Mgr, Claims Operations

Aflac, Incorporated•Farmington, CT

2d•$90,000 - $120,000

About The Position

The Manager, Claims Operations manages the daily operations, employees, and workflows of the Claims business unit. The role gathers and analyzes operational data, prepares reports on activities and trends, supports strategic and tactical planning, resolves complex operational problems, and improves processes to enhance service turnaround time, productivity, quality, and customer satisfaction. The position directs risk management and quality improvement efforts, facilitates calibration sessions, evaluates production performance, and develops quality standards, policies, programs, and system changes informed by industry trends and best practices. It also coordinates employee training and development, projects staffing needs, supports supervisors in coaching and counseling employees, and coordinates employee incentive initiatives. The manager identifies business technology requirements and improvement opportunities, recommends solutions, and leads assigned initiatives. The role monitors operating expenses, contributes to the business unit budget, and reviews legal files and coordinates with counsel in preparation for depositions and court hearings. The position may be hybrid or remote depending on the employee’s location within the continental United States. Employees within 50 miles of the Columbus, Georgia, or Columbia, South Carolina offices are expected to work in the office at least 60% of the work week; employees farther away work remotely, with possible office visits based on business needs.

Requirements

Bachelor’s degree in Health Administration, Business, or a related field, or an equivalent combination of education and experience.
Six years of job-related work experience, or an equivalent combination of education and experience.
Four years in a leadership, senior, or 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.
Ability to apply claims operations knowledge to complex or sensitive operational issues and use new developments and methodologies to improve efficiency.
Broad knowledge of federal, state, and local regulatory and industry requirements, concepts, practices, and procedures related to insurance and claims processing.
Knowledge of budgeting and expense control to plan and maximize expenditures while maintaining and improving quality standards.
Knowledge of employee relations and ability to proactively handle employee issues.
Strong personal computer skills and experience with Windows-based software.
Experience using Microsoft Outlook or similar email software.
Excellent presentation, oral, written, and interpersonal communication skills for interacting with senior management and internal and external business contacts.

Nice To Haves

Claims administration experience or experience in a related field or industry.
Insurance or other industry designations.

Responsibilities

Manage daily Claims business unit operations, employees, and functional-level operations.
Gather and analyze operational data and reports; prepare reports summarizing activities and trends.
Assist with strategic and tactical operational plans to achieve company and departmental goals.
Independently review problem situations, develop solutions, and implement actions to resolve problems and ensure customer satisfaction.
Review processes and procedures to improve service turnaround time, productivity, and quality.
Coordinate business unit workflow to promote effective and efficient use of corporate resources and customer satisfaction.
Direct risk management and quality improvement initiatives and facilitate calibration sessions.
Use work process studies, statistical analysis, and production performance assessments to evaluate adherence to quality standards and scorecards.
Monitor industry trends and technology changes, and incorporate best practices into quality standards, policies, programs, and system changes.
Ensure claims are processed according to appropriate risk selection principles.
Coordinate and monitor employee training; identify training needs and coordinate schedules with the training department.
Project business unit staffing requirements and guide supervisors in employee coaching and counseling.
Coordinate employee development and incentive initiatives.
Identify, analyze, and monitor business technology requirements and enhancement possibilities; recommend solutions, modifications, and applications.
Prepare recommendations for initiatives and lead assigned initiatives; participate in and support companywide projects and initiatives.
Monitor and control operating expenses, contribute to the annual business unit budget, and help meet financial goals.
Review legal files and coordinate with counsel to prepare for depositions and court hearings.
Perform other related duties as required.

Benefits

Medical, dental, and vision coverage
Prescription drug coverage
Health care flexible spending account
Dependent care flexible spending account
Aflac supplemental Accident, Cancer, Critical Illness, and Hospital Indemnity policies offered at no cost to employees
401(k) plans
Annual bonuses
Opportunity to purchase company stock
11 paid holidays annually
Up to 20 days of PTO to be used for any reason
State-mandated sick leave, if eligible
Other leaves of absence, if eligible
Adoption and parental leave in accordance with applicable laws