TPA Operations Lead

Role PurposeThe TPA Team Leader is responsible for the effective day-to-day management and delivery of Third-Party Administration (TPA) services, ensuring clients receive a consistent, high-quality and compliant claims service in line with agreed service standards and SLAs.The role has responsibility across client onboarding, service delivery, claims operations, application configuration, MI and performance, as well as people management. A key element of the role is developing a strong understanding of each client's requirements and ensuring these are accurately reflected in the claims application and operational processes.The TPA Team Leader will act as a key point of contact for clients, building strong working relationships and proactively identifying opportunities to improve service delivery, processes and client experience.Key Responsibilities1. Client Onboarding & Relationship ManagementLead the operational onboarding of new TPA clients, ensuring a structured and well-managed transition into the service.Work closely with clients to understand their business requirements, claims processes, reporting needs, SLAs and service expectations.Translate client requirements into clear operational processes and system specifications.Ensure all agreed requirements are accurately captured, documented and implemented before go-live.Act as a key day-to-day contact for clients, developing strong and professional relationships.Manage client expectations and proactively communicate service issues, risks, actions and improvements.Conduct regular service reviews with clients and ensure agreed actions are followed through.Identify opportunities to improve the client experience and expand or enhance the services provided.2. Claims Application & System OwnershipDevelop and maintain an in-depth understanding of the claims application, including its functionality, workflows, configuration and reporting capabilities.Understand how each client's requirements should be reflected within the application and ensure the system specification is appropriate for the individual client.Work with relevant internal teams to configure, test and implement client-specific requirements.Review proposed system changes to ensure they meet the client's operational and contractual requirements.Lead or support User Acceptance Testing (UAT), ensuring changes are fully tested before implementation.Identify system gaps, operational issues and opportunities for automation or process improvement.Act as the operational subject matter expert for the claims application within the TPA team.Ensure the team is using the application correctly and consistently.3. Service Delivery & SLA ManagementTake ownership of day-to-day TPA service delivery and ensure agreed SLAs and KPIs are consistently achieved.Monitor key service measures including claims volumes, turnaround times, outstanding claims, preliminaries, aged WIP, invoicing and other client-specific requirements.Review MI regularly to identify trends, performance issues and areas requiring intervention.Ensure service failures or potential SLA breaches are identified early and appropriate corrective action is taken.Establish clear ownership and accountability across the team for outstanding actions and claims.Ensure processes are documented, understood and consistently followed.Drive continuous improvement across the TPA operation.4. Management Information & PerformanceProduce and review regular MI for clients and internal management.Ensure reporting is accurate, timely and aligned with contractual and client requirements.Analyse operational performance and use data to identify trends, risks and opportunities for improvement.Monitor individual and team performance against agreed targets and KPIs.Ensure aged claims, WIP, outstanding preliminaries, invoicing and other key operational measures are actively managed.Provide clear commentary and recommendations alongside MI where performance requires attention.5. People ManagementLead, motivate and develop the TPA team, creating a culture of accountability, ownership and high service standards.Conduct regular one-to-ones with team members and provide ongoing coaching and support.Set clear objectives and expectations for individual team members.Conduct formal performance reviews and appraisals.Manage performance issues fairly and consistently, implementing appropriate improvement plans where required.Identify training and development needs and ensure appropriate support is provided.Monitor workloads and resource requirements to ensure the team can meet client demand and SLAs.Support recruitment, onboarding and training of new team members.Promote collaboration, knowledge sharing and consistency across the team.6. Operational Governance & RiskEnsure TPA processes are delivered in accordance with agreed client requirements, internal procedures and applicable regulatory or contractual obligations.Maintain appropriate operational controls and ensure issues are escalated promptly.Identify operational risks and implement appropriate mitigation plans.Ensure client-specific processes and requirements are documented and kept up to date.Support audits, client reviews and internal governance activities as required.Ensure complaints, incidents and service issues are investigated and resolved appropriately.7. Continuous ImprovementProactively identify opportunities to improve TPA processes, service quality and efficiency.Work with clients and internal stakeholders to implement process improvements.Challenge inefficient or manual processes and identify opportunities for system or workflow enhancements.Use MI, client feedback and team feedback to drive measurable improvements.Ensure lessons learned from onboarding, operational issues and client feedback are incorporated into future processes.Key AccountabilitiesThe successful candidate will be accountable for:Successful onboarding of new TPA clientsStrong and effective client relationshipsDelivery against agreed SLAs, KPIs and service standardsAccurate implementation of client requirements within the claims applicationQuality and accuracy of operational MIEffective management of claims performance, WIP and outstanding actionsTeam performance, development and engagementIdentification and management of operational risksContinuous improvement of the TPA serviceSkills & ExperienceEssentialExperience within TPA, claims administration, insurance operations or a similar service environment.Previous experience managing or leading an operational team.Strong understanding of claims processes and the end-to-end claims lifecycle.Experience managing client relationships and service delivery.Experience working against SLAs, KPIs and contractual service requirements.Strong analytical skills and confidence working with MI and operational data.Ability to understand client requirements and translate them into practical operational processes and system requirements.Strong understanding of systems and the ability to learn and navigate claims applications confidently.Excellent communication and stakeholder management skills.Strong organisational skills with the ability to manage multiple clients, priorities and deadlines.Experience managing performance, conducting one-to-ones and appraisals, and addressing performance issues.DesirableExperience implementing or onboarding TPA clients.Experience with claims system configuration, UAT or system implementation.Experience developing client-specific workflows and processes.Insurance/claims qualifications or relevant professional qualifications.Experience in a regulated insurance environment.Experience delivering process improvement or operational change projects.Personal AttributesThe successful candidate will be:Client-focused – builds trusted relationships and understands what good service looks like.Commercially aware – understands the importance of delivering an efficient service while meeting client expectations.Analytical – comfortable using MI and data to identify issues and drive decisions.Technically capable – willing and able to understand the claims application in detail rather than relying solely on technical teams.Organised and proactive – identifies issues before they become problems.Accountable – takes ownership of service delivery and follows actions through to completion.A strong people leader – provides clear direction, develops team members and manages performance effectively.Solutions-focused – looks for practical ways to resolve issues and improve the service.Adaptable – comfortable managing different client requirements and changing priorities.Role SuccessSuccess in this role will be measured by the ability to deliver a consistently high-quality TPA service, successfully onboard and retain clients, maintain strong SLA performance, ensure the claims application accurately supports client requirements, and build a high-performing and accountable team.