New York Life

Role Description As a Short Term Disability (STD) Claims Manager, you will develop the knowledge and skills needed to conduct thorough investigations, make determinations regarding short-term disability eligibility for our customers, provide ongoing claim administration, and communicate decisions and status updates. This is a fast-paced job where attention to detail counts. The Claim Manager’s decisions have a direct impact on customers’ health, well-being and sense of security. The ability to make and effectively communicate decisions within tight timeframes, while integrating knowledge of medical conditions, customer contracts, Group Benefit Solutions and corporate compliance are critical for success. What You'll Do - Make claim/customer eligibility determinations and manage ongoing claims for an assigned caseload of short-term disability claims. - Capture medical information, apply appropriate contractual provisions, follow legal guidelines, and leverage expert resources. - Communicate with claimants, employers, and various medical professionals to gather information regarding the application for, payment of, and ongoing management of short-term disability benefits. - Support and promote all integration initiatives (including Family Medical Leave, Life Assistance Programs, Integrated Personal Health Team, Your Health First, Healthcare Connect, etc.). - Handle potentially high levels of call volume from customers and clients. - Respond to various written and telephone inquiries, including eligibility, approval/denial determinations, status and continuation or closure of benefits. - Work directly with clients and Vocational Rehabilitation Counselors to facilitate return to work either on a full-time or modified duty basis. - Network with both customers and physicians to medically manage claims from initial medical requests to reviewing and evaluating ongoing medical information. - Pay all covered claims accurately and timely. - Execute on all customer performance guarantees. - Adhere to standard timeframes for processing mail, tasks and outliers. - Understand Group Benefit Solutions and Corporate Compliance, Policies and Procedures and best practices. - Stay abreast of ongoing trainings associated with role and business unit objectives. - Respond to all telephonic and email inquiries within customer service protocols in a clear, concise and timely manner. Qualifications - 2 year minimum of professional experience. - Strong critical, analytical and investigative skills; ability to gather information, analyze facts, and draw conclusions. - Ability to work with a sense of urgency and be a self-starter with a customer focus mindset. - Ability to build and maintain effective relationships. - Effective interpersonal, written and verbal communication skills. - Excellent planning, time management and organizational skills. - Ability to manage multiple and changing priorities. - Strong negotiation skills. - Technically savvy with the ability to toggle between multiple applications and/or computer monitors simultaneously. - Proficiency with MS Office applications is required (Word, Outlook). - Proven track record of successfully driving results in a complex matrix environment is a plus. - Additional experience administering FMLA and/or State Leaves is a plus. - Knowledge of legal liability, insurance coverage and medical terminology is a plus. - HS Diploma or GED required. Bachelor’s degree strongly preferred. Technology Requirements - Functioning broadband (cable/DSL) should meet the following minimum requirements: 50mb download/20mb upload speed. - Ability to hardwire into internet connection required. Pay Transparency - Salary range: $42,500 - $65,500 - Overtime eligible: Nonexempt - Discretionary bonus eligible: Yes - Sales bonus eligible: No Benefits - We provide a full package of benefits for employees, including leave programs, adoption assistance, and student loan repayment programs. - Based on feedback from our employees, we continue to refine and add benefits to our offering, so that you can flourish both inside and outside of work. Our Diversity Promise We believe in a diverse workforce because it is our mission to advocate for the financial security and success of people in every community. This is why diversity, equity, and inclusion (DEI) are guiding principles that are embedded in our brand and our culture.

Role Description We are seeking a physician to join our dynamic and collaborative team of Medical Directors. The successful candidate will possess broad and deep clinical expertise and the ability to apply medical knowledge to accurately assess mortality and morbidity risks associated with complex medical impairments. This individual will demonstrate professionalism, intellectual curiosity, motivation, strong customer service orientation, and excellent communication skills. As a Medical Director, you will partner closely with underwriting professionals to evaluate insurance risk, provide medical consultation, and contribute to the development of underwriting guidelines. Over time, you will have opportunities to support strategic initiatives that leverage medical expertise to enhance business outcomes, including regulatory and compliance efforts, workflow optimization, and the application of data and analytics. For physicians new to the life insurance industry, this is a hybrid position based in our New York City headquarters. Candidates with prior life insurance Medical Director experience may be eligible to work remotely with periodic visits to the Home Office. What You’ll Do - Review and evaluate medical records, laboratory results, ECGs, and other clinical information to assess mortality and morbidity risk for life insurance applicants. - Partner with Underwriters to determine appropriate risk classifications by applying medical expertise, company guidelines, and market considerations. - Provide consultative medical support to the Underwriting team and educate colleagues on the impact of medical impairments and emerging clinical developments. - Contribute to the development, maintenance, and enhancement of medical underwriting guidelines and risk assessment practices. - Participate in business-focused initiatives that may include regulatory and compliance activities, workflow optimization, automation and AI-enabled solutions, and the use of data analytics to improve risk prediction and decision-making. Qualifications - Medical degree (MD, DO, or equivalent) and active licensure to practice medicine in a U.S. state. - Minimum of three years of clinical practice experience with strong diagnostic and clinical assessment skills. - Demonstrated ability to interpret ECGs, laboratory findings, and complex medical information accurately and efficiently. - Strong verbal and written communication skills with the ability to explain medical concepts to non-clinical audiences. - Strong organizational skills, attention to detail, and the ability to manage multiple priorities effectively. - Proficiency with Microsoft Office applications, including Outlook, Teams, Word, PowerPoint, Excel, and SharePoint, and a commitment to transitioning into a non-clinical role. Requirements - Board certification in Internal Medicine or Family Medicine; candidates from other specialties with broad clinical expertise are also encouraged to apply. - Previous experience as a Medical Director within the life insurance industry. - Board certification or eligibility in Insurance Medicine. - Experience supporting process improvement, analytics, automation, AI-enabled initiatives, or other business transformation efforts. - Occasional travel is required. Physicians who are new to the life insurance industry will be expected to work toward board certification in Insurance Medicine. Benefits - We provide a full package of benefits for employees, including leave programs, adoption assistance, and student loan repayment programs. - Based on feedback from our employees, we continue to refine and add benefits to our offering, so that you can flourish both inside and outside of work.

Role Description The Vocational Rehabilitation Specialist is a frontline professional resource within the Vocational Services Department who applies accredited rehabilitation counseling expertise to support absence management and disability insurance services delivered under employer-based group benefit policies and contracts. This role provides vocational, occupational, and workplace accommodation expertise across multiple functional areas, including: - Pre-Disability and ADA accommodations - Short-Term and Long-Term Disability return-to-work services - Vocational analyses and reporting - Participation in live claim staffings This role requires in-depth practical expertise, independent problem-solving, sound professional judgment, and the ability to serve as a reliable vocational resource for internal and external clients, partners, and customers. What You’ll Do - Vocational Expertise and Analysis - Analyze occupational, vocational, and labor market information to support disability, accommodation, and return-to-work decision-making. - Complete vocational analyses and reports, including own occupation analyses and transferable skills analyses. - Interpret medical, vocational, occupational, and functional information within the context of policy definitions and program guidelines. - Document professional opinions, findings, and rationale in claims and vocational systems. - Return-to-Work and Stay-at-Work Services - Provide direct vocational rehabilitation services to employees of client organizations. - Conduct telephonic or virtual vocational interviews. - Collaborate with customers, employers, health care providers, and internal partners. - Support employer accommodation and modified duty discussions. - ADA, Pre-Disability, and Workplace Accommodation Support - Apply working knowledge of ADA concepts and workplace accommodations. - Analyze job duties and functional requirements to identify potential accommodations. - Communicate vocational and accommodation considerations clearly. - Live Claim Staffing and Collaboration - Participate in live claim staffings and consultations. - Provide real-time vocational input related to occupational demands. - Serve as a subject matter resource for vocational concepts and industry practices. - Collaboration, Quality, and Continuous Improvement - Work independently while collaborating closely with vocational peers and claims teams. - Apply established best practices and quality standards. - Identify trends, issues, or opportunities for improvement. - Participate in training, onboarding, calibration, and professional development activities. Qualifications - Master’s degree in Rehabilitation Counseling or a closely related field. - Active Certification as a Rehabilitation Counselor (CRC). - Demonstrated vocational rehabilitation counseling experience. - Strong working knowledge of occupational classification systems. - Ability to assimilate and apply policy language and vocational standards. - Proficiency with Microsoft Word, Outlook, SharePoint. - Strong written and verbal communication skills. - Effective time management and ability to manage competing priorities. - Commitment to ethical practice in accordance with company standards. Requirements - Experience supporting ADA accommodations and the interactive process. - Experience completing own occupation analyses and transferable skills analyses. - Additional relevant licenses or certifications (e.g., LPC, CVE, CCM, CDMS, CEAS). - Experience providing job retention, stay-at-work, or return-to-work services. - Experience working within a Continuous Improvement (CI) Management System. Benefits - Full package of benefits for employees. - Unique offerings for a modern workforce, including leave programs and adoption assistance. - Student loan repayment programs. - Annual discretionary bonus eligibility. Company Description Group Benefit Solutions delivers comprehensive insurance and absence management solutions for mid-sized and large companies. Our work fosters a healthier, happier, and more secure workforce, contributing to New York Life’s legacy of being there when we’re needed most.

Role Description The Business Planning team is part of the Experience & Digital Marketing organization (EDM). As EDM brings an increasing number of capabilities in-house, Business Planning plays a critical role in coordinating and driving the integration, sequencing, and delivery of workstreams into the broader portfolio. This is delivered through: - Management of EDM’s integrated business plan, roadmap, and portfolio of work. - Mobilization and delivery management of large-scale, cross-functional programs and production that support EDM’s strategic goals and activations. - Synthesis and packaging of complex work into clear plans and narratives. - Empowerment of EDM employees to organically grow, connect, and collaborate to achieve business outcomes. What great looks like in this role: - You are a motivated, energetic, adaptable, and extremely detail-oriented candidate. - You can seamlessly plan, coordinate, and drive a diverse portfolio of large-scale, cross-functional programs and activations. - You think at the portfolio level, understanding how individual programs connect and where dependencies exist. - You are eager to engage with and listen to employees and partners of all levels. - You have strong teamwork skills, excellent written and verbal communications, and the capacity to work cross-functionally. - You take initiative and are a process-oriented problem solver & critical thinker. - You have incredibly strong organizational skills and the ability to prioritize work in a deadline-driven environment. Qualifications - Experience within a marketing, creative, content, digital, or customer experience organization. - Strong collaboration and teamwork skills. - Strong written and verbal communications, especially regarding public speaking, email communications, and PowerPoint presentations. - Ability to work cross-functionally and partner with both colleagues and business leaders. - Self-starter, process-oriented problem solver. - Strong organization skills and ability to prioritize work in a deadline-driven environment. - Preferred if candidate brings strong knowledge of Tier 1 creative and content production. - Proficiency in using digital tools and platforms, specifically strong command of PowerPoint. Requirements - A minimum of a bachelor’s degree and at least 7 years of relevant experience. - Proven experience in cross-functional & large-scale business planning, activation production, strategy, project/program planning and/or management. Benefits - Full package of benefits for employees, including leave programs, adoption assistance, and student loan repayment programs. - Annual discretionary bonus eligibility. - Participation in an incentive program.

Role Description The Senior Associate, Morbidity Underwriting Risk & Quality Solutions is an advanced individual contributor responsible for ensuring the quality, consistency, and effectiveness of morbidity underwriting decisions across Long Term Care and Individual Disability Insurance. This role owns morbidity underwriting quality insights, monitoring, and reporting, and plays a critical role in identifying trends, assessing adherence to guidelines, and driving improvements to underwriting practices, tools, and processes. The individual operates with a high degree of independence, applying deep underwriting expertise and analytical judgment to evaluate outcomes, influence decision-making, and support continuous improvement across underwriting and modernization efforts. What You’ll Do: - Quality Oversight & Case Review: - Perform post-decision reviews of LTC and IDI underwriting cases to assess accuracy, consistency, and alignment with morbidity underwriting guidelines. - Apply expert judgment to evaluate whether underwriting decisions are equitable, balanced, and aligned with intended risk outcomes. - Identify decision inconsistencies, guideline deviations, training opportunities, and areas of elevated risk. - Trend Analysis & Insight Generation: - Own monitoring and analysis of morbidity underwriting quality trends across products, cohorts, and distribution channels. - Identify patterns in decisioning, including inconsistencies, leakage, or emerging risks. - Develop and maintain dashboards and reporting to track quality metrics and performance over time. - Process Improvement & Recommendations: - Drive recommendations to improve underwriting quality and consistency, including: - Training needs - Updates to underwriting guidelines and procedures - Enhancements to rules, tools, and systems - Partner with underwriting leadership to prioritize and implement improvements. - Cross-Functional Collaboration & Influence: - Collaborate with Morbidity Underwriting Managers, Product, and Underwriting Modernization teams to translate insights into actionable improvements. - Provide input into model evaluation, rule changes, and system enhancements impacting morbidity underwriting. - Facilitate working sessions to align stakeholders on findings, root causes, and solutions. - Subject Matter Expertise & Governance Support: - Serve as a subject matter expert in morbidity underwriting quality and best practices. - Ensure adherence to underwriting guidelines, regulatory requirements, and internal standards. - Support governance routines by providing clear, data-driven insights into underwriting performance and quality. Qualifications - 5–10+ years of experience in life/health, LTC, or IDI underwriting with strong morbidity expertise. - Deep understanding of underwriting guidelines, risk assessment, and decision frameworks. - Experience reviewing complex underwriting decisions and identifying inconsistencies or risk patterns. - Strong analytical skills with ability to synthesize data and generate actionable insights. - Experience with reporting and data visualization tools (e.g., Excel, Qlik, Tableau, Power BI, SQL). - Proven ability to influence cross-functional stakeholders without direct authority. - Strong written and verbal communication skills. Requirements - Experience in underwriting quality control, audit, or second-line review functions. - Experience supporting underwriting automation, models, or rules engines. - Experience using AI tools or willingness to research and build AI tools for efficiency of reviews. - Industry designations (FLMI, FALU, DIA, DIF LTCP). - Experience working in Agile or product-based environments. Benefits - Salary Range: $100,000-$143,000. - Overtime eligible: Exempt. - Discretionary bonus eligible: Yes. - Sales bonus eligible: No. - Annual discretionary bonus eligibility. - Participation in an incentive program.

Role Description The LTD Team Leader is a key contributor to the overall claims organization; mission, strategy and annual plan. This position will manage a team of 8-10 Claim Managers. The Team Leader ensures that their team is achieving operational goals by monitoring all aspects of inventory within their team and actively coaching their direct reports to optimize performance, champion quality, and uphold fair claim practices. What You’ll Do - Fosters a learning culture within the team focused on coaching, regular feedback, accountability, and development that energizes their employees. - Recognize and reinforce behaviors that support learning, experimentation, and incremental innovation. - Demonstrates ownership of their claim inventory through proactive management and produces consistent high-quality results. - Provide transparent communication so our teams can make informed decisions. - Empower decision-making at the right level while promoting accountability and ownership of outcomes. - Works closely with claim managers by scheduling and participating in case plan sessions and attending their team’s daily medical review sessions. - Utilize and proactively assess dashboard vs. various metrics reports to ensure consistent team and team performance. - Leverage AI-enabled tools and enterprise technologies (e.g., Co-pilot, ChatGPT, Tableau, PowerBI) to enhance decision-making, identify trends, improve claim quality, and drive operational efficiency. - Develop high performing team by providing growth opportunities, coaching and candid feedback to help others continue to learn and grow. - Champion adoption and responsible use of AI and digital tools within the team, encouraging innovation, automation opportunities, and data-driven performance management. - Works closely with LTD Director on customer, client, and organizational challenges. - Maintain Enterprise Mindset by acting in best interest of the entire company. - Manages team's claim performance according to published Quality and Compliance standards. - Ensure team alignment with established digital tools, standardized reporting, and AI supported best practices to achieve quality and compliance objectives. - Develop high-performing teams focused on continuous improvement and world-class experience by striving for excellence, not perfection, and learning from our missteps. - Partners with Director of LTD Operations and peer group to ensure contingency plans are in place to achieve outcomes when challenges arise, such as staffing shortages, new business, system implementation, etc. - Deliver excellent end-to-end customer experiences by embracing external and internal best practices, emerging technologies, and AI-enabled solutions to continuously improve claim management effectiveness and operational performance. - Partners with Account Management, Sales, and Director of Client Solutions to attend client visits/finalist presentations and responses to claim investigations/resolutions as needed. Qualifications - 5+ years of long-term disability claim management experience preferred. - Prior direct supervisor or management experience required. - Ability to work with high sense of urgency. - Bachelor degree preferred or applicable work experience. - Strong verbal and written communication skills required. - Maintain professionalism and flexibility despite conflicting demands. - Strong acumen for customer needs; solid understanding of financial principles of business. - Strong strategic and tactical skill set. - Ability to prioritize critical objectives focusing on high impact activities. - Demonstrate a mastery of Disability Claims Management, and the functional and technical knowledge and skills to perform the job. - Demonstrate the ability to meet or exceed goals. Motivates staff towards desired outcomes. - Ability to communicate clearly and succinctly with all levels of the organization. Encourage candor and openness to foster creativity and an exchange of ideas. - Effective at disseminating information for staff to successfully fulfill their duties and responsibilities. - Ability to manage complex and escalated issues with confidence and results. - Able to adapt to changing and often ambiguous circumstances. Requirements - It is recommended that all qualified candidates apply to this posting as soon as possible. - Residents of Colorado are hereby notified that the deadline to apply is two weeks from the Posting Date listed above. Benefits - We provide a full package of benefits for employees – and have unique offerings for a modern workforce, including leave programs, adoption assistance, and student loan repayment programs. - Based on feedback from our employees, we continue to refine and add benefits to our offering, so that you can flourish both inside and outside of work. Pay Transparency - Salary range: $77,200-$128,700 - Overtime eligible: Exempt - Discretionary bonus eligible: Yes - Sales bonus eligible: No - Actual base salary will be determined based on several factors but not limited to individual’s experience, skills, qualifications, and job location. - Additionally, employees are eligible for an annual discretionary bonus. - In addition to base salary, employees may also be eligible to participate in an incentive program.

Role Description The Institutional Life Sales Support Coordinator provides administrative support to the Institutional Life Sales Team. This is a part-time remote role (approximately 25 hours per week), generally supporting the team Monday through Friday during business hours. The position is responsible for: - Coordinating schedules - Arranging travel - Processing expenses - Maintaining records - Preparing meeting materials - Providing general administrative support Success in this role means helping the sales team stay organized, responsive, and efficient through accurate administrative support and timely coordination. Qualifications - 3+ years of administrative support experience - Strong organizational and administrative skills - Experience managing calendars and scheduling - Strong written and verbal communication skills - Proficiency in Microsoft Office (PowerPoint, Word, Outlook, Teams) - Ability to prioritize and complete assigned administrative tasks within established timelines Requirements - Salesforce familiarity - Experience supporting a business or sales team - Financial services or insurance industry exposure Benefits - Salary Range: $22.00 - $31.00 (Hourly Rate) - Overtime eligible: Nonexempt - Discretionary bonus eligible: Yes - Sales bonus eligible: No - Annual discretionary bonus eligibility - Participation in an incentive program Company Description At New York Life, our 180-year legacy of purpose and integrity fuels our future. As we evolve into a more technology-, data-, and AI-enabled organization, we remain grounded in the values that drive lasting impact. - Diverse business portfolio creating opportunities across industries and communities - Balance of long-standing stability and forward momentum - Inclusive team that honors tradition while embracing progress - Fortune 100 mutual company offering growth opportunities

Role Description The Absence Leave Manager will conduct investigations, determine eligibility for our customers, and provide ongoing Absence administration. This role is responsible for collaborating with customers and clients to ensure timely, accurate Absence administration and payments, if applicable. Upon approval of an Absence, the Absence Leave Manager will provide ongoing Absence management services, assist with return-to-work needs, and communicate decisions and status updates with customers and clients. This is a fast-paced role where service excellence and attention to detail are critical. The Absence Leave Manager plays a critical role in executing the New York Life Group Benefit Solutions (GBS) promise to our customers and has a direct impact on our customers in the moments that matter. The ability to make and effectively communicate decisions within tight timeframes, while integrating knowledge of medical conditions, client contracts, compliance, and acting as a steward to deliver in line with our value story are critical for success. What You'll Do - Responsible for managing a case load of Absence cases including Paid Family Medical Leave (PFML), Family Medical Leave Act (FMLA), Company Paid Leave (CPL), and Americans with Disability Act of 1990 (ADA) and providing service excellence to GBS customers. - Make determinations regarding a customer’s eligibility within compliance timeframes. - Manage an assigned desk load of leaves through capturing medical information, managing certifications, applying appropriate provisions, following legal guidelines, and leveraging expert resources. - Manage all requests within appropriate service and quality metrics and client performance guarantees as defined. - Support ongoing leave management including extensions and reviewing of additional information as needed to support updated claim decisions. - Effectively communicate with claimants, employers, and various medical professionals to gather information regarding the application for, and ongoing management of open leaves. - Initiate customer outreach to gather information and respond to all telephonic and email inquiries within customer service protocols and adhere to standard timeframes for processing mail, tasks, and outliers. - Execute all customer performance guarantees as defined. - Proactively work directly with clients and Vocational Rehabilitation Counselors when appropriate to facilitate return to work full-time or modified duty. - Execution of New York Life and Corporate Compliance, Policies and Procedures and best practices. - Ongoing development via training associated with role and business unit objectives. Qualifications - HS Diploma or GED required. Bachelor’s degree strongly preferred. - 1 year minimum of professional experience strongly preferred. - Proficiency with MS Office applications is required (Word, Outlook, Excel). - Strong critical, analytical, and investigative skills; ability to gather information, analyze facts, and draw conclusions. - Ability to work with a sense of urgency and be a self-starter with a customer-focus mindset. - Effective interpersonal, written, and verbal communication skills. - Must be technically savvy with the ability to toggle between multiple applications and/or computer monitors simultaneously. - Excellent planning, time management, and organizational skills. Ability to manage multiple and changing priorities. - Strong negotiation skills. - Ability to build and maintain effective relationships. - Experience administering FMLA and/or State Leaves is preferred. - Knowledge of legal liability, insurance coverage, and medical terminology is preferred. - Proven track record of successfully driving results in a complex matrix environment preferred. Benefits - We provide a full package of benefits for employees – and have unique offerings for a modern workforce, including leave programs, adoption assistance, and student loan repayment programs. - Based on feedback from our employees, we continue to refine and add benefits to our offering, so that you can flourish both inside and outside of work. Pay Transparency - Salary range: $37,000-$52,000 - Overtime eligible: Nonexempt - Discretionary bonus eligible: Yes - Sales bonus eligible: No - Actual base salary will be determined based on several factors but not limited to individual’s experience, skills, qualifications, and job location. - Additionally, employees are eligible for an annual discretionary bonus. - In addition to base salary, employees may also be eligible to participate in an incentive program.

Role Description The Complex Data Exchange Specialist is responsible for managing the overall process, practice, and project implementation of electronic data interfaces with New York Life clients in support of Life, Accident, Disability, Family Medical Leave products, and various service offerings, with a strong focus on National Accounts and highly complex data integrations. This role serves as both a technical and consultative resource, ensuring high-quality data exchange while educating clients on how their data powers downstream services including administration, billing, eligibility, enrollment, and reporting. - Manage multi-file data environments where multiple client files must be validated, sequenced, reconciled, and merged. - Drive inventory control of active interfaces and milestone management in partnership with internal and external stakeholders. - Demonstrate strong analytical capabilities to audit incoming files across multiple data sources, identify discrepancies or systemic errors, and implement corrective actions. - Partner closely with Implementation IT, Family Medical Leave Operations, Account Management, and external Ben Tech vendors. - Act as a leader among peers by contributing expertise, mentoring team members, and driving process improvements. What You'll Do - Integrate with TPAs and Ben Tech partners in support of eligibility, enrollment, remittance, and billing data for new and inforce business. - Serve as a consultative partner to clients and TPAs by educating them on data structure, file specifications, and the operational impact of their data. - Implement complex electronic interfaces based on established timelines while maintaining strict inventory control. - Manage multi-file integration environments, ensuring files are received, validated, and sequenced appropriately. - Review, audit, and validate test data across multiple related files and data sources. - Identify root causes of file discrepancies, mapping errors, transmission issues, or data inconsistencies. - Understand and articulate end-to-end data flow within New York Life systems. - Balance New York Life/LDEX standards with client requirements to deliver compliant solutions. - Prepare and maintain documentation confirming the method of data exchange. - Partner with Production Support and IT to ensure successful receipt, mapping, merging, and processing of data. - Articulate complex file mapping and merge logic requirements clearly to IT and technical partners. - Drive accountability with internal teams and Ben Tech partners to meet key deliverables. - Troubleshoot and diagnose issues related to electronic data exchange. - Track file status and ensure metrics are reported accurately within Salesforce. - Develop and maintain support documentation, SOPs, and training materials. - Proactively review and suggest improvements to existing procedures. - Serve as a subject matter expert for complex data exchange implementations. Qualifications - Bachelor’s Degree strongly preferred or minimum of 3 years relevant work experience required. - Prior experience working with clients, producers, TPAs, or Ben Tech partners preferred. - Strong understanding of complex data structures, file layouts, and electronic transmission methods preferred. - Demonstrated ability to analyze, audit, and interpret complex and high-volume data files. - Experience managing file dependencies, merge logic, and reconciliation across multiple data sources preferred. - Strong planning, project management, and inventory control skills. - Proficient/advanced Microsoft Excel skills required (VLOOKUP, Pivot Tables, Macros). - Proficiency in Access preferred. - Experience with mainframe TSO and JCL scripting preferred. - Excellent organizational skills with ability to manage multiple complex implementations simultaneously. - Excellent written and verbal communication skills. - Strong interpersonal and consultative skills. - Demonstrated ability to drive results and meet key milestones. - Ability to work independently while collaborating effectively across internal business partners. - Demonstrated leadership capability in a fast-paced, evolving environment. - Proven adaptability and willingness to embrace change and continuously improve processes. Pay Transparency - Salary Range: $81,000-$115,500 - Overtime eligible: Exempt - Discretionary bonus eligible: Yes - Sales bonus eligible: No Benefits - Full package of benefits for employees, including leave programs, adoption assistance, and student loan repayment programs. - Continuous refinement and addition of benefits based on employee feedback.

Role Description The LTD Claim Manager is responsible for accomplishing training requirements, learning, and applying the LTD concepts gained in classroom and on-the-job training to successfully manage an assigned LTD caseload. The Claim Manager is responsible for the development of strategic case plans informed by customer & key stakeholder interactions, leveraging Technical Coaches and Team Leaders where appropriate. As a key customer-facing role, the Claim Manager will communicate with customers, employers, and treating providers. The LTD Claim Manager will manage an assigned caseload of Long-Term Disability cases, including management of claims with longer duration and evolving medical conditions. LTD Claim Managers will partner with Team Leaders and Technical Coaches for guidance on having meaningful and transparent conversations with their customers and clinical partners to gather the information most relevant to each claim. It also requires potentially complex monthly benefit calculations, which will be reviewed for accuracy. The Claim Manager will also evaluate customer eligibility and interact with internal and external customers including, but not limited to, customers, employers, physicians, internal business matrix partners, and attorneys, etc., to gather the information to make the decision on the claim. What You'll Do - Proactively manage your block of claims by regularly talking with and knowing your customers, their level of functioning, and having a command of case facts for each claim in your block. - Develop and document Strategic Case Plans that focus on the future direction of the claim using a holistic viewpoint. - Determine customer eligibility by reviewing contractual language and medical documentation, interpret information, and make decisions based on facts presented. - Leverage claim dashboard to manage claim inventory to determine which claims to focus efforts on for maximum impact. - Have probing conversations with customers and employers regarding return-to-work opportunities and communicate with an action-oriented approach. - Work directly with clients and Vocational Rehabilitation Counselors to facilitate return to work either on a full-time or modified duty basis. - Ask focused questions of internal resources (e.g., nurse, behavioral, doctor, vocational) and external resources (customer, employer, treating provider) to question discrepancies, close gaps, and clarify inconsistencies. - Have detailed phone conversations with both customers and physicians to medically manage claims from initial medical requests to reviewing and evaluating ongoing medical information. - Execute on all client performance guarantees. - Respond to all communications within customer service protocols in a clear, concise, and timely manner. - Make fair, accurate, timely, and quality claim decisions. - Adhere to standard timeframes for processing mail, tasks, and outliers. - Support and promote all integration initiatives (including Family Medical Leave, Life Assistance Programs, Integrated Personal Health Team, Your Health First, Healthcare Connect, etc.). - Clearly articulate claim decisions both verbally and in written communications. - Understand Corporate Compliance, Policies and Procedures, and best practices. - Stay abreast of ongoing trainings associated with role and business unit objectives. Qualifications - High School Diploma or GED required, with 3 years minimum of professional experience or bachelor’s degree strongly preferred. - Experience in hospital administration, medical office management, financial services and/or business operations is a plus. - Comfortable talking with customers and having thorough phone conversations. - Excellent organizational and time management skills. - Strong critical thinker. - Must be technically savvy with the ability to toggle between multiple applications and/or computer monitors simultaneously. - Ability to focus and achieve production goals through high-quality work. - Proficiency with MS Office applications is required (Word, Outlook, Excel). - Strong written and verbal skills demonstrated in previous work experience. - Proven skills in positive and effective interaction with challenging customers. - Experience in effectively meeting/exceeding individual professional expectations and team goals. - Must have the ability to work with a sense of urgency and be a self-starter with a customer focus mindset. - Comfortable giving and receiving feedback. - Flexible to change and highly cooperative. - Demonstrated analytical and math skills. Requirements - Critical Thinking - Trust and Transparency - Bias for Action - Leads with Agility - Customer Orientation Benefits - Full package of benefits for employees, including leave programs, adoption assistance, and student loan repayment programs. - Annual discretionary bonus eligibility. - Participation in an incentive program.