Manager, Supplemental Medical Benefits

About the role

Direct and oversee a team, or teams, of highly skilled leaders and/or colleagues responsible for Disability, Absence Management and/or Supplemental Medical claim processing. Work with Supervisors and other departmental or divisional leadership to set and manage goals and performance expectations that support accurate, fair service and timely claim processing in compliance with state and federal regulations. Assist the Director with resolving complex claim issues and/or collaborating with internal and external legal representatives to provide direction and support in defense of lawsuits and to minimize litigation.

Responsibilities

• Actively manage staff and plans for appropriate allocation and use of resources; analyze past workloads to determine future needs and identify service trends that may detract from providing quality service to the customer.
• Develop supervisors and colleagues within area of responsibility, providing feedback to reinforce strengths and address areas needing improvement; hold supervisors accountable for colleague development.
• Demonstrate advanced judgment and collaborate with other leaders to develop standardized processes and procedures that advance service quality; identify deficiencies and areas for improvement.
• Act as a mentor and motivate colleagues to provide superior service; lead department or division improvement initiatives resulting in improved processes, procedures, and systems that support a positive customer experience.
• Assist the Director in administering the team or department to ensure goals and objectives are achieved while focusing on and improving the customer experience.
• Work with the leadership team to resolve customer and colleague matters requiring special attention, focusing on operational efficiency and delivering a simplistic and personable experience for internal and external customers.
• Identify inefficiencies in processes or the customer experience and develop and/or oversee plans for improvement; may develop and/or oversee assigned projects or future endeavors as a department or division representative.
• Coordinate work activities and manage a diverse team of colleagues responsible for Disability, Absence Management and/or Supplemental Medical claims, ensuring team, department, and operational goals are accurately set and achieved.
• Represent the company in legal cases to maintain accurate representation of the company’s actions; may represent the department to internal and external customers to ensure claim/contract/policyholder and/or service issues are appropriately, promptly, and accurately presented and resolved.
• Manage team and/or department staffing to ensure selection, development, review, and reward of colleagues align with operational standards and focus on achieving production, accuracy, and customer service standards; may be responsible for corrective actions up to and including termination.
• Ensure team or department processes, work tasks, or legal/compliance risks are accurately outlined, defined, and handled on a timely basis by monitoring reports and providing colleague training or resources as necessary.
• Participate in special assignments as determined by the department or division head.

Skills & Experience

• Minimum 6 years in a leadership/management position.
• Minimum 7–10 years in an insurance-related position with at least 4 years of claims experience.
• Company and industry knowledge required, including domestic and international markets.
• Strong oral and written communication skills, including outstanding interpersonal and consultative skills.
• Strong leadership skills with the ability to analyze and adjust organizational and departmental procedures for maximum efficiency.
• Diplomacy and decision-making capabilities.
• Proven analytical ability and case management claim skills.
• Proficient with PC Windows-based software, including Microsoft Office.
• Adapts easily to new software/technology applications and excels in a paperless environment.