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Role Description

This role involves supporting case managers and ensuring quality outcomes in claims management.

• Acts as a main point of contact for claims specific questions for the case managers.
• Serves as a mentor for new hires as well as supports new hiring training.
• Takes an active role in refresher training and development of existing staff.
• Ensures case managers are utilizing appropriate risk management skills to secure the appropriate claim outcome.
• Conducts manager reviews/audits of claims as necessary to ensure overall quality.
• Provides the appropriate coaching and feedback to case managers as needed.
• Monitors KPIs and reports to ensure service levels and commitments are met, working with case managers as needed.
• Monitors and adjusts workload balancing for case managers.
• Provides support to management in facilitating team meetings/ huddles.
• May periodically manage complex cases and customer escalations.
• Elevates any trends and/or coaching opportunities to the leadership team.
• Completes special projects and/or ad hoc assignments as requested by leadership.
• Performs other related duties as required.

Qualifications

• Bachelor's Degree in business, management or a related field.
• 4 or more years job related experience.
• 2 years STD/LTD case management experience.
• Or an equivalent combination of education and experience.

Requirements

• Ability to influence and champion change.
• Excellent critical thinking and decision-making skills.
• Strong leadership and organizational skills.
• Excellent Communication skills (verbal, written & presentation).
• Strong understanding of contracts, plans and products.
• Strong knowledge of best practices and effective case management skills.

Benefits

• 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.
• Opportunity to purchase company stock.
• 11 paid holidays.
• Up to 20 days PTO to be used for any reason.
• State-mandated sick leave (Washington employees accrue 1-hour sick leave for every 40 hours worked).
• Compliance with all applicable leave laws, including sick and safe leave, and adoption and parental leave.