WC Regional Manager, Claims (Remote - Residency in Western States)

Blue Cross Blue Shield of Michigan • Lansing, MI

39d • Remote

About The Position

Provides leadership for a regional workers' compensation claims organization in accordance with claims adjudication and benefit allocation. Responsible for the overall performance of claims operations, including claim quality, customer experience, workforce development, financial stewardship, regulatory compliance, and operational effectiveness. Leads claim professionals, and support staff in achieving organizational goals while promoting a culture of accountability, continuous improvement, collaboration, and service excellence.

Requirements

• Bachelor’s degree in a related field.
• Seven (7) years of experience in a claim environment with demonstrated technical experience that provides the necessary knowledge, skills and abilities.
• Three (3) years of supervisory or leadership experience in claims required.
• Knowledge of team building and employee motivation theories with the ability to effectively manage multi-functional employee teams.
• Demonstrated leadership abilities.
• Knowledge of laws, regulations and compliance requirements related to workers’ compensation insurance.
• Demonstrated technical knowledge of insurance administration, claims management or relevant insurance expertise.
• Ability to work with and empower others on a collaborative basis to ensure success of unit team.
• Excellent oral and written communication skills.
• Knowledge of insurance and underwriting techniques, agency and policyholder needs.
• Ability to effectively present budgetary and/or cost information and respond to questions as appropriate.
• Ability to establish workflows, manage multiple projects and meet necessary deadlines.
• Ability and proficiency in the use of computers and company standard software specific to position.
• Must possess a valid driver's license with a record that meets corporate standards.

Nice To Haves

• Relevant combination of education and experience may be considered in lieu of degree.
• Previous workers’ compensation claim management with multi-jurisdictional experience preferred.
• Bilingual skills preferred.

Responsibilities

• Manages monoline workers' compensation unit of claim professionals and support staff.
• Leads claim team in support of department initiatives and strategies in cost containment, case file handling, customer service and quality.
• Consistently monitors workflows to maximize accuracy and efficiency.
• Maintains an acceptable level of service and customer satisfaction and retention.
• Effectively manages the quality review process.
• Develops unit goals, objectives, processes, procedures and systems.
• Stays abreast of changes in workers’ compensation statutes, case law and rehabilitation advancements.
• Identifies team staffing needs and takes necessary measures to ensure appropriate levels of service.
• Mentors employees and develops career paths with growth opportunities.
• Participates in development of annual departmental budget, monitors budget and identifies budget discrepancies.
• Researches cause of discrepancies and makes recommendations.
• Participates in special projects and serves on committees as needed.
• Directly supervises a varied number of employees in the designated department(s).
• Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws.
• Responsibilities include interviewing, hiring and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

Benefits

• Pay Range - Actual compensation decision relies on the consideration of internal equity, candidate’s skills and professional experience, geographic location, market, and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $100,000 and $158,350.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager