Mgr, Claims Operations (PLADS STD/Integrated Claims)
Fully remote work opportunity within the continental United States.Full-TimeManager
Salary90,000 - 130,000 USD per year
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Job Details
- Experience
- Minimum 6 years of experience in claims operations, insurance administration, or related business functions. At least 4 years of leadership or supervisory experience managing teams in operational environments.
- Required Skills
- LeadershipCommunication SkillsAnalytical SkillsMicrosoft OfficeOrganizational skillsPresentation skillsInterpersonal skillsProblem-solving skillsBudget management
Requirements
- Bachelor’s degree in Business, Management, or a related field, or equivalent professional experience.
- Minimum 6 years of experience in claims operations, insurance administration, or related business functions.
- At least 4 years of leadership or supervisory experience managing teams in operational environments.
- Strong knowledge of claims processing operations, production management methodologies, and operational performance optimization.
- Understanding of federal, state, and local insurance regulations, compliance standards, and industry practices.
- Experience with absence and disability claims administration, including STD/FMLA processes, is preferred.
- Strong analytical, organizational, and problem-solving skills with the ability to manage complex operational issues.
- Excellent communication, presentation, and interpersonal skills with the ability to collaborate across multiple business functions.
- Proficiency with Microsoft Office tools and Windows-based software applications.
- Experience managing budgets, operational expenses, and workforce planning initiatives.
- Professional industry certifications such as FLMI or ALHC are considered a plus.
Responsibilities
- Manage daily operations within the claims business unit, ensuring efficient workflow management, productivity, quality standards, and customer satisfaction.
- Lead, coach, and support supervisory staff and claims teams while fostering employee development, engagement, and performance improvement.
- Analyze operational data, identify trends, and prepare reports to support strategic decision-making and departmental objectives.
- Develop and implement operational improvements, quality initiatives, and risk management practices to enhance service delivery and compliance.
- Ensure claims processing activities align with regulatory requirements, internal policies, and industry standards.
- Coordinate training initiatives, staffing projections, and development programs to support team effectiveness and operational goals.
- Partner with internal stakeholders to evaluate and implement technology enhancements, workflow improvements, and automation opportunities.
- Monitor departmental budgets and operating expenses to support financial objectives and resource optimization.
- Participate in organizational initiatives, process improvement programs, and cross-functional projects to support broader business goals.
- Support legal and compliance activities by coordinating documentation reviews and preparing for hearings or related proceedings when necessary.
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