John Kevin Roberts
Anaheim
Summary
Results-driven leader with strong background in strategic management and organizational growth. Skilled in developing and implementing effective business strategies, optimizing processes, and driving team performance. Known for adaptability, effective collaboration, and delivering measurable outcomes in dynamic environments. Strong communication and problem-solving abilities, coupled with focus on fostering productive and positive team culture.
Overview
30
30
years of professional experience
Work History
Director of Risk Management
San Diego Unified School District
12.2023 - Current
- Developed and executed a comprehensive in house claims and risk management strategy that reduced claims costs by $2 Million over one year, enhancing workers compensation and liability claims operational efficiency
- Led a cross-functional team to assess and mitigate risks associated with Workers Compensation claims, property damage, liability claims, and operational disruptions, ensuring alignment with objectives and compliance with industry regulations
- Collaborated closely with insurance providers and legal teams to negotiate favorable terms for claims settlements, resulting in a 30% improvement in resolution timelines
- Implemented data-driven analytics to identify trends in claims and risk exposure, leading to proactive measures that decreased incident rates by 15%
- Conducted training sessions for staff on risk awareness and claims reporting processes, fostering a culture of accountability and proactive risk management throughout the organization
- Spearheaded the integration of technology solutions to streamline claims processing and reporting, improving efficiency and accuracy in documentation
- Successfully managed a portfolio of claims exceeding $100 million while maintaining an average claims closure rate of 100% within established timelines
- Established partnerships with external stakeholders, enhancing collaboration and communication during the claims process, which improved satisfaction scores by 60%
- Led the recruitment process by developing job descriptions, interviewing candidates, and making hiring decisions to build a high-performing team aligned with SDUSD values
- Managed employee performance through regular evaluations and feedback, implementing corrective actions when necessary to maintain team effectiveness and morale
- Negotiated competitive salaries and benefits packages to attract and retain top talent, resulting in a reduction in turnover rate
AVP Claims
York/Sedgwick CMS
08.2008 - 12.2023
- Oversaw operations for multiple offices across California, Oregon, Washington, Idaho, Montana, and Utah, managing a diverse team of over 75 claims professionals to ensure high-quality service delivery and compliance with industry standards
- Developed and implemented strategic initiatives that improved operational efficiency by 20%, streamlining claims processing and enhancing client satisfaction across the region
- Collaborated with regional leadership to establish performance metrics and KPIs, resulting in the increase in overall claims resolution rates and a significant reduction in cycle times
- Fostered strong relationships with key accounts to include Municipalities, School Districts, Hotels Restaurants, Hospitality, Casinos, and Hospitals providing expert consultation on risk management strategies and claims handling processes, which contributed to a 25% growth in client retention
- Led training and development programs for staff to enhance their skills in claims management and customer service, promoting a culture of continuous improvement and professional growth
- Conducted regular audits and reviews of claims processes to identify areas for improvement and ensure adherence to regulatory requirements, successfully passing all compliance assessments during tenure
- Managed projects efficiently, ensuring timely delivery and high-quality results.
- Streamlined communication channels between departments, facilitating better collaboration on projects across the organization.
- Developed and maintained strong relationships with clients, resulting in increased business opportunities.
- Maintained compliance with industry regulations by implementing risk mitigation measures and maintaining accurate documentation.
- Successfully managed change within the organization, ensuring smooth transitions during periods of restructuring or process improvements.
- Promoted and led performance enhancement culture by actively coaching and mentoring direct reports.
- Negotiated contracts with suppliers, securing favorable terms and conditions for the company''s benefit.
- Oversaw talent acquisition efforts, selecting top candidates who contributed significantly to organizational success.
- Handled problematic customers and clients to assist lower-level employees and maintain excellent customer service.
AVP
Gallagher Basset Services
12.2005 - 08.2008
- Direct supervision of 4 supervisors and 21 claims examiners for UPS account
- Duties include monitoring work performance, monthly audits, merit appraisals and disciplinary issues
- Review all the legal mail, all new set-ups for timeliness, accuracy and diary control
- Audit award payments, internal corrections and release of payments
- Review and audit all reserve increases that exceed $100,000
- Review all litigation referrals, DWC delay notices and denials
- Prepare and attend client reviews, WCAB hearings and rehabilitation conferences
- Managed projects efficiently, ensuring timely delivery and high-quality results.
- Streamlined communication channels between departments, facilitating better collaboration on projects across the organization.
Director of CLAIMS
Equity Claims Management
04.2000 - 12.2005
- Directed every aspect of claims and operations for this Third Party Administrator with annual premium sales in the range of $10-$15 million for self-insured and insured programs
- Involved with the inception of the company, with primary responsibility for setting up and maintaining the workers compensation department, marketing, accounting, personnel, and administrative systems
- Ensured compliance with state and federal employment and insurance regulations
- Managed out of state licensing process
- Reported to the president and the board
- Prepared annual budgets, prepared all statements and reports, analyzed financial impact of proposed changes in business practices provided direction for strategic planning process
- Established policies and procedures for the workers’ compensation division
Senior CLAIMS Supervisor
Risk Enterprise Management
04.1998 - 04.2000
- In this position of authority, I was responsible for the supervision of 2 supervisors for out of state claims in AZ
- Supervised eight claims personnel as well as monitoring 4 Workers Compensation Units in our Concord office
- Duties included the administration of an MGA account, training personnel, and developing seminars for employers, supervisors and personnel, initial review of claims, review all large settlement negotiations and completed claims reviews with MGA
Claims Manager
Hazelrigg Risk Management San Diego
02.1995 - 04.1998
- Workers’ Compensation Manager accountable for a team of 4 Supervisors and (8-10) Workers Compensation Claim and Medical Professionals
- Responsible for ongoing performance management, compensation administration and providing meaningful development opportunities
- Also responsible for setting clear expectations, monitoring for adherence to these expectations and developing strategies to assist my office in meeting and exceeding these expectations
- Constant focus on building and maintaining relationships across product lines and with business partners to achieve organizational goals and better outcomes
- Actively partnering with Underwriting and Claims to acquire new customers and retain current customers
- Continual focus on achieving the highest level of customer service with both our internal and external partners
Education
B.A. - Political Science
California Polytechnic University Pomona
06.1985
Skills
- Liability and workers compensation claims
- Accounting
- Budgeting
- Claims Management Systems
- Composed Under Pressure
- Effective Communication Skills
- Effective Communication
- Health Safety Oversight
- Regulatory Compliance Monitoring
- Audit Oversight
- Legal compliance
- Vendor Risk Assessment
- Insurance Oversight
- Comprehensive Risk Reporting
- Crisis Management Coordination
- Risk Management Techniques
- Effective Team Collaboration
Languages
English
Full Professional
Timeline
Director of Risk Management
San Diego Unified School District
12.2023 - Current
AVP Claims
York/Sedgwick CMS
08.2008 - 12.2023
AVP
Gallagher Basset Services
12.2005 - 08.2008
Director of CLAIMS
Equity Claims Management
04.2000 - 12.2005
Senior CLAIMS Supervisor
Risk Enterprise Management
04.1998 - 04.2000
Claims Manager
Hazelrigg Risk Management San Diego
02.1995 - 04.1998
B.A. - Political Science
California Polytechnic University Pomona
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