Mgr, Claims Operations; Hybrid - Windsor, CT

About the role

The Manager, Claims Operations role is hybrid, requiring at least 60% in-office presence at Aflac's office in Windsor, CT, with the remainder of the workweek from home within the continental US.

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
• Aids in strategic and tactical operational plans to ensure achievement of company and departmental goals
• Reviews processes and procedures to streamline activities to enhance service turnaround time, productivity, and quality
• Captures workflow processes to 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, analyzes, and monitors business technology requirements and enhancement possibilities
• Prepares recommendations for implementation of initiatives and 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

Requirements

Bachelor's Degree in Health Administration, Business, or a related field. 6 years of job-related work experience, with 4 years in a leadership/senior/supervisory capacity.

Qualifications

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; 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.

Skills

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

Benefits

Total Rewards: 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. The range has been created in good faith based on information known to Aflac at the time of the posting. At Aflac, it is not typical for an individual to be hired at or near the top of the range for the role to allow for future and continued salary growth, and compensation decisions are dependent on the circumstances of each case. This salary range does not include any potential incentive pay or benefits, however, such information will be provided separately when appropriate. In addition to the base salary, we offer an array of benefits to meet your needs including 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, and an opportunity to purchase company stock. On an annual basis, you’ll also be offered 11 paid holidays, up to 20 days PTO to be used for any reason, and, if eligible, state-mandated sick leave (Washington employees accrue 1-hour sick leave for every 40 hours worked) and other leaves of absence, if eligible, when needed to support your physical, financial, and emotional well-being. Aflac complies with all applicable leave laws, including, but not limited to, sick and safe leave, and adoption and parental leave, in all states and localities.