Job Summary
Serves as the claim and/or leave subject matter expert providing support to the Operations leadership team as well as a mentor for case managers.
Principal Duties & Responsibilities
- Acts as a main point of contact for claims specific questions for the case managers
- Serves as a mentor for new hires as well as supports new hiring training
- Takes an active role in refresher training and developing of existing staff
- Ensures case managers are utilizing appropriate risk management skills to secure the appropriate claim outcome
- Conducts manager reviews/ audits of claims as necessary to ensure overall quality
- Provides the appropriate coaching and feedback to case managers as needed
- Monitors KPIs and reports to ensure service levels and commitments are met, working with case managers as needed
- Monitors and adjusts workload balancing for case managers
- Provides support to the manager in facilitating team meetings/ huddles
- May periodically manage very complex cases directly
- Elevates any trends and / or coaching opportunities to the leadership team
- May manage customer escalations
- Completes special projects and/or ad hoc assignments as requested by the leadership team
- Performs other related duties as required
Education & Experience Required
- Minimum Required Bachelor’s Degree In a related field.
- Minimum Required 5-year minimum STD industry experience
- Minimum Required 2 years minimum experience working with employees
Or an equivalent combination of education and experience
Job Knowledge & Skills
- Ability to influence and champion change
- Excellent critical thinking and decision -making skills
- Strong leadership and organizational skills
- Excellent Communication skills (verbal, written & presentation)
- Strong understanding of contracts, plans and products
- Strong knowledge of best practices and effective case management skills
Competencies
- Acting with Integrity
- Communicating Effectively
- Pursuing Self-Development
- Serving Customers
- Supporting Change
- Supporting Organizational Goals
- Working with Diverse Populations
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