Claims Case Management Team Leader

The Claims Case Management Team Leader is responsible for leading a team of Absence Management Case Managers to get results within their team and the organization.

The Team Leader will serve as a primary resource and provide direction to team members by setting objectives, communicating progress, and holding the staff accountable for adhering to all quality assurance, turnaround time, operational efficiency, and best practice standards.

The Team Leader is responsible for assisting staff with career development and career progression, along with encouraging candor and challenging the status quo to continuously improve the way we work.

The Team Leader partners with internal cross functional areas for program direction, goal setting, service delivery and development of action plans and using bench strength.

The Team Leader will validate that all FML, STD, State, and PFL are accurately adjudicated according to plan provisions, established standard methodologies and within state and federal guidelines.

The Team Leader must be able to manage and resolve issues that pertain to claim administration procedures, cost containment activities, reports, quality control and complex customer issues.

The Team Leader will work with external customers / clients to enhance the overall experience for the customer. The Team Leader is responsible for the overall functioning of the team and communicating to leadership on team status and performance.

You will

• Partner with leadership to develop and communicate objectives and performance goals for the team.
• Manage direct reports’ performance by coordinating with HR to implement coaching plans and performance improvement plans.
• Develop employee goals to promote career growth that enhance level of knowledge for future opportunities.
• Collaborate with internal business partners including Short Term Disability, Long Term Disability, Service, Sales and Account Management, Group Quality Management, and other areas within the Company.
• Create regular action plans based on results from employee engagement surveys the Team Leader owns and acts on engagement survey results.
• Review and analyze daily, weekly, and monthly reports on team productivity 1) for operational reporting and monitoring purposes;

2) to identify trends and training opportunities; and 3) to create action plans for improvement.

• Review processes / reports regularly for process improvement opportunities.
• Own relationship with client and get involved, when necessary, in meetings, phone calls, and closing the loop on service issues.
• Prioritize the customer / client experience in day-to-day interactions and processes.
• Identify Continuous Improvement opportunities by reviewing process and eliminating unnecessary steps.
• Empower staff to submit process improvement ideas to revise workflows and procedures.
• Support claims initiatives by encouraging / providing relevant feedback and acting as a change leader for project rollouts.
• Schedule and facilitate team meetings and individual touchpoints.
• Mentor, coach, supervise and develop talent of direct reports by acting as a partner in recommending and coordinating training resources, tools, and plans for individuals to achieve personal and departmental goals and objectives.
• Review claim staff QA / CMA assessments for training or enhancement opportunities.
• Use data and analytics to improve or change business process / procedures and team outcomes procedures and team outcomes.

You have

• Bachelor’s degree in related field and / or equivalent relevant disability work experience; integrated absence management preferred.
• 5+ years of disability claims experience.
• 3+ years of demonstrated leadership experience.
• Extensive knowledge of disability products, business rules and procedures.
• Familiarity with mandated state and federal regulations.
• Professional oral, written and presentation skills.
• Proven organizational and time management skills.
• Excellent math aptitude and analytical skills
• Strong PC skills, including Microsoft Office applications.

Leadership Behaviors

Team Leadership Hire, develop and retain top talent. Recognize and reward team members. Model leadership behavior and act as a servant leader to ensure team success.

Communicate effectively with team, champion, and challenge changes with positivity. Own messaging and decision making. Lead team through ambiguity.

Problem Solving Be creative and take calculated risks to achieve goals and deliverables. Make mistakes and learn quickly from them, model this behavior for your team.

Customer / Client Focused Act with urgency and ownership to resolve customer issues. Proactively identify and resolve issues when possible.

Work to ensure self and team prioritize the customer experience.

Results Focused drive team to achieve results, focusing on desired outcomes. Action plan for team management despite operational challenges.

Location

This is a flexible position with preference given to candidates in close proximity to our Plano, TX, or Bethlehem, PA offices, as well as to a regional office where you would come into an office two days per week with a flexible schedule.

Minimal travel to other locations and conferences

Salary Range

$56,200.00 - $92,335.00

The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate.

In addition to salary, this role may also be eligible for annual, sales, or other incentive compensation.

Our Promise

At Guardian, you’ll have the support and flexibility to achieve your professional and personal goals. Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.

Inspire Well-Being

As part of Guardian’s Purpose to inspire well-being we are committed to offering contemporary, supportive, flexible, and inclusive benefits and resources to our colleagues.

Health Care

Choice of high deductible / copay medical plans* with prescription drugs, including coverage for fertility and transgender inclusive benefits

Dental plan

Vision plan

Health care accounts flexible spending, health reimbursement, and health savings accounts

Critical illness insurance

Life and Disability Insurance

Company-paid Life and Disability insurance plus voluntary supplemental coverage

Accident insurance

Retirement and Financial

401(k) retirement plan with a company match, plus an annual age / service-based Company contribution and an annual profit-sharing contribution, if applicable

Complimentary 1 : 1 financial guidance with a licensed Fidelity representative

Time Off and Remote Work

Flexible work arrangements (part in-person / part remote)

Unlimited paid time off for most roles plus time off for volunteering, jury duty, voting, and bereavement

Personal holidays for colleagues to use in recognition of religious, cultural, or civic days

Paid parental leave and paid family and medical leave policies

Emotional Well-being and Work-Life

Emotional well-being, mental health, and work / life resources powered by Spring Health

Wellness programs, including fitness program and equipment reimbursement

Child, adult, and elder back-up care support through Bright Horizons

Adoption assistance

College planning

Tuition reimbursement

Student loan assistance

Commuter benefits in select metropolitan areas

Benefits apply to full-time eligible employees. Interns are not eligible for most Company benefits.

Equal Employment Opportunity

Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law.

Accommodations

Guardian is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities.

Guardian also provides reasonable accommodations to qualified job applicants (and employees) to accommodate the individual's known limitations related to pregnancy, childbirth, or related medical conditions, unless doing so would create an undue hardship.

If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and / or to receive other benefits and privileges of employment, please contact .