PLADS (LTD) Mgr, Claims Operations
$90,000–$120,000 year
RemoteUnited States
Job Summary
Manage the daily operations of the Claims business unit by gathering and analyzing data, completing reports on activities and trends, and performing independent reviews to resolve complex operational issues. Direct risk management and quality improvement initiatives by facilitating calibration sessions, using statistical analysis to establish adherence to quality standards, and incorporating best practices into policies and system changes. Coordinate training efforts, project staffing requirements, and guide supervisors in coaching employees while monitoring business technology needs and recommending viable solutions. Monitor and control operating expenses to ensure financial goals are met, provide input into the annual budget, and coordinate with counsel for legal matters. This remote role supports strategic operational plans to enhance service turnaround time and productivity within the Claims department.
Required Qualifications
- Bachelor's Degree In Health Administration, Business, or a related field
- 6 years of job-related work experience
- 4 years in a leadership/senior/supervisory capacity
- Or an equivalent combination of education and experience
- Broad knowledge of production management concepts, operating principles, and operational management methodology applicable to claims processing
- 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
- Remote work capability within the continental US
- Ability to come to the office based on business need when requested in advance
Desired Qualifications
- Claims administration, or experience in a related field or industry
- Insurance or other industry designations
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