Claims Manager – Workers Compensation | DC, VA, & MD Residents
Sedgwick
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Claims Manager – Workers Compensation | DC, VA, & MD Residents
PRIMARY PURPOSE : To manage the technical and operational functions within a dedicated client; to ensure consistent delivery of quality services; to manage staffing and training needs of specified unit; and to oversee budget preparation and profit and loss management within the dedicated client program.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Responsible for overall operational management for assigned dedicated client.
Oversees company and client internal quality review process and reports monthly.
Establishes policy and procedure to ensure compliance to best practices, claims management services standards, state regulations and client service requirements; ensures compliance with client internal controls, audit requirements and service agreement requirements; plans, develops and implements team, policies and procedures for dedicated client activity.
Establishes business plan with goal and objectives for the partnership of the dedicated client.
Works with Program Management to: (a) make recommendations for cost savings strategies for client and partners; (b) keep client, program manager and colleagues informed of statutory or regulatory requirements/developments by jurisdiction which may impact procedures; (c) resolve client issues; (d) communicate frequently with key client personnel; and (e) represent company as liaison to clients and partners.
Identifies and resolves issues with company representatives.
Monitors management reports relating to the dedicated clients performance.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Perform other duties as assigned.
Supports the organizations 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
Bachelors degree from an accredited college or university preferred. Licenses as required.
Experience
Eight (8) years of related experience or equivalent combination of education and experience required to include four (4) years claims management experience and two (2) years supervisory experience.
Skills & Knowledge
Thorough knowledge of claims management procedures
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Leadership/management/motivational skills
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
WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ( 75,313.00 – 105,438.00). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
If youre excited about this role but your experience doesnt align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.
Taking care of people is at the heart of everything we do. Caring counts
Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)