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Senior Manager - Claims Analytics, Data Security and Financial Controls

Req #: WHQ00011916-AG
Location: Chicago, IL US
Job Category: Professional Opportunities

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Corporate Safety

Our Corporate Safety division implements medical programs and workers compensation, helps employees dealing with lost time to injury, and more.


Job overview and responsibilities

This new position will lead a team which will enable the creation and analysis of complex data from various sources and then create meaningful information, e.g., claims data, bill review data (116,000 records / year), medical information (where appropriate). New skills and experience are required to enable continued improvement in the balance sheet liability account for workers' compensation.Workers' Compensation has made significant progress over the past four years. United's balance sheet has improved by and net open claims are better by 30%; however, to continue to progress and make significant improvements, new skills and experience are needed in key Senior Manager roles. This job will be critical to achieving United's goals.

 

  • Identifies workers’ compensation data resources and securely combines to create meaningful information, e.g., risx fac claims data, bill review data (116,000 records / year), medical information (where appropriate)
  • Creates and maintains scorecards measuring workers’ compensation key metrics for distribution to stakeholders
  • Oversees the development and maintenance of Workers’ Compensation RMIS (risk management information system) to support decision making by all department leaders
  • Interfaces with Information Security to ensure proper procedures and processes are maintained to protect personal and private information
  • Interfaces with technology for any required links and/or feeds to third party vendors
  • Interfaces with Corporate Risk and United’s professional actuary to ensure understanding of workers’ compensation initiatives and resulting impact on claim development, including indemnity, medical and allocated loss reserve changes
  • Develops, maintains and communicates monthly performance that is aligned with United’s outside actuary and makes recommendations for any necessary ‘course corrections'
  • Interfaces with Internal Audit 
  • Ensures RRE (Responsible Reporting Entity) reports to Medicare are timely and accurate
  • Interfaces with Finance to ensure proper reporting and reconciliations of workers’ compensation finances
  • Ensures statistical samples of aged and process and procedure audits are conducted annually
  • Compiles data from the audits and analyzes for trends and recommendations
  • Provides recommendations for efficiency improvements for how audits are conducted
  • Leads a team of analysts
  • Ensures calibration of auditors on a quarterly basis at a minimum
  • Builds and measures workers’ compensation budget
  • Oversees all required financial and process controls to ensure accuracy and compliance with corporate and regulatory requirements



 

 

Required 

  • Bachelor's Degree
  • SQL technology skills
  • Expert excel abilities
  • Minimum 6 - 7 years in workers' compensation or healthcare fields
  • Familiarity with and understanding of workers' compensation actuarial processes and reports
  • 1 - 3 years leading people and / or influencing across divisions
  • Must be legally authorized to work in the United States for any employer without sponsorship
  • Successful completion of interview required to meet job qualification
  • Reliable, punctual attendance is an essential function of the position

Preferred

  • Risk Management certification or experience
  • 3 - 4 years of increasing levels of leadership

 

 


 

Equal Opportunity Employer – Minorities/Women/Veterans/Disabled/LGBT

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