Intercare Holdings Insurance Services
Workers Compensation Program Manager
Intercare Holdings Insurance Services, Glendale, California, us, 91222
Summary:
Reports directly to the Associate Vice President, Vice President or Senior Vice President of the Claims Division. Under the general direction of the AVP, VP or SVP, is responsible for managing a claims program comprised of claims supervisors, claims adjusters, claims assistants, and possibly other personnel involved directly in the claims function. Has overall responsibility and accountability for the work product of the claims program 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 staff when required, monitoring 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:
Maintain excellent client relations, consults with client to define a need or a problem, conducts studies and surveys to obtain data.
Analyzes data to determine solutions as it relates to claims, client relationships, staffing, workflow, and/or reporting.
Accountable for the timely completion of all performance reviews for the claims program.
Provides monetary approval authority up to assigned authority level.
Works closely with representatives of our client(s) to ensure that contractual provisions are being followed and that client/customer related issues are addressed promptly.
Provides advice, mentoring, coaching, counseling and performance feedback to the supervisors and to others within the claims team as needed, or in response to a request for assistance from a supervisor.
Responsible for assuring that all claims handled by the claims team are handled in accordance with applicable statutes and company rules.
Assists the supervisors with customer and personnel issues when needed and keeps senior management 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 program 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 team and for implementing procedural adjustments as necessary to enhance or improve productivity and results.
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 Intercare and program assigned.
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 within 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.
Language Skills:
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.
Math Skills:
Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry.
Reasoning Ability:
Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
Computer Skills:
To perform this job successfully, an individual should have knowledge of Word Processing software; Spreadsheet software; Project Management software and Database software.
Certificates and Licenses:
Attainment of the Associate in Claims designation, and successful completion of, or active study for, IIA MGT 43, and MGT 44, or the equivalent in related studies or work experience.
Supervisory Responsibilities:
Manages three to seven subordinate supervisors who supervise a total of five to ten employees on the Claims Program. Is responsible for the overall direction, coordination, and evaluation of these units. Carries out managerial 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.
Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this Job, the employee is regularly required to talk or hear.
The employee is frequently required to stand; walk; sit and use hands to finger, handle, or feel.
The employee must occasionally lift and/or move up to 10 pounds.
Work Environment:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.
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Reports directly to the Associate Vice President, Vice President or Senior Vice President of the Claims Division. Under the general direction of the AVP, VP or SVP, is responsible for managing a claims program comprised of claims supervisors, claims adjusters, claims assistants, and possibly other personnel involved directly in the claims function. Has overall responsibility and accountability for the work product of the claims program 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 staff when required, monitoring 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:
Maintain excellent client relations, consults with client to define a need or a problem, conducts studies and surveys to obtain data.
Analyzes data to determine solutions as it relates to claims, client relationships, staffing, workflow, and/or reporting.
Accountable for the timely completion of all performance reviews for the claims program.
Provides monetary approval authority up to assigned authority level.
Works closely with representatives of our client(s) to ensure that contractual provisions are being followed and that client/customer related issues are addressed promptly.
Provides advice, mentoring, coaching, counseling and performance feedback to the supervisors and to others within the claims team as needed, or in response to a request for assistance from a supervisor.
Responsible for assuring that all claims handled by the claims team are handled in accordance with applicable statutes and company rules.
Assists the supervisors with customer and personnel issues when needed and keeps senior management 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 program 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 team and for implementing procedural adjustments as necessary to enhance or improve productivity and results.
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 Intercare and program assigned.
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 within 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.
Language Skills:
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.
Math Skills:
Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry.
Reasoning Ability:
Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
Computer Skills:
To perform this job successfully, an individual should have knowledge of Word Processing software; Spreadsheet software; Project Management software and Database software.
Certificates and Licenses:
Attainment of the Associate in Claims designation, and successful completion of, or active study for, IIA MGT 43, and MGT 44, or the equivalent in related studies or work experience.
Supervisory Responsibilities:
Manages three to seven subordinate supervisors who supervise a total of five to ten employees on the Claims Program. Is responsible for the overall direction, coordination, and evaluation of these units. Carries out managerial 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.
Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this Job, the employee is regularly required to talk or hear.
The employee is frequently required to stand; walk; sit and use hands to finger, handle, or feel.
The employee must occasionally lift and/or move up to 10 pounds.
Work Environment:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.
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