Mgr, Claims Operations (PLADS STD/Integrated Claims) in United States at Jobgether

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Mgr, Claims Operations (PLADS STD/Integrated Claims) in the United States.

This is an excellent opportunity for an experienced operations leader to oversee and optimize claims management processes within a dynamic insurance environment. The role combines strategic leadership, operational oversight, and continuous improvement initiatives to ensure high-quality claims administration and customer satisfaction. You will lead cross-functional teams, manage workflow efficiency, and contribute to process enhancements that support operational excellence and compliance. The position offers strong visibility across the organization and the opportunity to influence business performance through effective people management, risk mitigation, and technology-driven improvements. This fully remote role is ideal for professionals who thrive in fast-paced environments, excel at leading teams, and are passionate about delivering exceptional service while driving operational results. A collaborative culture, professional development opportunities, and a strong commitment to employee well-being make this an attractive long-term career opportunity.

• Manage daily operations within the claims business unit, ensuring efficient workflow management, productivity, quality standards, and customer satisfaction.
• Lead, coach, and support supervisory staff and claims teams while fostering employee development, engagement, and performance improvement.
• Analyze operational data, identify trends, and prepare reports to support strategic decision-making and departmental objectives.
• Develop and implement operational improvements, quality initiatives, and risk management practices to enhance service delivery and compliance.
• Ensure claims processing activities align with regulatory requirements, internal policies, and industry standards.
• Coordinate training initiatives, staffing projections, and development programs to support team effectiveness and operational goals.
• Partner with internal stakeholders to evaluate and implement technology enhancements, workflow improvements, and automation opportunities.
• Monitor departmental budgets and operating expenses to support financial objectives and resource optimization.
• Participate in organizational initiatives, process improvement programs, and cross-functional projects to support broader business goals.
• Support legal and compliance activities by coordinating documentation reviews and preparing for hearings or related proceedings when necessary.

• Bachelor’s degree in Business, Management, or a related field, or equivalent professional experience.
• Minimum 6 years of experience in claims operations, insurance administration, or related business functions.
• At least 4 years of leadership or supervisory experience managing teams in operational environments.
• Strong knowledge of claims processing operations, production management methodologies, and operational performance optimization.
• Understanding of federal, state, and local insurance regulations, compliance standards, and industry practices.
• Experience with absence and disability claims administration, including STD/FMLA processes, is preferred.
• Strong analytical, organizational, and problem-solving skills with the ability to manage complex operational issues.
• Excellent communication, presentation, and interpersonal skills with the ability to collaborate across multiple business functions.
• Proficiency with Microsoft Office tools and Windows-based software applications.
• Experience managing budgets, operational expenses, and workforce planning initiatives.
• Professional industry certifications such as FLMI or ALHC are considered a plus.

• Competitive salary ranging from $90,000 to $130,000 based on experience and qualifications.
• Fully remote work opportunity within the continental United States.
• Comprehensive medical, dental, and vision insurance coverage.
• Prescription drug coverage and flexible spending account options.
• Company-sponsored supplemental insurance plans, including accident, cancer, critical illness, and hospital indemnity coverage.
• 401(k) retirement savings plan and company stock purchase opportunities.
• Annual bonus potential and long-term career growth opportunities.
• Generous paid time off package including holidays, vacation days, and applicable sick leave.
• Parental leave, adoption leave, and additional leave programs supporting employee well-being.
• Inclusive and collaborative work environment focused on professional development and continuous improvement.