Pharmacists Mutual Insurance has an opening for a Claims Manager. This position will ensure superior delivery of claims services and products. The manager will also direct, coordinate and monitor the activities of a team of Claims Examiners and/or Specialists. The manager will provide consulting and training resources, and serve as a contact and technical resource to the field and internal business partners.
Claims Manager
- Learns how to make timely decisions, with guidance and direction from key stakeholders.
- Engages with the Claims team leadership to develop and implement strategic programs that meet our Company's goals and objectives.
- Learns different leadership styles and begins to develop own leadership style.
- Learns how to assess performance and growth needs of team members and how to engage in development discussions.
Senior Claims Manager
- Makes timely decisions, with guidance and direction from primary stakeholders.
- Engages with the Claims team leadership to develop and implement strategic programs that meet our Company's goals and objectives.
- Develops leadership style and motivates team to achieve a common goal by demonstrating the professional behaviors expected.
- Learns to identify strengths and growth needs of team members and how to engage in development discussions.
Essential Functions
Essential functions may include, but are not limited to the following:
- Timely decision making and action to meet Company guidelines and goals.
- Provides quality customer service by monitoring performance and establishing metrics.
- Resolves complaints, problems, and coverage questions which have been escalated through the team.
- Establishes focus of the team to properly manage Company indemnity & expenses.
- Recommends appropriate cases for discussion for claims roundtable; Attends and/or presents at roundtables/ authority discussions for collaboration of technical expertise resulting in improved payout on indemnity and expenses.
- Ensures that the Company’s claim quality, guidelines and metrics are successfully met.
- Assigns staff to attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
- Evaluates the work of assigned staff and prepares written performance evaluations; makes recommendations on personnel actions to include hiring, work assignments, training, and discipline.
- Manages relationships with large accounts and brokers from a claims and risk management perspective.
- Works with and manages a third party administrator and/or external business partners as applicable.
Knowledge, Skills And Abilities
- Understand principles and practices of insurance claims examination.
- Knowledge of employee management principles including hiring, supervision, training, retention, and performance evaluation.
- Conduct investigative interviews.
- Understand employee management and developing standards.
- Manage process, planning, and tracking of budgets.
- Correct English usage, spelling, grammar, vocabulary and punctuation.
- Ability and flexibility to work longer hours when workload fluctuations occur.
- Research and stay up-to-date with trends and changes in the claims/insurance industry.
- Communicate effectively with others (oral and written).
- Analyze complex issues and make critical decisions.
- Maintain records, prepare reports and conduct correspondence related to the work.
- Interpret and apply laws, rules and regulation, as well as complex policy and contract coverage.
- Obtain and use sensitive information discreetly and objectively, both internal and external.
- Determine when to escalate concerns to the appropriate level of management.
- Follow oral and written directions.
- Work effectively with others in a team environment.
- Contribute effectively to the accomplishment of team or work unit goals, objectives and activities.
- Establish and maintain effective working relationships with those contacted in the course of work.
- Excellent customer service skills.
- Ability to organize and prioritize work.
- Work independently and demonstrate drive and initiative.
- Ability to handle multiple tasks at once.
- Ability to meet definite deadlines and deal with pressure situations.
- Collect, interpret, and input data efficiently and accurately.
- Use computer and related software effectively.
- Use Microsoft Office programs efficiently and effectively.
- Expertise in Workers Compensation, Property, Subrogation, Auto & General Liability or Professional Liability claims.
Experience And Education Qualifications
Claims Manager
- High School Diploma or equivalent and 15 years of related experience; or
- Associate’s Degree and 12 years of related experience; and
- One of the following industry related certifications: AIC (Associates in Claims, AIC-M (Associates in Claims-Management), AIM (Associates in Management), CRM (Certified Risk Manager), or SCLA (Senior Claim Law Associate)
OR
- Bachelor’s Degree and 8 years of related experience; or
- Master’s Degree and 5 years of related experience
Senior Claims Manager
- HS Diploma or equivalent and 20 years of related experience with at least 5 years in leadership; or
- Associate's Degree or equivalent and 15 years of related experience with at least 3 years in leadership; and
- One of the following industry related certifications: AIC-M (Associate in Claims- Management), AIM (Associate in Management), CRM (Certified Risk Manager), SCLA (Senior Claim Law Associate), CPCU (Chartered Property Casualty Underwriter)
OR
- Bachelor's Degree and 8 years of related experience with at least 2 years in leadership; or
- Master's Degree and 6 years of related experience with at least 1 year in leadership
Special Requirements, Licenses and Certificates
- Licensing required in some states.
Preferred Qualifications
- Advanced or specialized training/certifications preferred: SCLA, AIC, ARM, CPCU
Work Environment
- Primary work environment is in a climate-controlled office setting
- Work may involve travel to attend meetings at other locations
Benefits
In addition to a competitive salary, eligible employees may receive an annual discretionary bonus and access to our benefits package including:
- Health, Dental, Vision & Life coverage
- 401(k) with Company Match
- Paid Time Off
- 8 Paid Holidays
- Volunteer Time Off
- Paid Parental Leave
- Hybrid/Remote Work Options
- Employee Assistance Program
- Tuition Reimbursement
Pharmacists Mutual Insurance Group is an Equal Opportunity Employer.
