To oversee technical and operational functions including compliance with company standards and industry best practices; to ensure consistent delivery of quality services; to oversee staffing and training needs; and to oversee budget preparation and profit and loss management.
Has direct responsibility for less than 25 colleagues.
Oversees internal quality review process and reports monthly.
Assures compliance with client internal controls, audit requirements and service agreement requirements.
Establishes business plan with goals and objectives for assigned clients.
Ensures claims management policies and procedures are followed to assure meeting service standards, state statutes/regulations, disability plan document, industry best practices and client service requirements.
Establishes and maintains client contacts.
Performs other duties as assigned.
Supports the organization's quality program(s).
Travels as required.
Requirements
Bachelor's degree from an accredited college or university preferred
Licenses as required
Professional certifications appropriate to line of business preferred
Eight (8) years claims management experience or equivalent combination of education and experience required to include two (2) years supervisory experience.
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Leadership/management/motivational skills
Analytical and interpretive skills
Strong organizational skills
Excellent interpersonal skills
Excellent negotiation skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies.
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