Mgr, Claims Operations The Company: CAIC PFML The Location: Windsor, CT, US, 06095 The Division: PLADS Job Id: 6810 Salary Range: $83,000 - $193,000 Job Posting End Date: September 16, 2024 We’ve Got You Under Our Wing We are the duck. We develop and empower our people, cultivate relationships, give back to our community, and celebrate every success along the way. We do it all…The Aflac Way. Aflac, a Fortune 500 company, is an industry leader in voluntary insurance products that pay cash directly to policyholders and one of America's best-known brands. Aflac has been recognized as Fortune’s 50 Best Workplaces for Diversity and as one of World’s Most Ethical Companies by Ethisphere.com. Our business is about being there for people in need. So, ask yourself, are you the duck? If so, there’s a home, and a flourishing career for you at Aflac. Worker Designation – This role ishybrid.This means you will be expected to report to one of our Aflac offices located in Windsor, CT for at least 60% of the work week. You will work from your home (within the continental US) for the remaining portion of the work week. Details of this schedule will be discussed with your leadership. Work Designation – Depending on your location within the continental US, this role may behybridorremote.
If you livewithin 50 milesof the Aflac offices located in Columbus, GA or Columbia, SC, this role will behybrid.This means you will be expected to work in the office for at least 60% of the work week. You will work from your home (within the continental US) for the remaining portion of the work week. Details of this schedule will be discussed with your leadership.
If you livemore than 50 milesfrom the Aflac offices located in Columbus, GA or Columbia, SC, this role will beremote.This means you will be expected to work from your home, within the continental US. If the role is remote, there may be occasions that you are requested to come to the office based on business need. Any requests to come to the office would be communicated with you in advance.
What does it take to be successful at Aflac?
Acting as a Champion for Change
Acting with Integrity
Communicating Effectively
Demonstrating Initiative
Developing Talent
Managing Performance
Pursuing Self-Development
Serving Customers
Supporting Change
Supporting Organizational Goals
Working with Diverse Populations
What does it take to be successful in this role?
Broad knowledge of production management concepts, operating principles, and operational management methodology applicable to claims processing; a high degree of skill in applying this knowledge to the analysis and resolution of very complex or sensitive claims operational issues; ability to apply new developments and methodologies to direct the improvement in efficiencies
Broad knowledge of federal, state, and local regulatory and industry requirements, standard concepts, practices, and procedures as they relate to the insurance industry and claims processing
Knowledge of budgeting and expense control to plan, implement, and maximize expenditure of funds while maintaining and improving quality standards
Knowledge of employee relations to conduct and deal with employee issues in a proactive manner
Strong personal computer skills with experience in Windows-based software; experience using Microsoft Outlook or a similar e-mail system software
Excellent presentation, oral, written, and interpersonal communications skills to effectively interact with senior management, and internal and external business contacts
Education & Experience Required
Bachelor's Degree In business or a related field
5 - 6 years of professional, related work experience
4 years in a supervisory/managerial capacity leading diverse work groups
Minimum Required For the State of New York: must possess a current New York independent adjuster license, and complete required CEUs to maintain an active license in good standing.
Or an equivalent combination of education and experience
Education & Experience Preferred
Experience in the insurance industry
Industry designations such as FLMI or ALHC
Principal Duties & Responsibilities
Manages the daily operations of the Claims business unit; manages employees and operations of the business unit at the functional level; gathers and analyzes data and reports that pertain to the overall operation of the Claims business unit and completes reports summarizing activities and trends; assists in strategic and tactical operational plans to ensure achievement of company and departmental goals; performs independent review of problem situations; develops solutions and implements actions to resolve problems and ensure customer satisfaction; reviews processes and procedures to streamline activities to enhance service turnaround time, productivity, and quality; coordinates overall workflow of the business unit and ensures that workflow processes facilitate effective and efficient use of corporate resources and enhance customer satisfaction
Directs efforts to implement risk management and quality improvement initiatives; facilitates calibration sessions; uses methods such as work process studies, statistical analysis, and assessments of production area performance to establish adherence to quality standards/scorecards; remains abreast of industry trends and technology changes; incorporates best practices in the development of quality standards, policies, programs, and system changes for the department; ensures that claims are processed according to appropriate risk selection principles
Coordinates and monitors training efforts to ensure that necessary education tools are provided to employees; identifies and communicates training needs and schedules with training department; projects staffing requirements for the business unit; guides supervisors in coaching and counseling employees; coordinates employee development and incentive initiatives
Identifies, analyzes, and monitors business technology requirements and enhancement possibilities; recommends viable technological solutions, modifications, and applications; prepares recommendations for implementation of initiatives; takes a leadership role in managing assigned initiatives; participates in and supports companywide initiatives through Quality Circles, Focus Groups, or other project initiatives
Monitors and controls operating expenses to ensure that corporate/divisional financial goals are met; provides input into the annual business unit budget; reviews legal files and coordinates with counsel to prepare for depositions and court hearings
Performs other related duties as required
Total Rewards
This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions including, but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. The range has been created in good faith based on information known to Aflac at the time of the posting. Compensation decisions are dependent on the circumstances of each case. This salary range does not include any potential incentive pay or benefits, however, such information will be provided separately when appropriate. The salary range for this position is $83,000 to $193,000.
In addition to the base salary, we offer an array of benefits to meet your needs including medical, dental, and vision coverage, prescription drug coverage, health care flexible spending, dependent care flexible spending, Aflac supplemental policies (Accident, Cancer, Critical Illness and Hospital Indemnity offered at no costs to employee), 401(k) plans, annual bonuses, and an opportunity to purchase company stock. On an annual basis, you’ll also be offered 11 paid holidays, up to 20 days PTO to be used for any reason, and, if eligible, state mandated sick leave (Washington employees accrue 1 hour sick leave for every 40 hours worked) and other leaves of absence, if eligible, when needed to support your physical, financial, and emotional well-being. Aflac complies with all applicable leave laws, including, but not limited to sick and safe leave, and adoption and parental leave, in all states and localities.
Nearest Major Market:Hartford