Workers Compensation Claims Manager

Job Type

Full-time

Summary:

Reports directly to the Vice President of Claims. Under the general direction of the Vice President of Claims, is responsible for managing a claims department comprised of claims supervisors, claims specialists, claims assistants, and possibly other personnel involved directly in the claims function. Has overall responsibility and accountability for the work product of the claims department to include the quantity of work processed as well as the quality. The nature of the work involves coaching and counseling of the claims supervisors as well as other department staff when required, monitoring department work product to assure compliance with Labor Code provisions as well as company rules and regulations, conducting performance evaluations, and instituting corrective action when appropriate. It also includes monitoring, controlling, and planning.

Essential Duties and Responsibilities:

• Accountable for the timely completion of all performance reviews in the department.
• Provides monetary approval authority up to assigned authority level.
• Works closely with representatives of our clients to assure that contractual provisions are being followed and that client/customer related issues are addressed promptly.
• Provides ongoing advice, mentoring, coaching, counseling and performance feedback to the supervisors and to others within the claims department as needed or in response to a request for assistance from a supervisor.
• Responsible for assuring that all claims handled by the department are handled in accordance with applicable statutes and company rules.
• Assists the supervisors with customer and personnel issues when needed and keeps the Vice President of Claims informed with regards to any corrective action activities within his/her department.
• Exhibits a highly knowledgeable and helpful attitude and projects a professional image on behalf of the company.
• Identifies and develops at least one supervisor to serve as claim manager backup.
• Represents the company at industry functions when needed and when appropriate.
• Responsible for developing and sustaining a spirit of teamwork and cooperation among claims personnel and between claims and the personnel of other departments.
• Responsible for monitoring productivity and compliance trends within the assigned claims department and for implementing procedural adjustments as necessary to enhance or improve productivity and results.
• Responsible for managing department operating expenses within the approved department budget.
• Requires a working knowledge of the Labor Code of the State of California as it pertains to workers compensation claims.
• Handles other duties and tasks as deemed appropriate by the Vice President of Claims.

Supervisory Responsibilities:

Manages 3 to 7 subordinate supervisors who supervise a total of 7 to 10 employees in the Claims Department. Is responsible for the overall direction, coordination, and evaluation of these units. Also directly supervises one non-supervisory employee. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

Competency:

To perform the job successfully, an individual should demonstrate the following competencies:

• Project Management - Develops project plans; Coordinates projects; Communicates changes and progress; Completes projects on time and budget; Manages project team activities.
• Business Acumen – Understands business implications of decisions; Displays orientation to profitability; Demonstrates knowledge of market and competition; Aligns work with strategic goals.
• Change Management - Develops workable implementation plans; Communicates changes effectively; Builds commitment and overcomes resistance; Prepares and supports those affected by change; Monitors transition and evaluates results.
• Leadership - Exhibits confidence in self and others; Inspires and motivates others to perform well; Effectively influences actions and opinions of others; Inspires respect and trust; Accepts feedback from others; Provides vision and inspiration to peers and subordinates; Gives appropriate recognition to others; Displays passion and optimism; Mobilizes others to fulfill the vision.
• Managing People - Includes staff in planning, decision-making, facilitating and process improvement; Takes responsibility for subordinates' activities; Makes self available to staff; Provides regular performance feedback; Develops subordinates' skills and encourages growth; Solicits and applies customer feedback (internal and external); Fosters quality focus in others; Improves processes, products and services; Continually works to improve supervisory skills.

Qualification Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience:

Bachelor's degree (B. A.) from four-year college or university; or one to two years related experience and/or training; or equivalent combination of education and experience. Eight or more years of progressive technical claim experience, demonstrating a high degree of judgment and discretion, is capable of providing adequate guidance on complex claim cases and can negotiate settlements effectively.