Mgr, Claims Operations

Aflac, a Fortune 500 company and industry leader in voluntary insurance products, is known for its commitment to developing and empowering employees, fostering strong relationships, and giving back to the community. This role is remote, based in Windsor, CT, with occasional office visits as needed.

About the role

This position involves managing the daily operations of a Claims business unit, ensuring efficient workflows, customer satisfaction, and adherence to quality and regulatory standards. You will lead a team, drive process improvements, and align operations with company goals.

Responsibilities

• Manage daily operations of the Claims business unit, including staff and workflow processes.
• Analyze operational data, identify trends, and implement strategic plans to meet company and departmental goals.
• Resolve complex or sensitive claims issues and enhance service turnaround time, productivity, and quality.
• Direct risk management and quality improvement initiatives, including calibration sessions and adherence to quality standards.
• Stay updated on industry trends and technology changes, incorporating best practices into policies and system updates.
• Ensure claims are processed according to risk selection principles and regulatory requirements.
• Coordinate training efforts, identify staffing needs, and support employee development and incentive programs.
• Analyze and recommend business technology enhancements, leading assigned initiatives.
• Monitor and control operating expenses, provide input for annual budgets, and coordinate with legal counsel for depositions and hearings.
• Participate in companywide initiatives such as Quality Circles and Focus Groups.

Requirements

• Bachelor’s degree in Health Administration, Business, or a related field.
• 6 years of job-related work experience, including 4 years in a leadership, senior, or supervisory capacity.
• Broad knowledge of production management concepts, operational principles, and claims processing methodologies.
• Familiarity with federal, state, and local regulatory requirements in the insurance industry.
• Experience with budgeting, expense control, and employee relations.

Preferred Qualifications

• Experience in claims administration or a related field.
• Insurance or industry-specific designations.

Skills for Success

• Acting with Integrity
• Communicating Effectively
• Pursuing Self-Development
• Serving Customers
• Supporting Change
• Supporting Organizational Goals
• Working with Diverse Populations
• Acting as a Champion for Change
• Demonstrating Initiative
• Developing Talent
• Managing Performance

Pay

The salary range for this role is $90,000 to $120,000, with offers considering factors such as education, experience, licensure, certifications, and geographic location. This range does not include potential incentive pay or benefits.

Benefits

• Medical, dental, and vision coverage
• Prescription drug coverage
• Health care and dependent care flexible spending accounts
• Aflac supplemental policies (Accident, Cancer, Critical Illness, and Hospital Indemnity offered at no cost to employees)
• 401(k) plans with company match
• Annual bonuses and opportunity to purchase company stock
• 11 paid holidays annually
• Up to 20 days of PTO for any reason
• State-mandated sick leave (e.g., Washington employees accrue 1 hour per 40 hours worked)
• Compliance with all applicable leave laws, including sick, safe, adoption, and parental leave

Schedule

This is a full-time, remote role with occasional in-office visits as needed.