Team Leader, Claims Case Management

The LTD Team Leader is responsible for validating that all LTD claims are accurately and fairly adjudicated according to plan provisions, established best practices and within state and federal guidelines. The Team Leader must be able to manage and resolve issues that pertain to claim administration procedures cost containment activities, reports and quality control issues. The Team Leader will serve as primary resource for the team and provide direction to the staff members by setting objectives, communicating progress and goals, and holding the staff accountable for adhering to all quality assurance, turnaround times, best practice standards, and operational efficiency. The Team Leader is responsible to assist staff with career development and career progression.

The Team Leader partners with internal cross functional areas for
program direction, goal setting, service delivery and development of action plans and leveraging bench strength. The Team Leader works with external customers to enhance the overall experience for the customer. The Team Leader is responsible for the overall functioning of the department.

You will

Manage People 40%
 Develop and communicate objectives and performance goals for the department.
 Managing direct report’s performance by coordinating with HR business partners to develop coaching plans and performance improvement plans.
 Develop employee goals to promote career growth that enhance level of knowledge for future opportunities.
 Cross collaboration with business partners including Life and Disability, CRU, SIU, Sales Force, Group Quality Management and other areas within the company.
 Promote leadership model to support Guardian values.
 Create yearly action plan based on the results from the employee engagement survey.

Manage Risk 30%
 Based on feedback from technical consultant review daily, weekly and monthly reports on team productivity 1) for operational reporting and monitoring purposes; and 2) to identify trends and training opportunities.
 Coordinate and monitor overpayment recovery efforts, vendor/legal negotiations and tracking for liability and reporting purposes.
 Monitor claim turnaround times to validate decisions are made within DOL and policy time frames.
 Oversee settlement checks in accordance with settlement agreements.
 Assist in self-testing for MARs Financial Control.

Training and Development 20%
 Develop training tools in conjunction with technical experts to deliver training to the staff.
 Empower staff through brainstorming sessions to revise workflows and procedures that promote best practices.
 Support strategic initiatives from a Life/DI claim perspective with contract rewrites and related projects.
 Prepare agenda, schedule and facilitate team meetings.
 Mentor, coach, supervise and develop talent of direct reports by recommending and coordinating training plans for individuals to exceed personal and departmental goals and objectives.
 Review claim staff QA assessments for training or enhancement opportunities.

Manage Processes 10%
 Identify Continuous Improvement opportunities by reviewing process and eliminating unnecessary steps.
 Validate refund and returned checks are processed in an accurate and timely manner and in accordance to departmental policy.
 Assist manager with departmental budget and vendor expenses.
 Identify claim success stories that promote Guardian’s value proposition.

You Have:

Qualifications
 Minimum of 5 years of disability claims experience.
 Bachelor’s Degree in related field and/or equivalent relevant disability work experience.
 Previous leadership experience in decision making, trouble shooting, staff development, and related skills and abilities.

Functional Skills
 Excellent organizational and time management skills.
 Excellent math aptitude and analytical skills.
 Professional oral, written and presentation skills.
 Strong PC skills, including Microsoft Office applications.
 Extensive knowledge of Guardian’s disability products, business rules and procedures.
 DCMS claim system knowledge a plus.
 Familiarity with mandated state and federal regulations.

Leadership Behaviors
 Actively coaches, develops and rewards team members.
 Builds teams to ensure the very best people are in place.
 Trusts the team to get the job done.
 Fosters a culture where diverse thoughts, experiences, and backgrounds are valued and celebrated.
 Empowers employees to take the initiative to further team and company goals.
 Creates a safe environment to try new ideas and make mistakes.
 Demonstrates the courage to make difficult decisions and have candid conversations.
 Encourages candor and transparency.
 Communicates the business need for change.
 Leads effectively in ambiguous environments.
 Sets high performance standards for employees and team.
 Builds commitment to achieve goals and deliverables.
 Balances risk with growth opportunities.
 Maintains a strong external focus, voice of customer, industry and regulatory.
 Strategically aligns processes and resources to future goals and objectives.

Reporting Relationships
Report to the Manager, Group Disability Claims who, in turn, reports to the Assistant Vice President.

Group Claims Location
 Remote work flexibility.

Travel
 Minimal travel to other locations and conferences.

Our Promise
 Through skill-building, leadership development and philanthropic opportunities, we provide
opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards

We Offer
 Meaningful and challenging work opportunities to accelerate innovation in a secure and compliant
way.
 Competitive compensation package.
 Excellent medical, dental, supplemental health, life and vision coverage for you and your dependents with no wait period.
 Life and disability insurance.
 A great 401(k) with company match.
 Tuition assistance, paid parental leave and backup family care.
 Dynamic, modern work environments that promote collaboration and creativity to develop and empower talent.
 Flexible time off, dress code, and work location policies to balance your work and life in the ways that suit you best.
 Employee Resource Groups that advocate for inclusion and diversity in all that we do.
 Social responsibility in all aspects of our work. We volunteer within our local communities, create.
educational alliances with colleges, drive a variety of initiatives in sustainability.
About Guardian

Salary Range

The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate. In addition to salary, this role may also be eligible for annual, sales, or other incentive compensation.

Our Promise

At Guardian, you’ll have the support and flexibility to achieve your professional and personal goals. Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.

Inspire Well-Being

As part of Guardian’s Purpose – to inspire well-being – we are committed to offering contemporary, supportive, flexible, and inclusive benefits and resources to our colleagues.

Health Care

Life and Disability Insurance

Retirement and Financial

Time Off and Remote Work

Emotional Well-being and Work-Life

Justice, Equity, Diversity & Inclusion (J.E.D.I.)

Equal Employment Opportunity

Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law.

Guardian is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact .