First Party Medical Claims Manager III (Hybrid)

The 1st Party Medical Claim Manager III role at American Family Insurance Group is a leadership position that oversees teams within the medical claims department. This leader of leaders guides and mentors managers, ensuring that their teams effectively handle medical claims in compliance with company policies and regulatory requirements. The role involves strategic planning, resource allocation, and performance management to achieve departmental goals. Additionally, the 1st Party Medical Claim Manager III collaborates with other departments to streamline processes, improve customer satisfaction, and drive continuous improvement initiatives within the claims operations.

Position Compensation Range:

$111,000.00 - $190,000.00

Pay Rate Type:

Salary

Compensation may vary based on the job level and your geographic work location. Relocation support is offered for eligible candidates.

Primary Accountabilities

• Creates a collaborative, performance-driven work environment by facilitating and fostering trust, transparency, and inclusion. Works with team members to set clear goals, provide feedback, perform performance assessments, and support on-going development.
• Leads with influence and expertise. Actively contributes to division or department leadership team. Communicates and supports organization mission, vision, values, policies, and practices.
• Leads teams to ensure consistent delivery of services that meet or exceed customer expectations and compliance with regulatory and company standards.
• Maintains awareness of existing and proposed legislation, court decisions and emerging trends in claims litigation to monitor the company's compliance and recommend process and procedure changes as appropriate.
• Provides direction to claims managers and staff on all aspects of claims handling including those related to coverage and escalated through the team.
• Reviews, evaluates and maintains file-handling process to meet company and statutory guidelines.
• Participates in corporate claims initiatives including quality file handling, process improvement, training, and development of staff.
• Prepares and manages annual operating budget. Assist in preparing business plans.
• Identifies and implements opportunities for process improvements.

Specialized Knowledge & Skills Requirements

• Demonstrated experience providing customer-driven solutions or service.
• Demonstrated extensive knowledge of office and field claim handling processes.
• Demonstrated thorough understanding of policy language, coverages and underwriting intent.
• Demonstrated organization and time management skills with the ability to work under pressure and adhere company productivity guidelines.
• Demonstrated claims handling experience and licensing.
• Demonstrated ability to recognize developing problems/conflicts and ability to resolve.
• Previous leadership experience required.
• First party medical experience preferred.

Licenses

• Obtain state specific property casualty claims licensing as required.
• Valid driver's license required plus an acceptable driving record.

Travel Requirements

• Up to 25%.

Physical Requirements

• Work that primarily involves sitting/standing.

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