Mgr, Claims Operations

We develop and empower our people, cultivate relationships, give back to our community, and celebrate every success along the way. We do it all…The Aflac Way. Aflac, a Fortune 500 company, is an industry leader in voluntary insurance products that pay cash directly to policyholders and one of America's best-known brands.

About the role

This is a remote role based in the continental US. Occasional office visits may be requested with advance notice.

What it takes to be successful at Aflac

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

What it takes to be successful in this role

• Broad knowledge of production management concepts, operating principles, and operational management methodology applicable to claims processing; ability to apply this knowledge to analyze and resolve very complex or sensitive claims operational issues; ability to apply new developments and methodologies to improve efficiencies
• Broad knowledge of federal, state, and local regulatory and industry requirements, standard concepts, practices, and procedures as they relate to the insurance industry and claims processing
• Knowledge of budgeting and expense control to plan, implement, and maximize expenditure of funds while maintaining and improving quality standards
• Knowledge of employee relations to conduct and deal with employee issues in a proactive manner
• Strong personal computer skills with experience in Windows-based software; experience using Microsoft Outlook or similar email systems
• Excellent presentation, oral, written, and interpersonal communication skills to effectively interact with senior management and internal/external business contacts

Requirements

• Bachelor’s Degree in Health Administration, Business, or a related field
• 6 years of job-related work experience
• 4 years in a leadership/senior/supervisory capacity
• Or an equivalent combination of education and experience

Preferred Qualifications

• Claims administration or related field experience
• Insurance or other industry designations

Responsibilities

• Manages the daily operations of the Claims business unit; oversees employees and operations at the functional level
• Gathers and analyzes data and reports pertaining to the overall operation of the Claims business unit; completes reports summarizing activities and trends
• Assists in strategic and tactical operational plans to ensure achievement of company and departmental goals
• Performs independent review of problem situations; develops solutions and implements actions to resolve problems and ensure customer satisfaction
• Reviews processes and procedures to streamline activities, enhance service turnaround time, productivity, and quality
• Coordinates overall workflow of the business unit to ensure effective and efficient use of corporate resources and enhance customer satisfaction
• Directs efforts to implement risk management and quality improvement initiatives; facilitates calibration sessions
• Uses methods such as work process studies, statistical analysis, and assessments of production area performance to establish adherence to quality standards/scorecards
• Remains abreast of industry trends and technology changes; incorporates best practices in the development of quality standards, policies, programs, and system changes for the department
• Ensures claims are processed according to appropriate risk selection principles
• Coordinates and monitors training efforts to ensure necessary education tools are provided to employees; identifies and communicates training needs and schedules with the training department
• Projects staffing requirements for the business unit; guides supervisors in coaching and counseling employees; coordinates employee development and incentive initiatives
• Identifies, analyzes, and monitors business technology requirements and enhancement possibilities; recommends viable technological solutions, modifications, and applications
• Prepares recommendations for implementation of initiatives; takes a leadership role in managing assigned initiatives; participates in and supports companywide initiatives
• Monitors and controls operating expenses to ensure corporate/divisional financial goals are met; provides input into the annual business unit budget
• Reviews legal files and coordinates with counsel to prepare for depositions and court hearings
• Performs other related duties as required

Pay

The salary range for this job is $90,000 to $120,000. This range is specific to the job and salary offers consider factors including education, experience, licensure, certifications, geographic location, and peer compensation. The range is based on information known to Aflac at the time of posting. Compensation decisions depend on individual circumstances.

Benefits

• Medical, dental, and vision coverage
• Prescription drug coverage
• Health care flexible spending account
• Dependent care flexible spending account
• Aflac supplemental policies (Accident, Cancer, Critical Illness, and Hospital Indemnity offered at no cost to employee)
• 401(k) plans
• Annual bonuses
• Opportunity to purchase company stock
• 11 paid holidays annually
• Up to 20 days PTO for any reason
• State-mandated sick leave (Washington employees accrue 1 hour of sick leave for every 40 hours worked)
• Other leaves of absence, if eligible, to support physical, financial, and emotional well-being