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Public Employees Claims Manager

The Public Employees Claims Manager oversees the administration and resolution of claims filed by public employees, ensuring compliance with applicable laws, policies, and procedures. This role involves managing claims processes, investigating disputes, and coordinating with a variety of assorted personnel in an attempt to achieve impartial and timely outcomes. The Claims Manager plays a critical role in safeguarding the interests of public employees while maintaining the integrity of the claims system. This classification requires strong leadership, analytical skills, and a thorough understanding of claims management and public sector regulations.

Class Code:

PPE10C

Job Grade:

SPC09

Special Job Requirements:

Typical Functions:

Manage the claims process, including intake, investigation, adjudication, and resolution. Ensure compliance with state and federal laws governing public employee claims. Develop and implement policies and procedures for efficient claims handling. Investigate complex claims and disputes, providing recommendations for resolution. Collaborate with legal teams, insurance providers, and a variety of assorted personnel as needed. Maintain accurate records and prepare reports on claims activities and outcomes. Provide training and guidance to personnel on claims management practices. Monitor trends and identify areas for improvement in claims processes. Represent the department in hearings, mediations, and public forums.

Knowledge, Abilities, and Skills:

Strong analytical and problem-solving skills. Excellent communication and interpersonal abilities. Leadership and team management expertise. Familiarity with claims management software and tools. Ability to navigate legal and regulatory frameworks.

Minimum Qualifications:

Bachelor’s degree in business administration, public administration, or a related field. Minimum of 12 years of experience in claims management, insurance, or a related field. Demonstrated leadership and supervisory experience. Knowledge of public sector regulations and policies related to employee claims. Proven ability to handle complex claims and disputes effectively.

Required Certificates:

N/A OTHER JOB RELATED EDUCATION AND/OR EXPERIENCE MAY BE SUBSTITUTED FOR ALL OR PART OF THESE BASIC REQUIREMENTS, EXCEPT FOR CERTIFICATION OR LICENSURE REQUIREMENTS, UPON APPROVAL OF THE QUALIFICATIONS REVIEW COMMITTEE.

Exempt:

E
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