• Job Description

  Req#: 746170

  Job Description

  The person would be responsible for managing a team of Medical professionals (Associate / Sr. Associate/Specialists and analyst level), responsible for medical summary, claims handling, investigating and processing complex policy administration transactions, by following defined guidelines laid down by the process Demonstrates a broad knowledge for leading/managing all facets of assigned team and handles the achievement of department / enterprise goals and objectives, programs, policies, and procedures in a business area gained through experience and training. Provides functional, procedural, or strategic guidance to create value, maximize growth and improve business performance for the organization.

  Job Responsibilities

  
  Lead People Resources

  Manage a team of Medical Summarizers who will review claims medical packages and summarize a medical profile with consideration of insurance mortality, morbidity and claims adjudication. Output will be used by an stateside claims evaluation consultants, claims adjusters, litigation team or underwriting team to make a final decision regarding claim settlement and claims management.
  Manages/leads front-line non exempt employees (Allstate/vendor partners).
  Implements the Performance Management and Progressive Discipline Processes.
  Write and administer Progress Development Summaries, evaluate employee potential and recommend employee promotions, merit increases, or terminations.
  Interviews and selects job candidates.
  Creates a positive and satisfying work environment through the use of recognition, empowerment, listening, valuing diversity, and acting as a role model for others.
  Administer Human Resources guidelines and policy and resolves employee’s issues and concerns regarding these policies.
  Is a resource to other front-line managers on issues relating to the management of front-line employees/units.
  Recommend training and education programs to enhance associates knowledge and development.

  Communicates Information

  Provides information to employees and management participates in and leads meetings, and creates complex reports, proposals and business cases.
  Facilitate and /or attend meetings with stakeholder, customers, and vendors to address and/or resolve work issues.
  Effectively communicates with all stakeholders to ensure quality delivery of customer service and expedient resolution of problems
  Assist employees in interpreting internal and external departmental information.
  Develop and Coordinate Workflow
  Manages front-line employees by providing appropriate direction, coordinating unit activities, monitoring employee/unit performance, formulating and implementing action plans, recommending work procedures, and directing workflow.
  Anticipates workflow levels through effective planning and is able to adjust resources to ensure work is completed and unit goals are met.
  Perform compliance or other quality spot-checks.
  Serve as a technical resource to staff questions regarding procedures and customer inquiries.

  Leads/Manages Projects

  Leads projects of moderate complexity that require the coordination of multiple resources.
  Documents progress of project to include key measurements and opportunity areas.
  Communicates the status of projects to leadership team and key stakeholders external to the department.
  Understands and operates software and/or hardware necessary of position.
  Coordinates repair/replacement and preventative maintenance needs.

  Implements and Monitors Plan

  Prepare analysis of budgetary, expense, and quality control.
  Contribute and implement strategic plans into work unit in order to achieve stated objectives and goals.
  Assist with the identification of future technology and systems, develop information management tools, documents, and reports to effectively manage results.
  Identifies impacted areas and implements action plans and goals for achieving optimum business results.
  Drive optimization and efficiency within the teams.
  Contribute and implement strategic plans into work unit in order to achieve stated objectives and goals.
  Ensure the Division’s compliance with company policies, procedures and reporting requirements by monitoring the quality process and implementing corrective action to ensure policy and procedures are adhered

  Experience

  • Medical Graduate/PG from a UGC recognized institute and equivalent life insurance, claims management, medical underwriting work experience of four to five relevant years in US/UK insurance management space.

  • Medical graduate/postgraduate with business management degree preferred

    Minimum 6-7 years of work experience in life/health/disability insurance claims or underwriting,

    At least 1 Year as people manager or process lead in an International BPO/KPO/captives or insurance organization

    Relevant experience in life/health/disability claims handling/settlement/adjudication and investigation process

• About the company

  The Allstate Corporation is an American insurance company, headquartered in Northfield Township, Illinois, near Northbrook since 1967.

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