Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

　　A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

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　　Director National Appeals

　　PRIMARY PURPOSE : To be responsible for the technical and operational functions within assigned office(s) ensuring compliance with company standards and industry best practices; to ensure continuous quality improvement measures through appeal result analysis; to determine management strategies related to client service plans; to be responsible for staffing and training needs; and to be responsible for budget preparation and profit & loss management.

　　ESSENTIAL FUNCTIONS and RESPONSIBILITIES

　　Responsible for operations management for assigned programs/offices.

　　Establishes policy and procedure to ensure compliance to best practices, claim management service standards, ERISA regulations and client service requirements.

　　Monitors changes to ERISA legislation; incorporates workflow changes into the process as defined in legislative changes.

　　Establishes business plan with goals and objectives for partnership with assigned locations/offices.

　　Ensures effective process management; ensures accuracy of final customer deliverables resulting in reduction of errors, increased productivity and customer satisfaction.

　　Facilitates the reduction or process barriers, technology constraints, or resource constraints by directing and influencing the activities of other internal departments (i.e. IT, operations and business development).

　　Works with program managers to resolve all major customer service issues regarding the appeal administration process.

　　Assists program managers in educating the client on appeals data-drivers of cost impacting assigned programs.

　　Coordinates project activities; acts as primary contact for the national Appeals team for clients and internal customers with focus on maintaining and improving overall customer satisfaction.

　　Identifies issues that impact customer satisfaction and works with program managers to get issues resolved as it relates to the appeals unit.

　　Gathers, prepares and monitors operations and financial statistical data for reporting provided to the client.

　　Assists in coordination of sales and client service efforts.

　　Ensures compliance with all applicable quality initiatives.

　　ADDITIONAL FUNCTIONS and RESPONSIBILITIES

　　Performs other duties as assigned.

　　Supports the organization's quality program(s).

　　Travels as needed

　　QUALIFICATIONS

　　Education & Licensing

　　Bachelor's degree from an accredited college or university preferred.

　　Experience

　　Ten (10) years insurance industry experience required to include two (2) years auditing experience and two (2) years supervisory experience. Experience in management and short-term and long-term disability claims management preferred.

　　Skills & Knowledge

　　Strong knowledge of disability claims management practices

　　Knowledge of ERISA regulations

　　Excellent oral and written communication, including presentation skills

　　PC literate, including Microsoft Office products

　　Leadership/management/motivational skills

　　Analytical and interpretive skills

　　In-depth knowledge of client servicing

　　Excellent interpersonal skills

　　Strong organizational skills

　　Excellent negotiation and facilitation skills

　　Ability to handle conflict and confront challenging issues in a fast-paced work environment

　　Ability to work in a team environment

　　Ability to meet or exceed Performance Competencies

　　WORK ENVIRONMENT

　　When applicable and appropriate, consideration will be given to reasonable accommodations.

　　Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

　　Physical: Computer keyboarding, travel as required

　　Auditory/Visual: Hearing, vision and talking

　　NOTE : Credit security clearance, confirmed via a background credit check, is required for this position.

　　The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

　　Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

　　If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

　　Taking care of people is at the heart of everything we do. Caring counts

　　Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)