Apply on Employer Site

Sun Life · 1 day ago

Senior Manager, Absence & Disability Claims

Portland, ME

Full-time

Hybrid

Mid, Senior Level

$73K/yr - $109K/yr

5+ years exp

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. The Senior Manager will provide leadership and direction to a team of Case Specialists managing Absence and Disability claims, ensuring compliance and best practices while focusing on client experience and team performance.

FinanceFinancial ServicesInsurance

Culture & Values

Responsibilities

Responsible for the leadership and development of a high performing team

Oversee and direct the work of a team of 10 – 12 Case Specialists including regular reviews & assessment of team performance against Service and Performance Guarantees

Is actively involved in the team’s work, setting objectives, creating plans, assigning work, and addressing team performance issues

Develop, implement, and evaluate claim practices to deliver best in class service and processes. Ensure uniformity and consistency with all claim practices and procedures

Ensure compliance with all relevant laws, regulations, and company policies

Analyze claims data and trends to identify areas for improvement

Communicate verbally and in writing with clients, vendors, and internal resources including senior management, in response to inquiries including claimant or case specific statuses, escalated calls or departmental process and performance measures

Collaborate with peers and partner teams to deliver on department expectations in support of sales objectives and client service goals

Participate and/or lead continuous improvement initiatives or special projects aligned to our KPIs

Interprets contracts and ensures consistent, fair claims practices and adherence to appropriate laws, regulations, and procedures

Reviews and signs off on claim payments within established limits and/or reviews recommendations made by medical resources to determine proper disposition of claims

Protect and maintain personal health information with a high level of confidentiality abiding by Sun Life procedures and by HIPPA rules and regulations

Contribute to fraud detection and prevention efforts

Other duties and responsibilities as assigned

Qualification

Disability ManagementAbsence ManagementLeadership SkillsClaims AnalysisTeam DevelopmentRegulatory ComplianceAnalytical SkillsPC ProficiencyCommunication SkillsOrganizational SkillsProblem SolvingAttention to Detail

Required

Ability to work with a diverse group of people

A minimum of five years' management experience of an Absence or STD Claims team

Proven success in developing, building and fostering high performance teams

Strong Disability and Absence Management knowledge with demonstrated expertise in Federal/State FMLA, short-term disability, statutory disability plans, or ADA

Strong leadership skills with an ability to engage employees to deliver top performance related to service, risk and quality

Able to set direction, monitor performance and initiate and communicate changes in direction as needed

Able to build agreement on actions by resolving conflicts in an open and positive manner

Demonstrated ability to influence others to achieve results

Ability to work professionally and effectively with a diverse group of people

Strong organizational skills, including the ability to prioritize work and multi-task

Strong research, analytical, critical thinking, problem solving skills and decision-making skills

Strong computer skills, proficient in PC environment and MS Word, Excel, and email systems

Attention to detail with documentation, reporting and communication

Ability and desire to work in a fast-paced, service-oriented environment

Excellent verbal and written communication skills, with the ability to be both pleasant and professional

Ability to initiate and prioritize regular work duties and projects