Mgr, Review Services

Salary Range: $85,000 - $198,000

Job Posting End Date: January 28, 2025

We’ve Got You Under Our Wing

We are the duck. We develop and empower our people, cultivate relationships, give back to our community, and celebrate every success along the way. We do it all…The Aflac Way.

Aflac, a Fortune 500 company, is an industry leader in voluntary insurance products that pay cash directly to policyholders and one of America's best-known brands. Aflac has been recognized as Fortune’s 50 Best Workplaces for Diversity and as one of World’s Most Ethical Companies by Ethisphere.com.

Our business is about being there for people in need. So, ask yourself, are you the duck? If so, there’s a home, and a flourishing career for you at Aflac. 

Work Designation – Depending on your location within the continental US, this role may be hybrid or remote.

• If you live within 50 miles of the Aflac offices located in Columbus, GA or Columbia, SC, this role will be hybrid. This means you will be expected to work in the office for at least 60% of the work week. You will work from your home (within the continental US) for the remaining portion of the work week. Details of this schedule will be discussed with your leadership. 
• If you live more than 50 miles from the Aflac offices located in Columbus, GA or Columbia, SC, this role will be remote. This means you will be expected to work from your home, within the continental US. If the role is remote, there may be occasions that you are requested to come to the office based on business need. Any requests to come to the office would be communicated with you in advance.

What does it take to be successful at Aflac?

• Acting as a Champion for Change
• Acting with Integrity
• Communicating Effectively
• Demonstrating Initiative
• Developing Talent
• Managing Performance
• Pursuing Self-Development
• Serving Customers
• Supporting Change
• Supporting Organizational Goals
• Working with Diverse Populations

What does it take to be successful in this role?

• Extensive clinical, vocational, behavioral health and/or ADA experience/knowledge

• Strong investigative and analytical skills

• Strong customer service skills

• Strong written and oral communication skills

• Strong organizational and time management skills

• Ability to analyze documentation in the context of functional capacity/abilities

• Kean instincts on how to work in a team environment.

• Pass applicable certification and licensing continuing education and maintain active license and/or certification, as required

Education & Experience Required

• Bachelor's Degree In nursing, healthcare or a related field.
• Certification - Active and Unrestricted Licensure/Certification in one or more of the following: Professional Registered Nurse, Certified Rehabilitation Counselor (CRC), ADA/HR Certification, Licensed Clinical Social Worker (LCSW), Licensed Mental Health Counselor, Licensed Professional Counselor.
• 3 years of hands-on relevant expertise in: Vocational Rehabilitation, Clinical, ADA and/or Behavioral Health.
• 4 years of supervisory, managerial, and/or leadership experience.
• 4 years of disability and absence relevant industry experience.

Or an equivalent combination of education and experience

Education & Experience Preferred

• Master's Degree In business, rehab counseling, behavioral health or related field, e.g., MSW, MA or MS in counseling.
• CDMS, CCM, CCRN, CCM, ADA certifications

Travel

Less than or equal to 10%

Principal Duties & Responsibilities

• Acts as a first level specialist resource for customer complaints and/or escalates issues to upper leadership; oversees the day-to-day operations within the team including monitoring of reviewer tasking volume, urgency and timeliness; accountable for team accuracy (e.g. quality of rationales and capturing dynamic indicators, productivity and value, impact points); assists in issue resolution and troubleshooting within the team; regularly monitors and evaluates activities to identify potential risks and issues of non- compliance; participates or may lead risk assessment for area of responsibility and escalates potential issues to higher management.

• Manages relationships for customers and/or area of responsibility; may function as a leader in addressing appeals unit processes and protocols; anticipates, recognizes, and responds timely to needs of customers to ensure customer satisfaction.

• Provides detailed procedural advice to internal clients to ensure that internal standards and or procedures are adhered to related to referrals and necessary co-management; develops business with existing customers by recognizing and initiating resource opportunities.

• Assist leadership with developing policies, procedures and best practices.

• Independently collates and analyzes production report data using pre-determined tools, methods and formats and makes recommendations in order to support the department’s effectiveness; communicates effectively with staff, case managers, employers, employees, operations manager, and treating providers.

• Supports implementation of new accounts and account initiatives to drive outcomes; reviews assigned customer cases, prioritizes workload, and interprets established policies, applying discretion in order to resolve customer issues; provide status updates on co-management volumes to ensure caseloads are within best practice limits; resolves workflow or addresses technical problems by generating policies, procedures, and referring to IT specifications to ensure accuracy and operational consistency.

• Assists in completion of team audits on a regular basis; provides feedback to staff to assist in completion of 90-day reviews of new hires, and mid-year and end-of-year performance reviews of team; provides mentoring, guidance and support for team members, including new team member training and staff development.

• Educates team members and business partners on areas of specialized expertise needed to manage disability and absence claims, and ADA cases; presents training designed to educate staff as requested.

• Collects data and prepares service reports, including commentary and analysis to facilitate decision-making; analyzes data sing tools, methods, and formats and makes recommendations to support the department’s timely claim reviews.

• Fosters cross-functional interdependent relationships to achieve business results; identifies opportunities and risks associated with changes in the external environment, looking forward for the current year; implements changes to and maintains procedures and policies; ensures that appropriate documentation, implementation, and communication of established policy, procedures and operating standards is completed for area of responsibility; sets and executes operational objectives and plans; contributes to planning and budgeting

• Models behaviors that demonstrate commitment to corporate values; completes the performance management cycle with staff, including providing coaching and feedback for improved performance; builds positive team environment; ensures all staff have and are implementing personal development plans; performs time keeping/PTO management for the team.

• Manages own personal development and encourages others to do the same which includes promoting a healthy, balanced and positive work environment.

• Upon managements request, and depending on account requirements, will visit clients for new travel to visit clients for new account implementation and maintenance of existing accounts.

• Performs other duties as required.

Total Rewards

This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions including, but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. The range has been created in good faith based on information known to Aflac at the time of the posting.  Compensation decisions are dependent on the circumstances of each case. This salary range does not include any potential incentive pay or benefits, however, such information will be provided separately when appropriate. The salary range for this position is $85,000 to $198,000.

In addition to the base salary, we offer an array of benefits to meet your needs including medical, dental, and vision coverage, prescription drug coverage, health care flexible spending, dependent care flexible spending, Aflac supplemental policies (Accident, Cancer, Critical Illness and Hospital Indemnity offered at no costs to employee), 401(k) plans, annual bonuses, and an opportunity to purchase company stock.  On an annual basis, you’ll also be offered 11 paid holidays, up to 20 days PTO to be used for any reason, and, if eligible, state mandated sick leave (Washington employees accrue 1 hour sick leave for every 40 hours worked) and other leaves of absence, if eligible, when needed to support your physical, financial, and emotional well-being. Aflac complies with all applicable leave laws, including, but not limited to sick and safe leave, and adoption and parental leave, in all states and localities.