Claims Operations Director

Job Summary

A company is looking for a Claims Operations Director - Appeals.

Key Responsibilities

• Lead service teams for LOA, STD, ADA, and/or LTD Appeals
• Develop strategies and business plans for market-centric capabilities
• Manage departmental budget and enhance team alignment with organizational goals

Required Qualifications

• Advanced education, equivalent work experience, training, or DMEC certification
• 10 years of experience in claims/appeals and 7 years in leadership within absence management
• Qualifications or experience in healthcare, rehabilitation, or a medical field
• Lean Six Sigma Certification and/or formal Operations Strategy training
• Experience leading a team of Managers within Appeals, overseeing approximately 40 professionals