Supplemental Health Claims Manager

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. Collaborate with supervisors, colleagues, 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 the most complex claim issues and work with internal and external legal representatives to provide direction and support in defense of lawsuits, helping to minimize litigation. Actively manage staff and plan for the appropriate allocation and use of resources, analyzing past workloads to determine future needs and identify service trends that may impact quality service to customers.

Develop supervisors and colleagues within your area of responsibility by providing appropriate feedback on performance to reinforce strengths and address areas needing improvement. Hold supervisors accountable for colleague development within their areas. Demonstrate advanced judgment and collaborate with other leaders to leverage past experience in developing standardized processes and procedures that enhance service delivery.

Work with others to identify deficiencies and areas for improvement, acting as a mentor to motivate colleagues to provide superior service. Lead department or division improvement initiatives that result in enhanced processes, procedures, and systems supporting a positive customer experience.

Responsibilities

• Direct and oversee teams responsible for Disability, Absence Management, and/or Supplemental Medical claim processing.
• Set and manage performance goals and expectations in compliance with state and federal regulations.
• Resolve complex claim issues and collaborate with legal representatives to minimize litigation.
• Manage staff and resources, analyzing workloads and service trends to ensure quality customer service.
• Develop supervisors and colleagues through performance feedback and accountability.
• Lead initiatives to improve processes, procedures, and systems for a better customer experience.
• Mentor colleagues and identify areas for improvement within the department or division.

Requirements

• Minimum 6 years in a leadership/management position.
• Minimum 7-10 years in an insurance-related position, with at least 4 years of life claims experience.
• Company and industry knowledge, including domestic and international markets.
• Strong oral and written communication skills, including outstanding interpersonal and consultative abilities.
• Proven leadership skills with a focus on analyzing and adjusting organizational procedures for maximum efficiency.
• Diplomacy and strong decision-making capabilities.
• Proven analytical ability and case management claim skills.
• Proficient with PC Windows-based software, including Microsoft Office.
• Ability to adapt to new software/technology applications and excel in a paperless environment.