Claims Quality Audit Director jobs in Springfield, MO

Claims Quality Audit Director directs and oversees the operations of the claims quality audit department to follow the audit policies, procedures and regulation. Provides professional knowledge and guidance on technical or procedural problems. Being a Claims Quality Audit Director creates claims audit policies and procedures. May recommend changes in claims processing procedures. Additionally, Claims Quality Audit Director typically Requires a bachelor's degree. Typically reports to top management. The Claims Quality Audit Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. To be a Claims Quality Audit Director typically requires 5+ years of managerial experience. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. (Copyright 2024 Salary.com)

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Director of Claims
  • Missouri Employers Mutual
  • Springfield, MO FULL_TIME
  • Are you driven to keep people safe? That’s what we do every day at Missouri Employers Mutual.

    At MEM, we’ve created a casual, values-driven work culture that’s making a
    positive impact on the way people live and work. We offer a hybrid work model,
    with positions to accommodate the changing needs of today’s employees. Our
    team enjoys a variety of different work environments, which allows for more
    flexibility, less time spent commuting, and greater ability to address personal and
    family needs. This is a place where you can grow with confidence – because
    that’s what safety and success really mean to us.

    MEM is headquartered in Columbia, MO, and our virtual team serves our
    policyholders and partners from across the U.S.

    JOB PURPOSE
    The Director of Claims is integral in steering the strategic direction and
    operational excellence of the claims department at MEM. Responsibilities for this
    role include leading a team of claims professionals, partnering with executive
    leadership to develop and execute strategies that drive towards overall claims
    risk management and mitigation, while driving a focus to continuously improve
    return to work and claim outcomes.

    This further includes monitoring and enhancing quality assurance and technical
    training programs, in accordance with MEM strategic objectives. Leadership at
    this level will drive the team towards efficiency, effectiveness, and high-quality
    service delivery, ensuring the company's competitive edge in the workers'
    compensation insurance market.

    ESSENTIAL DUTIES AND RESPONSIBILITIES

    To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
    Leadership and Direction
    Identify and communicate the actions needed to implement the function's
    strategy and business plan within the business area or department; explain the
    relationship to the broader organization's mission, vision, and values; motivate people to commit to these tenets and do extraordinary things to achieve
    business goals.
    Policy Development and Implementation
    Oversee the development of policies and procedures to ensure consistent and
    efficient implementation of best practices.
    Resource Allocation
    Prioritize and allocate resources based on complexity and risk, so that the team
    can operate efficiently and ensure high quality service and outcomes.
    Relationship Management
    Oversee agent and policyholder relationships to ensure effective communication
    and realization of customer value. This also includes regular cross-functional
    partnerships with units across the business (e.g., SRS, CompLegal).
    Team Management
    Provide support to team members to enable effective delivery of services
    according to expected standards. Includes leading in the areas of performance
    management, coaching, and identifying development needs.
    Performance Management
    Help establish and monitor department metrics and key performance indicators
    to drive action and results. Manage and report on the performance of the
    department; set appropriate performance objectives for direct reports and
    departmental teams and hold individuals accountable for achieving them; take
    appropriate corrective action where necessary to ensure the achievement of
    team/individual objectives.
    Solutions Analysis
    Develop innovative solutions by integrating and analyzing complex and diverse
    information sources and market trends.
    Regulatory and Compliance Management
    Ensure appropriate processes and controls are in place to comply with legal and
    regulatory requirements.
    Organizational Capability Building
    Use the organization's formal development framework to identify the team's
    individual development needs. Plan and implement actions, including continuing
    professional development specified by professional or regulatory institutions, to
    build their professional capabilities. Provide informal training or coaching to
    others throughout the organization in own area of expertise to enable others to
    improve performance and fulfill personal potential.
    Budgeting
    Develop and manage an operational budget that aligns with the company
    strategy and priorities.

    QUALIFICATIONS:
    Education:
    Bachelor's Degree or Equivalent Experience

    Experience:
    10 years workers compensation claims experience
    10 years management experience

    Our home office is located in vibrant Columbia, Missouri — #6 in Livability’s 2019 Best Places to Live.
  • 8 Days Ago

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Director of Claims
  • Missouri Employers Mutual
  • Springfield, MO FULL_TIME
  • Are you driven to keep people safe? That’s what we do every day at Missouri Employers Mutual. At MEM, we’ve created a casual, values-driven work culture that’s making a positive impact on the way peop...
  • 8 Days Ago

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Accounting Clerk
  • Acorn Claims
  • Springfield, MO FULL_TIME
  • Acorn Claims is an Independent Adjusting Firm specializing in National Catastrophe and Daily Claims service across the country. With a bright vision for the future, and a team of difference-making pro...
  • 15 Days Ago

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Program Quality Director
  • Convoy of Hope
  • Springfield, MO OTHER
  • Ministry Function: The Program Quality Director supports the ministry of Convoy of Hope (COH) by directing Monitoring, Evaluation and Learning (MEL), quality assessments, improvements, and assurance, ...
  • 9 Days Ago

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Director-Quality Improvement (Exempt)
  • Mercy
  • Springfield, MO FULL_TIME
  • We're a Little Different Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service. At Mercy, we believe in careers that match the unique gifts o...
  • 15 Days Ago

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Audit Specialist
  • Jencap
  • Springfield, MO FULL_TIME
  • Why Jencap? We are one of the largest wholesale insurance intermediaries in the United States with expertise in wholesale brokerage, binding authority, and program management. The common thread woven ...
  • 13 Days Ago

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0 Claims Quality Audit Director jobs found in Springfield, MO area

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Internal Medicine Physician
  • Jordan Valley Community Health Center
  • Springfield, MO
  • Physician- Internal Medicine - Outpatient Full Time, 36 hours a week with full benefits! Salary Range for an Internist: ...
  • 4/26/2024 12:00:00 AM

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Assembler
  • Azenta Life Sciences
  • Springfield, MO
  • Job Description Job Description Company Overview Azenta Life Sciences is dedicated to enabling life science organization...
  • 4/26/2024 12:00:00 AM

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Account Service Representative
  • Wil Fischer Distributing Companies
  • Springfield, MO
  • Job Description Job Description Account Service Representative Department: Sales Location: Springfield, MO Reports to: D...
  • 4/25/2024 12:00:00 AM

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Superintendent
  • Nabholz Corporation
  • Springfield, MO
  • Summary: Project Superintendent has full responsibility for the onsite production of the project. Superintendent is resp...
  • 4/24/2024 12:00:00 AM

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Respiratory Therapist (Full-time) Monday - Friday Day shift
  • Owens & Minor
  • Springfield, MO
  • At Owens & Minor, we are a critical part of the healthcare process. As a Fortune 500 company with 50+ facilities across ...
  • 4/24/2024 12:00:00 AM

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Operations Manager - Chemistry Laboratory
  • Mérieux NutriSciences - North America
  • Springfield, MO
  • Operations Manager - Chemistry Springfield Regular MERIEUX NUTRISCIENCES As a trusted partner, our Public Health mission...
  • 4/24/2024 12:00:00 AM

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Recoupment Representative, Client Financial Services
  • Burrell Behavioral Health
  • Springfield, MO
  • Recoupment Representative, Client Financial Services page is loaded Recoupment Representative, Client Financial Services...
  • 4/24/2024 12:00:00 AM

5
Shift Supervisor - Springfield
  • 5.11 Tactical
  • Springfield, MO
  • ** Shift Supervisor - Springfield** **Job Category****:** RETAIL/MERCH **Requisition Number****:** SHIFT003567 Showing 1...
  • 4/22/2024 12:00:00 AM

Springfield is the third-largest city in the state of Missouri and the county seat of Greene County. As of the 2010 census, its population was 159,498. As of 2017, the Census Bureau estimated its population at 167,376. It is the principal city of the Springfield metropolitan area, which has a population of 462,369 and includes the counties of Christian, Dallas, Greene, Polk, Webster. Springfield's nickname is "Queen City of the Ozarks" and it is known as the "Birthplace of Route 66". It is home to three universities, Missouri State University, Drury University, and Evangel University. Springf...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Quality Audit Director jobs
$136,294 to $194,782
Springfield, Missouri area prices
were up 1.3% from a year ago

Claims Quality Audit Director in Olympia, WA
Based on our compensation data, the estimated salary potential for Claims Quality Audit Director will increase 16 % over 5 years.
December 23, 2019