Claims - Manager

Wellcove•PENSACOLA, FL

About The Position

This position plays an integral role in the success of our assessment service. Responsible for managing the end-to-end inventory to ensure assessments are handled efficiently, effectively, and in a quality manner. Partner with leadership to identify areas for improvement in service and workflow and ensure efficient and proper handling of assessments and escalations. Duties/Responsibilities: Responsible for managing multiple end-to-end inventory streams for assessments: Monitors daily, weekly and monthly inventory to ensure assessments are handled timely (within agreed upon Service Levels (SLAs)) and appropriately Improve and streamline processes by re-designing workflows, processes and procedures Excellent people management skills and able to work under pressure Provide and implement a suggestion and feedback process to promote and support an environment of continuous process improvement Audit team’s phone calls, stats, and completed tasks to measure associates’ accuracy to policies and procedures Perform monthly reviews with employees to ensure thorough understanding of goals and expectations Provide strategic leadership in assessing and addressing gaps across the National Network of Nurse Assessors, ensuring optimal geographic distribution, clinical expertise, and operational readiness. Oversee the design and implementation of comprehensive recruitment strategies to expand the assessor network in underserved and high‑priority regions, aligning growth with organizational goals and service demand. Direct initiatives to drive adoption of the organization’s digital assessment platform, including developing training frameworks, change‑management approaches, and engagement strategies to increase utilization and standardization across the network. Guide cross‑functional collaboration to strengthen workforce capacity, enhance assessment quality, and support long‑term scalability of the national program. Interact with stakeholders at multiple levels and dynamically lead business and service to define and deliver solutions Ensure ongoing success of quality and process improvement strategies across multiple data sources through metrics and analysis Translate customer critical quality characteristics to operational requirements and continuous improvement opportunities Provide authoritative advice and guidance to team including associate training, coaching or monitoring where appropriate Ensure team delivers outstanding customer service via phone and email, displaying professionalism, empathy, and a sense of urgency Display a genuine willingness to assist escalated situations and proactively identify solutions Other projects, as defined

Requirements

People Management
Proven ability to manage multiple, complex inventories
Excellent computer skills including but not limited to proficiency in Microsoft Office Suite of applications, Nitro Pro Acrobat
Ability to work remotely and independently
Display a positive ‘can do’/customer-first attitude
Excellent communication skills and appropriate etiquette and ability to manage a wide range of personalities
Demonstrate a high level of proficiency in the use of the English language in oral and written forms
Drive to learn new techniques and technology-related skills as required
Collaborative team spirit
Bachelor’s Degree preferred, or equivalent combination of education, training, and experience.

Responsibilities

Responsible for managing multiple end-to-end inventory streams for assessments
Monitors daily, weekly and monthly inventory to ensure assessments are handled timely (within agreed upon Service Levels (SLAs)) and appropriately
Improve and streamline processes by re-designing workflows, processes and procedures
Excellent people management skills and able to work under pressure
Provide and implement a suggestion and feedback process to promote and support an environment of continuous process improvement
Audit team’s phone calls, stats, and completed tasks to measure associates’ accuracy to policies and procedures
Perform monthly reviews with employees to ensure thorough understanding of goals and expectations
Provide strategic leadership in assessing and addressing gaps across the National Network of Nurse Assessors, ensuring optimal geographic distribution, clinical expertise, and operational readiness.
Oversee the design and implementation of comprehensive recruitment strategies to expand the assessor network in underserved and high‑priority regions, aligning growth with organizational goals and service demand.
Direct initiatives to drive adoption of the organization’s digital assessment platform, including developing training frameworks, change‑management approaches, and engagement strategies to increase utilization and standardization across the network.
Guide cross‑functional collaboration to strengthen workforce capacity, enhance assessment quality, and support long‑term scalability of the national program.
Interact with stakeholders at multiple levels and dynamically lead business and service to define and deliver solutions
Ensure ongoing success of quality and process improvement strategies across multiple data sources through metrics and analysis
Translate customer critical quality characteristics to operational requirements and continuous improvement opportunities
Provide authoritative advice and guidance to team including associate training, coaching or monitoring where appropriate
Ensure team delivers outstanding customer service via phone and email, displaying professionalism, empathy, and a sense of urgency
Display a genuine willingness to assist escalated situations and proactively identify solutions
Other projects, as defined