ESSENTIAL RESPONSIBILITIES:
WORKFLOW DOCUMENTATION AND STANDARDIZATION
- Owns end-to-end documentation of critical Claims workflows across Adjusting, Medical Management, and operational support functions.
- Translates complex workflows into clear, structured process maps and execution standards.
- Establishes and enforces documentation standards to ensure consistency across all Claims functions.
- Ensures the integrity and ongoing accuracy of a centralized repository for Claims workflows, updating documentation as processes evolve.
JOB AIDS AND PRACTICAL ENABLEMENT
- Designs and delivers high-quality job aids that support real-time decision making.
- Ensures materials are usable in the flow of work, reducing reliance on tribal knowledge or inconsistent practices.
- Continuously refines tools based on frontline feedback and observed execution gaps.
CHANGE COMMUNICATION AND ADOPTION DISCIPLINE
- Partners with Claims leadership and Transformation team to translate system changes and process updates into clear, actionable communications.
- Ensures a singular, consistent voice across all Claims communication related to workflow and execution changes.
- Establishes a repeatable model for change rollout, including sequencing, reinforcement, and adoption tracking.
- Identifies breakdowns in adoption and drives correction actions.
EXECUTION QUALITY AND CONTINUOUS IMPROVEMENT
- Monitors execution consistency across teams and identifies gaps between defined standards and actual practice.
- Utilizes data, audits, and frontline feedback to prioritize improvements.
- Drives continuous refinement of workflows, job aids, and communication practices
QUALIFICATIONS:
EDUCATION
- Bachelor's degree from an accredited four-year college or university.
- LICENSES AND CERTIFICATIONS: One or more preferred:
- Licensed to adjust workers compensation claims in one or more jurisdictions.
- Prosci Change Management Certification or Certified Change Management Professional (CCMP).
- Project Management Professional (PMP).
EXPERIENCE
- A minimum of seven (7) years of experience in workers compensation claims management, claims operations, or closely related functions.
- Demonstrated experience translating complex processes into clear, structured, and actionable guidance.
- Proven experience with Claims Management Systems (CMS).
- Experience supporting or leading operational change initiatives, including system implementations or workflow designs; experience driving adoption, not just awareness.
TECHNICAL KNOWLEDGE/SKILLS
- Deep understanding of end-to-end Claims workflows, including Adjusting, Medical Management, and regulatory considerations.
- Strong process orientation with ability to simplify complexity without losing substance.
- Ability to convert strategy and system design into practical execution.
- Strong ability to influence without direct authority across multiple levels of the organization.
- Proven ability to bring structure, discipline, and clarity to ambiguous or evolving environments.
- Demonstrated proficiency in Microsoft Office suite of applications, Power BI, and currently adopted proprietary and vendor software programs.
- Ability to master and become proficient in additional proprietary and vendor software programs.
CRITIAL THINKING
LANGUAGE ABILITY
MATH AND REASONING ABILITY
WHAT WE OFFER
- Hybrid Work Schedule (up to 2 days work from home upon eligibility)
- Paid Time Off
- Paid Holidays
- Immediate Vesting of Retirement Savings + Company Match
- Group Health Insurance (Medical, Dental, and Vision)
- Life and AD&D Insurance
- Long Term Disability Insurance
- Hospital Indemnity Insurance
- Accident and Critical Illness Insurance
- Flexible Savings Accounts
- Paid Community Volunteer Day
- Employee Assistance Program
- Tuition Reimbursement Program
- Employee Referral Program
- Diversity, Equity and Inclusion Program