What are the responsibilities and job description for the Manager, Small Block Claims position at illumifin?
- Leads the strategic and organizational planning, staff acquisition, performance management and team development for illumifin's Small Block Claims decisions, TPA Policy Administration and Ongoing Care Management services division. This includes data entry, processing adjudication and ongoing management of open claims as well as assuring that claims are closed when insured are no longer eligible for benefits.
- Ensures that Small Block Claims teams are meeting key metrics including quality, productivity, and internal and external SLAs and KPIs.
- Determines proper staffing through workforce and process management.
- Participates in management of Small Block Claims and Ongoing Care Management services to achieve forecasted contribution margin expectations.
- Assures that proper onboarding and continued learning objectives are met as new members are trained through demonstration of proficiency in decision making skills and ongoing care management skills.
- Assists in gaining efficiencies in workflow processing inside operating system, including automation and queue management.
- Takes a lead role in the system build, release, and prioritization processes related to Small Block Claims decisions. TPA Policy Administration and Ongoing Care Management operations.
- Participates in meetings and presentations to customers and assists in the implementation process for new customers.
- Other duties that are assigned.
- Minimum of 3 years of prior management and/or supervisory experience
- Minimum of 3 years of LTC Claims experience
- Minimum of 2 years of office, customer service experience
- College degree or RN
- Typing speed of 50 WPM or better
- Demonstrated strong leadership skills and a high degree of self-motivation and initiative, along with the ability to develop and coach members
- Strong medical, procedural and technical knowledge
- Superior analytical and flexible decision-making skills and ability to exercise judgment when applying standards and contract language
- Excellent communication with the team, claimants, claimants' families and other parties with proven ability to exercise tact, diplomacy, resourcefulness, and understanding to gain trust and customer confidence. Demonstrated negotiation skills required.