Job Information
Prudential Director of LTC Claim Operations, Legacy Business Solutions - R-118064 in Dresher, Pennsylvania
Director of LTC Claim Operations, Legacy Business Solutions - R-118064
DESCRIPTION/RESPONSIBILITIES: Job Classification: Project Mgmt, Transformation & Strategy - Project Mgmt, Transformation & Strategy
Reporting directly to the Vice President of Long-Term Care (LTC) Operations, this role is responsible for overseeing and managing the day-to-day claim operations of the long-term care insurance department. This key leadership role provides strategic & tactical insights and analysis to support business decision-making and drive the achievement of key objectives. This position ensures efficient and effective delivery of insurance services to policyholders, an enhanced customer experience, initiative value accretion and talent development.
The current employee work arrangement for this position is dependent on the business preferences and your location, potentially requiring your on-site presence on occasion at a Prudential office.
What you can expect: This individual will lead LTC Claim Operations and be accountable for: * Operational Oversight/Transformation -- Responsible for execution of transformation and optimization strategy initiatives associated with the LTC business claim operating model. * Oversees LTC Third Party Administrators (TPA) claim teams as well as other strategic partners. * Claims Management -- Ensuring timely and accurate claims adjudication. Collaborate with the LTC TPA and internal and external business partners to develop and implement enhanced transformation and consistent process innovation thru predictive analytics within the management of the LTC claim block. * Drive transformation by identifying opportunities for streamlining operations, increasing efficiency, and improving customer experience. * Develop and implement strategic claim initiatives based on data analysis to optimize business processes, improve operational efficiency, and enhance overall customer experience. * Monitor industry trends related to claims management. Actively engage with the industry with the development of LTC best practices, identify areas for process improvement and determine insights that could drive future value. * Partners closely with legal on all ongoing claim litigation including depositions and serving as a corporate witness. * Ensure compliance with all relevant laws, regulations, and internal policies governing long-term care insurance operations. Develop and implement controls to meet regulatory requirements and conduct regular audits to assess compliance. * Provide strategic and technical direction to a Third-Party Administrator (TPA) and other selected vendor partners. * Responsible for quality assurance program to ensure claims are adjudicated within standards. * Design and implement dashboards and reports that provide clear and concise visibility into claims handling, trends, and opportunities.
What you'll need: * Bachelor's degree. * 10+ years of management experience, leading through both authority and influence. * Demonstrated strong leadership and management skills, including analytical, organizational and problem-solving skills, which support sound decision making. * Proven track record of identifying areas of innovation, opportunity, developing a plan of action, and executing. * Excellent communication skills, with the ability to present complex information and insights in a clear and concise manner to senior leadership and key stakeholders. * Strong analytical skills and ability to translate complex data into clear and actionable insights. * Demonstrated project management skills, with the ability to prioritize and manage multiple priorities simultaneously. * Must have flexibility and ability to adapt to changing priorities and ambiguous environment. * Highly self-motivated and able to thrive in an extremely fast-paced and changing environment.
It'd be a plus if you had: * CLTC or LTCP designations a plus not required. * MBA degree is a plus. * 5+ years of ong-term care experience and knowledge of product features and deep knowledge of the industry's regulations and solutions/capabilities a plus * Knowledge of principles, methods and techniques of long-term care insurance claims management a plus. * Oversight or experience with TPA and other vendor management experience a plus. * Experience in vendor contract negotiations and development a plus.
What we offer you: * Market competitive base salaries, with a yearly bonus potential at every level * Medical, dental, vision, life insurance, disability insurance, Paid Time Off (PTO), and leave of absences, such as parental and military leave * Retirement plans: 401(k) plan with company match (up to 4%), company-funded pension plan * Wellness Programs to help you achieve your wellbeing goals, including up to $1,600 a year for reimbursement of items purchased to support personal wellbeing needs * Work/Life Resources to help support topics such as parenting, housing, senior care, finances, pets, legal matters, education, emotional and mental health, and career development. * Tuition Assistance to help finance traditional college enrollment toward obtaining an approved degree, many accredited certificate programs, and industry designations. * Employee Stock Purchase Plan: Shares can be purchased at 85% of the lower of two prices (Beginning or End of the purchase period), after one year of service.
To find out more about our Total Reward package, see our Total Rewards Brochure. Some of the above benefits may not apply to part-time employees scheduled to work less than 20 hours per week.
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Note: Prudential is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $137,700.00 to $186,300.00. Specific pricing for the role may vary within the above range based on many factors including geographic location, candidate experience, and skills. Roles may also be eligible for additional compensation and/or benefits. Eligibility to participate in a discretionary annual incentive program is subject to the rules governing the program, whereby an award, if any, depends on various factors including, without limitation, individual and organizational performance. In addition, employees are eligible for standard benefits package including paid time off, medical, dental and retirement.
Prudential is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, ancestry, sex, sexual orientation, gender identity, national origin, genetics, disability, marital status, age, veteran status, domestic partner status , medical condition or any other characteristic protected by law.