Senior Manager, Technical Standards & Compliance - 101656633-5
Sedgwick
TN
há 5 dias

PRIMARY PURPOSE

  • To ensure product quality and regulatory standards compliance by line-of-business; to establish policies and procedures;
  • and to develop and train colleagues on technical components of new programs.

    ESSENTIAL FUNCTIONS and RESPONSIBILITIES

  • Establishes policies and procedures to assure compliance to best practices, claims management services standards, state regulations, and client service requirements on new programs.
  • Analyzes management reports related to new program performance and quality; mentors new colleagues to improve performance as needed.
  • Maintains complete understanding of new program design, processes, client expectations and partner relationships; makes recommendations for improvements;
  • and develops best practices for disability and leave operational processes.

  • Serves as subject matter expert responsible for the training of technical processes and requirements; leads training initiatives for colleagues, supervisors / managers and clients as needed.
  • Leads projects focused on large process, procedural and / or compliance changes / updates; communicates changes / updates to field offices, IT, Legal and other applicable business units regarding regulatory requirements and changes.
  • Plays key role in maintaining client relationships; assists in new business productions; and represents Company with specified industry groups.
  • ADDITIONAL FUNCTIONS and RESPONSIBILITIES

  • Performs other duties as assigned.
  • Supports the organization's quality program(s).
  • Travels as required.
  • SUPERVISORY RESPONSIBILITIES

  • Administers company personnel policies in all areas and follows company staffing standards and training recommendations.
  • Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions.
  • Provides support, guidance, leadership and motivation to promote maximum performance.
  • QUALIFICATIONS

    Education & Licensing

    Bachelor's degree from an accredited college or university or equivalent preferred.

    Experience

    Ten (10) years of claims management, managed care and / or other related experience or equivalent combination of education and experience required to include three (3) years in a supervisory capacity in the specified field.

    Skills & Knowledge

  • In depth knowledge of claims management, managed care and / or absence management processes and procedures
  • Excellent oral and written communication, including presentation skills
  • PC literate, including Microsoft Office products
  • Analytical and interpretive skills
  • Strong organizational skills
  • Excellent interpersonal skills
  • Excellent negotiation skills
  • Ability to work in a team environment
  • Ability to meet or exceed Performance Competencies
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