Director, Supplemental Health Claims at Prudential Ins Co of America in Portland, Maine

Job Description:

Job Classification:

At Prudential, we believe talent is key to achieving our vision. When you join Prudential, you’ll unlock a motivating and impactful career – all while growing your skills and advancing your profession at one of the world’s leading financial services institutions!

The Director of Supplemental Health Claims is accountable for claim management and administration for Critical Illness, Hospital Indemnity and Accident Insurance. The Director will demonstrate exceptional leadership and bring strong technical expertise in customer service, quality and claim management practices. In addition, the incumbent will serve as an operational excellence ambassador identifying and implementing opportunities for continuous process improvement.

The Director manages a staff of direct and indirect reports with ultimate responsibility of staff development through coaching, professional development, and performance management. The incumbent will collaborate with internal leaders as well as outsourced partners identifying and implementing strategic initiatives to meet business goals and deliver an exceptional experience for our customers. The Director will also be responsible for leading strategic initiatives for Supplemental Health claim management and product enhancements and improving processes and procedures for all Supplemental Health management.

The current employee work arrangement for this position is hybrid and requires your on-site presence on a reoccurring basis as determined by your business. Your manager will provide additional details relative to the specific number of days you are expected to be on-site.

What you can expect:

Claim Management and Administration:

• Oversee and manage the end-to-end processes for Critical Illness, Hospital Indemnity, and Accident Insurance claims.




• Ensure timely and accurate processing of claims in compliance with company policies and regulatory requirements.




• Develop and implement strategies to enhance claim management practices and improve overall efficiency.

Leadership and Staff Development:

• Lead, mentor, and develop a team of direct and indirect reports to achieve high performance.




• Provide coaching and professional development opportunities to foster career growth and skill enhancement.




• Conduct regular performance evaluations and manage performance improvement plans as necessary.

Customer Service and Quality:

• Ensure the delivery of exceptional customer service and maintain high standards of quality in claim management.




• Monitor customer feedback and implement improvements to enhance the customer experience.




• Develop and enforce quality assurance protocols to maintain accuracy and consistency in claims processing.

Operational Excellence and Process Improvement:

• Serve as an ambassador for operational excellence, identifying opportunities for continuous process improvement.




• Implement best practices and innovative solutions to streamline operations and reduce costs.




• Collaborate with internal and external stakeholders to drive process enhancements and achieve operational efficiencies.

Strategic Initiatives and Collaboration:

• Lead strategic initiatives related to Supplemental Health claim management and product enhancements.




• Collaborate with internal leaders and outsourced partners to identify and implement strategic initiatives that align with business goals.




• Partner with cross-functional teams to ensure seamless integration and execution of strategic projects.

Compliance and Risk Management:

• Ensure compliance with all relevant regulations, policies, and procedures related to claim management.




• Identify and mitigate risks associated with claim management processes and practices. Maintain up-to-date knowledge of industry trends, regulatory changes, and emerging best practices. Reporting and Analytics:




• Develop and maintain key performance indicators (KPIs) to measure and monitor the effectiveness of claim management processes.




• Prepare and present regular reports on claim performance, trends, and improvement initiatives to senior leadership.




• Utilize data analytics to identify areas for improvement and drive data-driven decision-making.

Innovation and Product Enhancement:

• Collaborate with product development teams to design and implement product enhancements that improve customer satisfaction and competitive positioning.




• Stay abreast of industry developments and leverage insights to drive product innovation and differentiation.

By fulfilling these responsibilities, the Director of Supplemental Health Claims will play a critical role in ensuring the effective and efficient management of claims, driving operational excellence, and delivering an exceptional experience for our customers.

What you’ll need:

• 10 years claims experience with 5 years of Supplemental Health claims experience




• Experience working with outsource partners




• 5 to 7 years of management experience




• Experience leading an organization through change




• Demonstrated success in driving culture change and employee development




• Excellent communication skills, both verbal and written




• Excellent relationship building and partnership skills




• Understanding of customers' needs and delivering an outstanding service experience

Prudential welcomes all applicants, even if you don't meet every requirement. If your skills align with the role, we encourage you to apply.

At Prudential, you can:

Take charge of your career. We equip and empower our employees to expand their skills and experience by using powerful learning, gigs, and job opportunities. We offer a suite of services such as on demand resources and networking to propel your career forward.

We’re a global organization, full of outstandingly dedicated people who aren’t afraid to think differently, challenge the status quo and take sensible risks along the way. You will enjoy pushing boundaries as we build innovative technology that helps clients, customers and employees live their best lives. You will have access to leadership and learning opportunities and the resources needed to take your career in any direction. We will help you do your best work, offering flexibility, while delivering on our Purpose.

What we offer you:

• Market competitive base salaries, with a yearly bonus potential at every level




• Medical, dental, vision, life insurance, disability insurance, Paid Time Off (PTO), and leave of absences, such as parental and military leave




• Retirement plans: 401(k) plan with company match (up to 4%), company-funded pension plan




• Wellness Programs to help you achieve your wellbeing goals, including up to $1,600 a year for reimbursement of items purchased to support personal wellbeing needs




• Work/Life Resources to help support topics such as parenting, housing, senior care, finances, pets, legal matters, education, emotional and mental health, and career development.




• Tuition Assistance to help finance traditional college enrollment toward obtaining an approved degree, many accredited certificate programs, and industry designations.




• Employee Stock Purchase Plan: Shares can be purchased at 85% of the lower of two prices (Beginning or End of the purchase period), after one year of service.

To find out more about our Total Reward package, see our Total Rewards Brochure. Some of the above benefits may not apply to part-time employees scheduled to work less than 20 hours per week.

#LI-RRJ

Note: Prudential is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $127,500.00 to $172,500.00. Specific pricing for the role may vary within the above range based on many factors including geographic location, candidate experience, and skills. Roles may also be eligible for additional compensation and/or benefits. Eligibility to participate in a discretionary annual incentive program is subject to the rules governing the program, whereby an award, if any, depends on various factors including, without limitation, individual and organizational performance. In addition, employees are eligible for standard benefits package including paid time off, medical, dental and retirement.

Prudential Financial, Inc. of the United States is not affiliated with Prudential plc. which is headquartered in the United Kingdom.

Prudential is a multinational financial services leader with operations in the United States, Asia, Europe, and Latin America. Leveraging its heritage of life insurance and asset management expertise, Prudential is focused on helping individual and institutional customers grow and protect their wealth. The company's well-known Rock symbol is an icon of strength, stability, expertise and innovation that has stood the test of time. Prudential's businesses offer a variety of products and services, including life insurance, annuities, retirement-related services, mutual funds, asset management, and real estate services.

We recognize that our strength and success are directly linked to the quality and skills of our diverse associates. We are proud to be a place where talented people who want to make a difference can grow as professionals, leaders, and as individuals. Visit www.prudential.com to learn more about our values, our history and our brand.

Prudential is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, ancestry, sex, sexual orientation, gender identity, national origin, genetics, disability, marital status, age, veteran status, domestic partner status , medical condition or any other characteristic protected by law. 

The Prudential Insurance Company of America, Newark, NJ and its affiliates.

Note that this posting is intended for individual applicants. Search firms or agencies should email Staffing at staffingagencies@prudential.com for more information about doing business with Prudential.

PEOPLE WITH DISABILITIES:
If you need an accommodation to complete the application process, which may include an assessment, please email accommodations.hw@prudential.com.

Please note that the above email is solely for individuals with disabilities requesting an accommodation.  If you are experiencing a technical issue with your application or an assessment, please email careers.technicalsupport@prudential.com to request assistance.