Dir, PLADS Claims Operations
Salary Range: $80,000 - $185,000
We’ve Got You Under Our Wing
We are the duck. We develop and empower our people, cultivate relationships, give back to our community, and celebrate every success along the way. We do it all…The Aflac Way.
Aflac, a Fortune 500 company, is an industry leader in voluntary insurance products that pay cash directly to policyholders and one of America's best-known brands. Aflac has been recognized as Fortune’s 50 Best Workplaces for Diversity and as one of World’s Most Ethical Companies by Ethisphere.com.
Our business is about being there for people in need. So, ask yourself, are you the duck? If so, there’s a home, and a flourishing career for you at Aflac.
Work Designation. This role is remote. This means you will be expected to work from your home, within the continental US. There may be occasions when you are requested to come to the office based on business needs. Any requests to come to the office would be communicated with you in advance.
What does it take to be successful at Aflac?
- Acting with Integrity
- Communicating Effectively
- Pursuing Self-Development
- Serving Customers
- Supporting Change
- Supporting Organizational Goals
- Working with Diverse Populations
What does it take to be successful in this role?
- Extensive knowledge of operating principles and methodologies applicable to claims, training, and risk management; expert knowledge of PLADS mission, objectives, and procedures, the Disability & Absence Claims department’s relationship with other departments, and the framework in which the program operates; a very high degree of skill in applying this knowledge to the analysis and resolution of very complex or sensitive claims problems related
- Broad knowledge of federal, state, and local regulatory and industry requirements; knowledge of legal and medical terminology; understanding of principles and practices of organization, administration and management
- Knowledge of budgeting and expense control to plan, implement, and maximize funds expenditure while maintaining and improving quality standards
- Knowledge of employee relations to handle employee issues proactively
- Demonstrated ability to apply operations management and business process re-engineering tools and techniques to a wide variety of business techniques
- Successful completion of Aflac’s Management Development Training or equivalent management/leadership training
- Strong project management, leadership, organizational, and practice development skills
- Broad knowledge of PLADS products and systems
- Strong knowledge of Claims Operations in the Disability insurance
- Strong and professional communication skills, both verbal and written
- Ability to effectively interact and communicate with all levels of external and/or internal business partners
- Ability to drive results by identifying and resolving problems.
- Ability to implement systems, processes and procedures directed toward operational excellence •
- Demonstrated adaptability and flexibility to change and to implement change successfully within the organization
Education & Experience Required
- Bachelor's Degree in health administration, business administration, or a related field
- 10 years experience in disability and absence claims administration, 5 years management experience
Or an equivalent combination of education and experience
Education & Experience Preferred
- Claims management experience including four or more years managing claims supervisors
- Insurance industry designations
- Not Required
Principal Duties & Responsibilities
- Directs and oversees the operations of an insurance claims department to meet operation, financial, and service requirements; assists with managing the claims production process and is responsible for the timely administration of the company’s claims production activities for assigned lines of PLADS business
- Develops long-range visionary strategic plans and annual budget for the areas within scope of responsibility and ensures that operations are managed within authorized budgets; advises, develops, reviews, and approves budgets, disability plans, and business goals
- Coordinates efforts with other departments, e.g., legal, special investigation unit, actuary, policy service, compliance, internal audit, training, quality, etc.
- Manages personnel including performance management, salary planning and administration, training and development, workflow planning, hiring and placement, disciplinary actions, etc.
- Determines, settles, and authorizes payment of claims for assigned lines of PLADS business; provides guidance to team on the most complex claims
- Administers policies and procedures to assure compliance with best practices, claims management services standards, state regulations, and client service requirements
- Monitors management reports relating to the performance of claims recommending, directing, and guiding corrective action as needed
- Provides support, guidance, leadership, and motivation to promote maximum performance
- Supports the quality assurance program to drive consistent delivery of quality claims service; works closely with the Claims audit department to understand results, implement corrective action of audit errors, partner with training, provide feedback for ongoing improvement of the claims operations; responsible for the strategic accuracy in processing and payment of claims
- Reviews and interprets performance against operating plans and standards for the division; provides information and reports to subordinates on interpretation of results and approves changes in plans; presents monthly reports on performance, and develops and presents matters requiring decisions to key management team for the division
- Drives technical excellence; manages productivity; conducts open file reviews; reinforces corporate communications; enforces compliance regulations; identifies and resolves ethical dilemmas; enforces quality initiatives; networks with officers and management of other divisions to stay abreast of operational innovation and visions at the divisional and corporate levels; keeps abreast of any changes to legislation and regulations which pertain to insurance claims
- Performs other duties as required
This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions including, but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. The range has been created in good faith based on information known to Aflac at the time of the posting. Compensation decisions are dependent on the circumstances of each case. This salary range does not include any potential incentive pay or benefits, however, such information will be provided separately when appropriate. The salary range for this position is $80,000 - $185,000.
In addition to the base salary, we offer an array of benefits to meet your needs including medical, dental, and vision coverage, prescription drug coverage, health care flexible spending, dependent care flexible spending, Aflac supplemental policies (Accident, Cancer, Critical Illness and Hospital Indemnity offered at no costs to employee), 401(k) plans, annual bonuses, and an opportunity to purchase company stock. On an annual basis, you’ll also be offered 11 paid holidays, up to 20 days PTO to be used for any reason, and, if eligible, state mandated sick leave (Washington employees accrue 1 hour sick leave for every 40 hours worked) and other leaves of absence, if eligible, when needed to support your physical, financial, and emotional well-being. Aflac complies with all applicable leave laws, including, but not limited to sick and safe leave, and adoption and parental leave, in all states and localities.