandlingcomplexoperationalescalationsandcross-functionalstakeholder management.
• Experienceestablishinggovernanceforums,KPIs,dashboardsandoperationalperformance reporting.
• Experiencesupportingaudits,controltesting,businesscontinuityplanningordata-protection requirements in an outsourced service environment would be advantageous.

TechnicalKnowledge

• Strong understanding of employee benefits programmes, group medical insurance, claims administrationprocesses,TPAoperatingmodelsandservicedeliverygovernanceframeworks.
• Goodknowledgeofhealthcareprovidernetworks,operationalrisk,servicecontrolsand outsourcing governance.
• Familiaritywithhealthcareservicingplatforms,digitalclaimssolutions,reportingdashboardsand member servicing technologies would be advantageous.
• Workingknowledgeofdataprotection,informationsecurity,businesscontinuityandaudit requirements relevant to healthcare and outsourced service arrangements.
• StrongproficiencyinMicrosoftExcel,PowerPointandWord.

Leadership&StakeholderManagement

• Strongabilitytoinfluenceandcoordinatemultiplestakeholdersacrossdifferentorganizations.
• Abilitytobuildcredibilityandtrustedrelationshipswithinsurers,TPAsandinternalteams.
• Strongnegotiation,conflict-resolutionandstakeholdermanagementskills.
• Abilitytooperateeffectivelyinamatrixandcross-functionalenvironment.

Operational Excellence

• Strongprojectmanagement,organizationalandexecutionskills.
• Abilitytomanagemultipleprioritiesanddeliverundertighttimelines.
• Strongattentiontodetailandfocusonoperationaldiscipline.
• Abilitytoidentifyimprovementopportunitiesandimplementpractical,scalablesolutions.

Communication&ProblemSolving

• Excellentverbalandwrittencommunicationskills.
• Stronganalyticalandcritical-thinkingabilities.
• Abilitytomanageambiguityandnavigatecomplexoperationalchallenges.
• Proactive,solutions-orientedandcollaborativeworkingstyle.

Personal Attributes

• Client-centricmindsetwithstrongfocusonservice excellence.
• Resilient,adaptableandcomfortableworkinginafast-pacedenvironment.
• Strongsenseofownershipand accountability.

Highlevelofprofessionalism,integrityandcommercialawareness

Equal Opportunity Employer