Exl Service

  • RN - Disability/Operations Manager

    Job Location US-FL-Tampa
    ID
    2018-5551
    Group
    Global Client Services
    Type
    Regular Full-Time
  • Overview

    EXL (NASDAQ: EXLS) is a leading operations management and analytics company that designs and enables agile, customer-centric operating models to help clients improve their revenue growth and profitability. Our delivery model provides market-leading business outcomes using EXL’s proprietary Business EXLerator Framework™, cutting-edge analytics, digital transformation and domain expertise. At EXL, we look deeper to help companies improve global operations, enhance data-driven insights, increase customer satisfaction, and manage risk and compliance. EXL serves the insurance, healthcare, banking and financial services, utilities, travel, transportation and logistics industries. Headquartered in New York, New York, EXL has more than 26,000 professionals in locations throughout the United States, Europe, Asia (primarily India and Philippines), South America, Australia and South Africa. For more information, visit www.exlservice.com.

     

     

     

    As a Senior Disability Claims Manager, you will have oversite of medical retrieval, summarization and low complexity nurse review. You will need the knowledge and skills to conduct thorough investigations of disability claims. This is a fast-paced job where attention to detail counts. The Senior Disability Claim Manager's oversite has a direct impact on claimant health, well-being and sense of security. The ability to make and effectively communicate decisions within tight time frames, while integrating knowledge of medical conditions, customer contracts, and corporate compliance are critical for success

    Responsibilities

    Job Responsibilities:

    Leadership/Coaching: Provides overall leadership to teams and day-to-day leadership to team leaders. Coach teams to be able to identify inquiries which are beyond scope of authority and take appropriate actions. Inspire team leaders to focus on adherence to policies and processes, as well as federal and state laws and regulations. Fosters a positive work environment. Develops and maintains productive working relationship with team leaders, setting a positive example for their working relationships with their teams

    Career Development/Performance & Dialogue: Set goals and standards of performance for team leaders and team members which are linked to business goals; use appropriate measurement methods to monitor progress; take suitable accountability for successful completion of assignments or tasks. Provide on-going dialogue to team leaders about their performance. Coaches and helps establish individual development.

    Issue Resolution: Investigates and resolves issues as required – whether customer issues, team issues or departmental issues.

    Operations Management/Continuous Improvement: Identifies and approves process changes to improve customer experience. Maintains in-depth knowledge of customer needs. Promotes and maintains a positive, professional image of EXL. Participates in special projects as directed by Leadership.

    Communication: Informs team leaders and members of changes, potential changes and other pertinent information affecting the departmental areas. Plans, coordinates and conducts meetings to discuss operational procedures.

    As a Senior Disability Claims Manager, You Are Responsible for:

    • Oversite of medical retrieval, summarizations, low complexity nurse review and vendor rehabilitation (return to work) which include short-term, long-term and rehabilitation disability. The success of this work will be through capturing medical information, applying appropriate contractual provisions (scope of work), following legal guidelines, and leveraging expert resources.
    • Oversite of the communication process with claimants, employers, and various medical professionals to gather information regarding the claim for, short-term, long-term and rehabilitation disability benefits.
    • Support and promote all integration initiatives.
    • Ability to oversee, and manage a team that will handle potentially high levels of inbound correspondence from claimants and medical professionals. This role will ensuring that the team responds to various written, faxed and emails response of the request for medical records.
    • Oversite of vendors who will work directly with clients to facilitate return to work assessments.
    • Oversite of the team as they network with both claimant and physicians to gather medical records, labs, diagnostic test and any other pertinent medical requests for review and ongoing evaluation of medical information.
    • Oversite of the delivery of clients expectations outlined in the scope of work SOW.
    • Adhere to standard timeframes for processing mail, tasks and outliers as outlined in the scope of work.
    • Understand Operations and Corporate Compliance, Policies and Procedures and best practices.
    • Stay abreast of ongoing trainings associated with role and business unit objectives.
    • Respond to all telephonic and email inquiries within client service protocols (SOW) in a clear, concise and timely manner.
    • Oversite and management of multiple subcontractors responsibilities as outlined by the SOW.
    • Other duties as outlined by leadership.

    Qualifications

    10+ years of experience in Long Term Disability, Short Term Disability, Low Complexity Nurse Review and Vocational Rehabilitation Service. required

    8+ year’s prior experience directly and indirectly leading medium sized teams. required

    Strong interpersonal and demonstrated team-building and coaching skills, proven teamwork and collaboration. required

    Demonstrated analytical and clinical critical thinking skills. required

    In-depth knowledge and understanding of the Independent Medical Examination process. required

    In-depth knowledge and understanding of the High Level Review process. required

    Proven ability to organize and prioritize; demonstrated success in multitasking and managing multiple, competing priorities.

    Strong ability to communicate at all levels with clarity and precision, both written and verbal.

    Ability to adapt in a changing work environment.

    Advanced technical/computer skills, including MS Word, Excel, PowerPoint, Share Point, etc.

    EEO Statement

    EEO/Minorities/Females/Vets/Disabilities

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