Senior Manager, STD Claims

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.

Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.  

Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work.  Our team members and leaders are expected to foster connection and teamwork by being present in the office at least 2 days per week.

The opportunity:  

Senior Managers provide leadership, guidance and direction to a team of Case Specialists adjudicating Short Term Disability claims. The position is responsible for the service, risk, financial performance, leadership and development of a team of Case Specialists.   This role is accountable for Client experience and strong claims management practices which require aligning work practices, performance, and initiatives to reflect the organization’s strategic priorities. 

How you will contribute:  

• Responsible for the leadership and development of a high performing team
• Oversee and direct the work of a team of 10 – 12 Case Specialists including regular reviews & assessment of team performance against Service and Performance Guarantees.
• Is actively involved in the team’s work, setting objectives, creating plans, assigning work, addressing team performance issues.
• Develop, implement, and evaluate claim practices to deliver best in class service and processes. Ensure uniformity and consistency with all claim practices and procedures.
• Ensure compliance with all relevant laws, regulations, and company policies
• Analyze claims data and trends to identify areas for improvement
• Communicate verbally and in writing with clients, vendors, and internal resources including senior management, in response to inquiries including claimant or case specific statuses, escalated calls or departmental process and performance measures.
• Collaborate with peers and partner teams to deliver on department expectations in support of sales objectives and client service goals.
• Participate and/or lead continuous improvement initiatives or special projects aligned to our KPIs.
• Interprets contracts and ensures consistent, fair claims practices and adherence to appropriate laws, regulations, and procedures.
• Reviews and signs off on claim payments within established limits and/or reviews recommendations made by medical resources to determine proper disposition of claims.
• Protect and maintain personal health information with a high level of confidentiality abiding by Sun Life procedures and by HIPPA rules and regulations.
• Contribute to fraud detection and prevention efforts
• Other duties and responsibilities as assigned.

What you will bring with you:  

• A minimum of five years management experience of an Absence or STD Claims team
• Proven success in developing, building and fostering high performance teams
• Strong Disability and Absence Management knowledge with demonstrated expertise in Federal/State FMLA, short-term disability, statutory disability plans, or ADA.  
• Strong leadership skills with an ability to engage employees to deliver top performance related to service, risk and quality
• Able to set direction, monitor performance and initiate and communicate changes in direction as needed.
• Able to build agreement on actions by resolving conflicts in an open and positive manner.
• Demonstrated ability to influence others to achieve results.
• Ability to work professionally and effectively with a diverse group of people.
• Strong organizational skills, including the ability to prioritize work and multi-task.
• Strong research, analytical, critical thinking, problem solving skills and decision-making skills.
• Strong computer skills, proficient in PC environment and MS Word, Excel, and email systems.
• Attention to detail with documentation, reporting and communication.
• Ability and desire to work in a fast-paced, service-oriented environment.
• Excellent verbal and written communication skills, with the ability to be both pleasant and professional.
• Ability to initiate and prioritize regular work duties and projects.
• BA/BS in a related field of business is highly preferred.
• Field or industry specific designations are a plus.

Not ready to apply yet but want to stay in touch?   Join our talent community to stay connected until the time is right for you! 

We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive.  We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate.  We encourage applications from qualified individuals from all backgrounds.

Life is brighter when you work at Sun Life

At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program.  Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account.  Enjoy a flexible, inclusive and collaborative work environment that supports career growth.  We’re proud to be recognized in our communities as a top employer.  Proudly Great Place to Work® Certified in Canada and the U.S., we’ve also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row.  Visit our website to learn more about our benefits and recognition within our communities.

We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email [email protected] to request an accommodation.

For applicants residing in California, please read our employee California Privacy Policy and Notice.

We do not require or administer lie detector tests as a condition of employment or continued employment.

Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.