AVP Workers Compensation

5 days ago

Glendale, California, United States Intercare Holdings Insurance Services, Inc. Full time
Job Type

Full-time

Description

Summary:

Reports directly to the Vice President of Claims. Under the general direction of the Vice President of Claims.

Claims Operations - is responsible for managing designated offices with claims department 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 department including quantity and quality of work processed. The nature of the work involves coaching and counseling of the claims managers/supervisors as well as other department staff when required, managing department work product to assure compliance with Statutory provisions, company policies and procedures, best practice standards and Specific Client Instruction Guidelines. Conduct performance evaluations, and instituting corrective action when appropriate. Planning, controlling and monitoring results.

Account Management - Provides the necessary support to enable the company to maximize its client service, its standard operating procedures, and to maintain excellent client relations. Consults with client to define a need or a problem, conducts studies and surveys to obtain data, and analyzes data to advise on or recommend solution by performing the following duties. Work with COO to renew existing programs.

Responsible for leading Quality Control in the interim.

Essential Duties and Responsibilities:
  • Responsible for managing department operating expenses within the approved department budget.
  • Provides ongoing advice, mentoring, coaching, counseling and performance feedback to the supervisors and to others within the claims department as needed or in response to a request for assistance from a supervisor.
  • Responsible for assuring that all claims handled by the department are handled in accordance with applicable statutes and company rules.
  • Assists the supervisors with customer and personnel issues when needed and keeps the Vice President of Claims informed concerning any corrective action activities within his/her department.
  • Responsible for monitoring productivity and compliance trends within the assigned claims department and for implementing procedural adjustments as necessary to enhance or improve productivity and results.
  • Consults with client to ascertain and define need or problem area, and determine scope of investigation required to obtain solution.
  • In conjunction with work associates, conducts study or survey on need or problem to obtain data required for solution.
  • Analyzes data to determine solutions as it relates to claims, client relationships, staffing, workflow, and/or reporting.
  • Communicates and coordinates resolution with all departments and/or teams and advises client on alternate methods of solving need or problem, or recommends specific solution.
  • Conducts a customer satisfaction survey and organizes an annual Stewardship Reporting mechanism for client and company management.
  • With a focus on managing retention of accounts, the Account Manager will attend Quarterly Review Meetings, provide an "accounts at risk" report, and support sales team efforts.
  • Works closely with representatives of our clients to assure that contractual provisions are being followed and those client/customer related issues are addressed promptly.
Other Duties:
  • Maybe requested to attend trade association meetings to promote services
  • Assist Sales and Marketing Department in delivering sales presentation to key clients
  • Assists Sales and Marketing Department in determining proposed claims team to service programs and analyzing scope of work to ensure delivery of appropriate services
Requirements

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 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. Technical Skills - With experience in Workers' Compensations programs, strives to continuously build knowledge and skills.
  • Customer Service - Solicits customer feedback to improve service. Responds to requests for service and assistance. Meets commitments.
  • Team Work - Contributes to building a positive team spirit; supports everyone's efforts to succeed.
  • Change Management - Builds commitment and overcomes resistance.
  • Quality Management - Looks for ways to improve and promote quality. Demonstrates accuracy and thoroughness.
  • Business Acumen - Understands business implications of decisions.
  • Initiative - Undertakes self-development activities; Seeks increased responsibilities.
  • Innovation - Meets challenges with resourcefulness.
  • Professionalism - Treats others with respect and consideration regardless of their status or position.
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 five to ten years related experience and/or training; or equivalent combination of education and experience. Specific experience and knowledge with California Labor Code, its updates, and its application to the Workers' Compensation program is essential.

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