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Mgr, PLADS STD/Leave

AFLAC Orlando, FL
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Job Summary

The Manager, STD/Leave is responsible for management and administration of multiple functions, or management of general business operations within Disability Claims Department.

 

Principal Duties & Responsibilities

  • Oversee daily operations of multiple levels of staff and multiple functions across one or more business units

     

  • Manage day to day site operations, and accountability for financial and non - financial results (budgets and actuals)

     

  • Provide expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting Insurance and Leave of Absence claims

     

  • Attend/participate in select customer meetings as appropriate to discuss feedback and/or needed process enhancements.

     

  • Initiates and maintains partnerships with others throughout the organization. Encourages cooperation by promoting common goals and building trust. Inspires, supports, and initiates cross[1]functional activities.

     

  • Authorize the appropriate payment or refers claims to investigators for further review

     

  • Analyzes and identifies trends and provides reports as necessary

     

  • Lead project management and implementation initiatives

     

  • Identifies trends and assist in developing creative solutions to improve overall efficiencies of Short Term Disability and leave of Absence processes

     

  • Analyzes and distribute daily reports and ensure Performance Guarantees and critical claim indicators are consistently met

     

  • Consistently cascade critical compliance and process updates to team members; provides appropriate oversight to ensure team successfully achieves targets to meet Performance Guarantees; supports employee development by conducting regularly scheduled 1x1s with direct reports; coaches and develops direct reports to advanced claim management practices

     

  • Travel Less than 10% of the time

     

  • Performs other duties as required

     

    Education & Experience Required

    • Bachelor's Degree in a related field
    • 5+ years of claims industry experience
    • 5+ years of Supervisory, Managerial, and / or leadership experience in claims adjudication or customer service
    • 2+ years of experience managing relationships with clients and / or vendors
    • 2+ years of experience managing budgets, process improvement and quality assurance

     

     

    Education & Experience Preferred

    • Operation Excellence (Six Sigma) experience

     

    Or an equivalent combination of education and experience

     

    Job Knowledge & Skills

  • Experience using specific medical and/or behavioral health criteria or protocols

     

  • Extensive clinical experience/knowledge

     

  • Strong customer service skills

     

  • Strong written and oral communication skills.

     

  • Strong organizational and time management skills

     

  • Ability to analyze clinical records in the context of functional capacity

     

  • Kean instincts on how to work in a team environment

     

  • Pass Applicable certification and licensing continuing education and maintain active license and/or certification, as required.

     

  • Seeks and/or maintains current or enhanced profession credentials.

     

  • Proficiency within Microsoft Excel (ability to create pivot tables, basic formulas, sorting, and read data)

     

  • Solid understanding of the regulations governing FMLA, Statutory Disability and ERISA as it relates to absence programs

     

    Competencies

    • Acting with Integrity
    • Communicating Effectively
    • Pursuing Self-Development
    • Serving Customers
    • Supporting Change
    • Supporting Organizational Goals
    • Working with Diverse Populations
  • Date Posted June 19, 2022
    Date Closes July 19, 2022
    Requisition 859597900
    Located In Orlando, FL
    SOC Category 00-0000.00
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