Claims Manager - Technical Standards and Compliance | Brea, CA

Claims Manager - Technical Standards and Compliance

Brea, CA

To ensure product quality and regulatory standards compliance by line-of-business; to establish policies and procedures; and to develop and train colleagues on technical components of new programs.

• Establishes policies and procedures to assure compliance to best practices, claims management services standards, state regulations, and client service requirements on new programs.
• Analyzes management reports related to new program performance and quality; mentors new colleagues to improve performance as needed.
• Maintains complete understanding of new program design, processes, client expectations and partner relationships; makes recommendations for improvements; and develops best practices for disability and leave operational processes.
• Serves as subject matter expert responsible for the training of technical processes and requirements; leads training initiatives for colleagues, supervisors/managers and clients as needed.
• Leads projects focused on large process, procedural and/or compliance changes/updates; communicates changes/updates to field offices, IT, Legal and other applicable business units regarding regulatory requirements and changes.
• Plays key role in maintaining client relationships; assists in new business productions; and represents Company with specified industry groups.

• Performs other duties as assigned.
• Supports the organization’s quality program(s).
• Travels as required.

• Administers company personnel policies in all areas and follows company staffing standards and training recommendations.
• Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions.
• Provides support, guidance, leadership and motivation to promote maximum performance.

Preferred:
Bachelor’s degree from an accredited college or university or equivalent.

Five (5) years of California Workers Compensation claims management experience required.

California workers compensation claims management experience; SIP required.

• In depth knowledge of claims management, managed care and/or absence management processes and procedures
• Excellent oral and written communication, including presentation skills
• PC literate, including Microsoft Office products
• Analytical and interpretive skills
• Strong organizational skills
• Excellent interpersonal skills
• Excellent negotiation skills
• Ability to work in a team environment
• Ability to meet or exceed Performance Competencies

• Flexible work schedule.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental, vision, 401K on day one.

Compensation
As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $110,000 - $127,000.

A comprehensive benefits package is offered including but not limited to: medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.