Regional Claims Leader: WC Operations & Growth

Blue Cross Blue Shield of Michigan; Colorado; Remote; USD 100,000 - 158,000; Full time

Job summary

Blue Cross Blue Shield of Michigan is seeking a Senior Leader to oversee a regional workers' compensation claims organization in Colorado. You will drive performance across adjudication, benefit allocation, and customer experience while promoting accountability, continuous improvement, and service excellence.

Responsibilities include leading a team of claims professionals, managing budgets, and staying current with relevant statutes and case law to ensure compliant, efficient operations in a

Qualifications

• Bachelor’s degree in a related field.
• Seven years of experience in a claim environment with demonstrated technical experience.
• Three years of supervisory or leadership experience in claims.
• Previous workers’ compensation claim management with multi-jurisdictional experience preferred.
• Bilingual skills preferred.

Responsibilities

• Manages monoline workers' compensation unit of claim professionals and support staff.
• Leads claim team in support of department initiatives and strategies in cost containment, case file handling, customer service and quality.
• Consistently monitors workflows to maximize accuracy and efficiency. Maintains an acceptable level of service and customer satisfaction and retention.
• Effectively manages the quality review process.
• Develops unit goals, objectives, processes, procedures and systems.
• Stays abreast of changes in workers’ compensation statutes, case law and rehabilitation advancements.
• Identifies team staffing needs and takes necessary measures to ensure appropriate levels of service.
• Mentors employees and develops career paths with growth opportunities.
• Participates in development of annual departmental budget, monitors budget and identifies budget discrepancies.
• Participates in special projects and serves on committees as needed.

Skills

Team building

Leadership abilities

Insurance compliance

Insurance administration

Collaboration

Communication skills

Budget presentation

Workflow management

Multi-project management

Computers/Software

Education

Bachelor's degree in related field

Job description

Blue Cross Blue Shield of Michigan is seeking a Senior Leader to oversee a regional workers' compensation claims organization in Colorado. You will drive performance across adjudication, benefit allocation, and customer experience while promoting accountability, continuous improvement, and service excellence.

Responsibilities include leading a team of claims professionals, managing budgets, and staying current with relevant statutes and case law to ensure compliant, efficient operations in a