Managing Director, Operations - Claims, REMOTE

$163,100 - $273,300/Yr

Af - Group - Los Angeles, CA

Full-time - Senior

Onsite - Los Angeles, CA

Religious, Grantmaking, Civic, Professional, and Similar Organizations

About the position

This position reports to the Senior Vice President of Claims and plays a crucial role in collaborating with leaders across all business units within the Claims organization. The primary focus of this role is to lead, plan, organize, and implement operational efficiencies while assisting the business units in achieving the strategic goals and objectives of the Claims department. The successful candidate will work closely with Divisional Directors to ensure that consistent practices and procedures are developed and adhered to across the division. In addition to overseeing the day-to-day operations of the Medical Bill Review, Medical Management, Decision UR, and Claims Assistants business units, this role will involve coordinating, planning, problem-solving, and implementing solutions to enhance productivity and efficiency. The position requires the development of business partnerships within the enterprise and the leadership of corporate strategic initiatives within operations. A comprehensive understanding of various corporate business and operational issues and their implications for the company is essential. The role also encompasses managing various projects and initiatives from ideation through to execution and tracking. Close collaboration with the leadership team is necessary to develop annual and long-term goals and objectives. Responsibilities include creating key performance indicators, maintaining data sources, dashboards, and analytics, as well as managing long-term staffing plans, budgeting, business continuity planning, and TPA management. The essential duties include evaluating the results of workers' compensation and property & casualty claims operations, developing and managing strategic plans, and ensuring timely execution of strategies and budgets. The candidate will identify areas for operational efficiency and collaborate with business units to provide effective solutions. Monitoring and governing operational functions to reduce redundancy and enhance efficiencies is also a key responsibility. The role requires building collaborative relationships with executive leadership and representing the company in community and industry programs and conferences. Overall, this position demands visionary leadership to create and maintain a cost-effective department while facilitating efficient operations to meet current and future business needs within the organization.

Responsibilities

• Lead, plan, organize, and implement operational efficiencies within the Claims department.
• Oversee day-to-day operations of Medical Bill Review, Medical Management, Decision UR, and Claims Assistants.
• Develop and manage the workers' compensation and property & casualty strategic plan.
• Create and monitor key performance indicators to provide insights for claims leadership.
• Identify areas for operational efficiency and collaborate with business units to provide solutions.
• Build and foster collaborative relationships with executive leadership within the enterprise.
• Represent the company in community and industry programs and conferences.
• Create executive-level analysis and reporting for budgeting and expense management.
• Participate in the development of programs that support the company plan.

Requirements

• Bachelor's degree in a related field required.
• Ten years of progressively more responsible experience in a claim environment with demonstrated technical claims experience required.
• Five years of claims management experience required, including supervising managerial staff and operational oversight.
• Demonstrated experience in problem analysis and resolution at both strategic and functional levels.
• Expert knowledge of workers' compensation statutes and filing procedures, medical terminology, and property & casualty lines of business.
• Excellent communication, presentation, and facilitation skills.
• Demonstrated leadership and project management abilities.
• Strong strategic planning, program development, project management, budgeting, and staff development skills.

Nice-to-haves

• Certification in claims management or related field is highly preferred and encouraged.
• Experience in culture and change management.

Benefits

• Competitive salary range between $163,100 and $273,300 based on experience and qualifications.
• Equal Opportunity Employer with a commitment to diversity and inclusion.