Mgr, Claims Operations; Hybrid - Windsor, CT

About the role

The Worker Designation for this role is hybrid. You will be expected to report to our Aflac office in Windsor, CT for at least 60% of the work week and work from your home (within the continental US) for the remaining portion.

Responsibilities

• Manages the daily operations of the Claims business unit
• Manages employees and operations of the business unit at the functional level
• Gathers and analyzes data and reports that pertain to the overall operation of the Claims business unit
• Assists in strategic and tactical operational plans to ensure achievement of company and departmental goals
• Performs independent review of problem situations and develops solutions and implements actions to resolve problems and ensure customer satisfaction
• Reviews processes and procedures to streamline activities to enhance service turnaround time, productivity, and quality
• Captures and analyzes data and reports that pertain to the overall operation of the Claims business unit
• Coordinates overall workflow of the business unit and ensures that workflow processes facilitate effective and efficient use of corporate resources and enhance customer satisfaction
• Directs efforts to implement risk management and quality improvement initiatives
• Facilitates calibration sessions and 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 and incorporates best practices in the development of quality standards, policies, programs, and system changes for the department
• Ensures that claims are processed according to appropriate risk selection principles
• Coordinates and monitors training efforts to ensure that necessary education tools are provided to employees
• Identifies and communicates training needs and schedules with 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 through Quality Circles, Focus Groups, or other project initiatives
• Maintains compliance with federal, state, and local regulatory and industry requirements
• Monitors and controls operating expenses to ensure that 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

Qualifications

• 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
• Claims administration, or experience in a related field or industry
• Insurance or other industry designations

Skills

• Broad knowledge of production management concepts, operating principles, and operational management methodology applicable to claims processing
• A high degree of skill in applying this knowledge to the analysis and resolution of very complex or sensitive claims operational issues
• Ability to apply new developments and methodologies to direct the improvement in 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 a similar e-mail system software
• Excellent presentation, oral, written, and interpersonal communications skills to effectively interact with senior management, and internal and external business contacts

Benefits

• Total Rewards: Salary range $90,000 to $120,000
• Medical, dental, and vision coverage
• Prescription drug coverage
• Health care flexible spending
• Dependent care flexible spending
• Aflac supplemental policies (Accident, Cancer, Critical Illness and Hospital Indemnity offered at no costs to employee)
• 401(k) plans
• Annual bonuses
• Opportunity to purchase company stock
• 11 paid holidays
• Up to 20 days PTO to be used for any reason
• State-mandated sick leave (Washington employees accrue 1-hour sick leave for every 40 hours worked)
• Other leaves of absence, if eligible, when needed to support your physical, financial, and emotional well-being

Pay

The salary range for this job is $90,000 to $120,000. This range is specific to the job and salary offers consider a wide range of factors that are considered in making compensation decisions, including, but not limited to: education, experience, licensure, certifications, geographic location, and peer compensation.

Schedule

The Worker Designation for this role is hybrid. You will be expected to report to our Aflac office in Windsor, CT for at least 60% of the work week and work from your home (within the continental US) for the remaining portion.