Managing Director, Operations - Claims, REMOTE at AF Group in Richmond, Virginia

Job Description:

This position requires EST business hours.




AF Group (or any Emergent Holdings) employees who cannot access our internal job board "Opportunity Marketplace", please reach out to Mary George to apply.




SUMMARY



This role reports to the Senior Vice President of Claims and will work closely with leaders of all business units that report within the Claims organization. This role will lead, plan, organize, implement and/or assist the business units in implementing operational efficiencies and assist with strategies to achieve the goals and objectives of the Claims department. Working directly with the Divisional Directors, this role will work to ensure consistent practices and procedures are developed and followed across the division. This position will also be responsible for overseeing the day-to-day operations within the business units of Medical Bill Review, Medical Management, Decision UR, and Claims Assistants. They will have direct oversight of these business units along with coordinating, planning, problem solving and implementing solutions to solve productivity and efficiency challenges.


This position will develop business partnerships within the enterprise while leading the development and integration of corporate strategic initiatives within the operations. Understands multiple perspectives of corporate business and operational issues and their impact to the Company. Manages various projects and initiatives from ideation through development, approval, execution, and tracking. Works closely with the leadership team to develop annual and long-term goals and objectives. Responsible for the creation of key performance indicators, maintaining data sources, dashboards and analytics, long-term staffing plans, staffing model enhancements, budgeting, business continuity planning, and TPA management.



ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.

Systematically evaluate the workers' compensation and property & casualty claims operations results and report these to the Senior Vice President of Claims and Divisional Directors.

Work with the Senior Vice President of Claims and divisional leaders to develop and manage the workers' compensation and property & casualty strategic plan.

Architect success by continuously providing focus and direction on the most important matters and searching for and highlighting best practices or potential disconnects that could create risk.

Accountable for creation, support, and assistance with timely execution of strategy, budgeting, long-term staffing, staffing model analysis, and business continuity plan adherence.

Identify and analyze areas for operational efficiency needs and work with the business units and collaborate with key stakeholders to provide solutions. Develop, monitor, and review key performance indicators to provide insight for all claims leadership. Monitor and govern operational functions to reduce redundancy and build efficiencies.

Build and foster collaborative relationships with executive leadership within the enterprise to stay informed and abreast of new initiatives and services of the enterprise.

Partner with Marketing and Corporate Communications on communication efforts including Division's strategy communications, employee communications and highlighting strategy plans, status, and related materials. Represent the company in community and industry, programs, and conferences.

Create executive-level analysis and reporting to assist key stakeholders with budgeting, expense management, briefings, and identification of emerging trends that may have a substantial impact on profitability and results.

Participate in the development of programs as a strategic partner that supports the company plan.

Provides visionary leadership to create and maintain a cost-effective department while facilitating efficient operations to meet current and future business needs within the organization.

Responsible for management of the Medical Bill Review Director, Medical Management Director, Decision UR, and the field Claims Assistants Manager

EDUCATION AND EXPERIENCE

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. Includes supervising managerial staff and operational oversight is required.

Demonstrated experience in problem analysis and problem resolution at both a strategic and functional level.

Continuous learning required, as defined by the Company's learning philosophy. Certification, or progress toward, highly preferred and encouraged.

QUALIFICATIONS



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.



OTHER SKILLS AND ABILITIES

Expert knowledge of workers' compensation statutes and workers' compensation filing procedures, medical terminology, bill review procedures, and property & casualty lines of business.

Excellent communication, presentation, and facilitation skills. Ability to clearly and concisely exchange information, share ideas, and employing active listening techniques.

Demonstrated leadership and project management abilities.

Must demonstrate leadership ability and team building skills to effectively supervise professional and non-professional staff and interact with all levels of management.

Ability to work with and empower others on a collaborative basis to ensure success of unit team.

Ability to understand business needs and conceptualize and implement processes and products that support those business strategies.

Strong strategic planning, program development, project management, budgeting, and staff development skills. Ability to think ahead and plan over a 3-to-5-year span.

Ability to establish workflows, manages multiple projects, and meets necessary deadlines.

Culture and Change Management experience.

Excellent analytical, organizational, and problem-solving skills, and senior level skills in managing ambiguous situations and issues.

Ability to appropriately manage resources, budgets, issues, and risks for the successful completion of projects.

Experience communicating and acting as an advisor to key partners and stakeholders.

Detail-oriented professional who adapts quickly and earns credibility and trust interfacing with various leaders across the organization.

Understands overall enterprise operations functions and financial levers, budgeting, reporting and projections. Drives business performance excellence and best practices.

A commitment to continuously improve the customer experience for injured workers, policyholders, and agents.

SUPERVISORY RESPONSIBILITIES



Directly supervises a varied number of employees in the designated department(s). 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.



ADDITIONAL INFORMATION



The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. This job description does not constitute a contract for employment.



AF Group (or any Emergent Holdings) employees who cannot access our internal job board "Opportunity Marketplace", please use your corporate email address to apply here.




WORKING CONDITIONS



Work is performed in an office/remote setting with no unusual hazards. Minimal travel required.


The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.


Pay Range
"Actual compensation decision relies on the consideration of internal equity, candidate's skills and professional experience, geographic location, market and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $163,100 and $273,300."


We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an \"at will\" basis. Nothing herein is intended to create a contract.


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