Job Description

Claim Manager

Home

Full time

R-10363

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.

Job Posting Title

Claim Manager

Job Description Summary

Responsible for managing multiple service or business units to meet or exceed customer requirements and business objectives. Responsible for maintaining a supportive work environment. Must conduct activities within guidelines set forth by individual state or federal regulations.

Job Description

  • Develops strategic, operational and tactical business plans to achieve desired business goals for responsible units.
  • Reviews and directs service operation performance to meet or exceed business goals.
  • Builds and maintains collaborative relationships and alliances with internal and external customers including but not limited to Employer and Provider Groups, Members, Marketing, Finance and Client Services IT and Compliance to achieve business goals.
  • Meets regularly with internal partners to determine service requirements and expectations for overall satisfaction.
  • Provides reporting and project support to management as needed.
  • Recruits, attracts, develops, motivates and manages a high caliber of talent.
  • Fosters confidence and trust with client base.
  • Ability to understand and manage expense budget, as well as the incremental per unit costs associated with production environments.
  • Identifies and implements process improvements on multiple systems or units within the business unit.
  • Maintains a positive work environment that supports self-directed teams; provides a structure to optimize the experience, skill, knowledge and capability of the teams.
  • Rewards employees based on contribution and performance.

Responsibilities

  • A combination of education and work experience may be considered.
  • 7+ years’ experience in service industry/operations.
  • Knowledge of MS Office software, specifically Excel.
  • Experience in developing and managing budgets.
  • Progressive supervisory responsibilities and experience in managing cross-functional, self-directed teams.
  • Strong influencing, negotiation and analytical skills.
  • Team advocate.
  • Ability to travel 10%.

Work Experience

Work Experience – Required:

Claims, Customer Service, Supervisory

Work Experience – Preferred:

Education

Education – Required:

A Combination of Education and Work Experience May Be Considered., Bachelors

Education – Preferred:

Certifications

Certifications – Required:

Certifications – Preferred:

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