BPO Operations Manager | Claims Management  

The Service Delivery Operations Manager will oversee staff whose teams’ primary duties may include, but are not limited to: Developing claims processes, policy and performance standards for the claim department. Responsible for directing and managing all claim personnel and claim functions as it pertains to absence management, short term and long term disability, FMLA and ADAAA administration. Develop claims policy, procedures, standards and methods for case management and return to work protocols. He/She will also be responsible to the following tasks:

• Provide complex case management technical support.
• Management of claim intake and customer service center
• Oversee incoming problems/complaints and respond to employer and employee questions
• Oversee quality control and audit functions within the claim department
• Provides support to all litigation processes that may occur during the course of claims management
• Work hand in hand with the Claims Operations Managers in making independent decisions, which have major day-to-day impact in area of responsibility.

• Open to College graduate and undergraduate with relevant work experience
• Must have at least 12 years overall experience in Operations
• Must have at least 7 years of Insurance Industry management experience
• Must have at least 3 years of Claims & Case management experience under Insurance Industry
• Experience in leading a Team of at least 100 FTEs
• Experience in managing case managers in the area of absence management, disability, clinical and appeal processes
• Knowledge and experience in managing claim systems, work flows, client expectations, renewals and personnel decisions
• Knowledge in Telephony Systems & Technology
• PHRN or USRN is an advantage
• Training & Quality experience is an advantage