Mgr, Claims Operations (PLADS LTD)
- 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
- 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
- Bachelor's Degree In business or a related field
- 5 - 6 years of professional, related work experience
- 4 years in a supervisory/managerial capacity leading diverse work groups
- Absence & Disability Industry Experience (Specifically LTD)
- Industry designations such as FLMI or ALHC
- 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 and 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 to enhance service turnaround time, productivity, and quality; 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; 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 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
- 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
- Performs other related duties as required
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