VP Premium Audit Manager
Fa-Ewgu-Saasfaprod1 Cx_2001 · Philadelphia, Pennsylvania, United States
Role Summary
The Vice President, Premium Audit is the executive leader responsible for the strategic direction, operational execution, and compliance of the Premium Audit department. This role oversees a high-volume operation comprising a carefully calibrated mix of internal staff and external BPO vendors to ensure policyholder exposures are accurately captured and reported. The VP serves as the critical bridge between Underwriting, Actuarial, and Finance, ensuring the integrity of the company's top-line revenue.
Strategic Operational Leadership
Defines and drives the enterprise-wide audit strategy, optimizing the delivery mix across physical, virtual, and self-audit channels.
- Define the enterprise audit strategy, including the optimal mix of physical, virtual, and self-audits to maximize ROI and minimize customer friction.
- Lead large-scale transformational initiatives, such as migrating to automated audit workflows or integrating predictive analytics into audit selection models.
- Manage a multi-million dollar departmental budget, with focused oversight of FTE allocation, field staff capacity planning, and productivity benchmarks.
- Establish performance frameworks and scorecard metrics reported regularly to SVP-level leadership.
Strategic Sourcing & Vendor Management
Drives rigorous governance of third-party audit firms (BPOs) through structured vendor lifecycle management.
- Negotiate and manage complex, transaction-based pricing models for all external BPO vendor-partners.
- Establish and monitor SLAs and KPIs including Quality Score, Audit Cycle Time, and Cost per Audit.
- Conduct annual vendor performance reviews; recommend contract renewals, renegotiations, or terminations based on results.
- Maintain a preferred vendor panel with defined tier-one and tier-two routing logic to ensure continuity and cost efficiency.
Data Analytics & Revenue Integrity
Leverages advanced analytics to drive premium accuracy
- Partner with Analytics team to build high-yield audit selection models
- Monitor portfolio-level trends in classification changes, exposure shifts (e.g., payroll vs. sales basis), and audit dispute rates.
- Maintain a closed-loop feedback system between audit outcomes and underwriting to refine policy pricing at renewal.
Regulatory & Statutory Compliance
Ensures the department operates in full compliance with all applicable insurance regulations, bureau requirements, and internal audit standards.
- Ensure absolute adherence to NCCI, ISO, and state-specific Bureau regulations across all lines of business.
- Oversee the Dispute Resolution process, balancing premium recovery objectives with policyholder experience and retention.
- Maintain audit documentation standards that satisfy both internal audit requirements and external regulatory scrutiny.
Candidates who demonstrate the following capabilities will be strongly positioned in this role.
- Resource Planning: Sophisticated FTE utilization tracking across global delivery centers, with demonstrated results in workforce right-sizing and cost optimization.
- Digital Transformation: Experience replacing manual, paper-based audit processes with digital platforms using technology and direct API integrations
- BPO Optimization: Proven ability to transition vendor engagements from TBP arrangements to FTE based pricing models, driving measurable cost-per-audit reductions.
Dimension
Requirement
Experience
12–15+ years in Insurance Operations with a carrier / BPO in Premium Audit; minimum 4 years in executive leadership.
Education
Bachelor's degree required.
Financial Acumen
Deep expertise in BPO cost-benefit analysis, transaction-based pricing, and large-scale P&L management.
Technology
Proficiency in audit platforms (e.g., Majesco, Duck Creek), analytics tools, and workflow automation systems.
Communication
Demonstrated ability to translate complex operational data into executive-level strategic proposals.
Leadership
Track record of managing geographically distributed teams, including onshore and offshore delivery models.