Summary:- Responsible for the management and development of a highly technical and analytical SIU staff in the development of new capabilities and finding business solutions through the use of technology and analytical techniques.
- Provide leadership in the development of logistic regression modeling and analytics that aids in the identification of insurance fraud.
- Plans at an operational level and manages the effective use of resources. Directs assigned applications systems analysis staff to develop, implement and/or maintain a medium system or multiple smaller systems and/or assigned project(s).
Primary Duties:- Directly manages a staff of 8-10 direct reports.
- Demonstrates sound analytical and diagnostic skills in the movement of very large data sets that must be further manipulated to support a hypothesis. Once decisions are made, is able to follow the management plan and direct action to implement intended results.
- Creates an atmosphere where business partner's issues are seeking creative solutions to their business objectives. Suggests solutions that make sense and optimize the value of technical and analytical resources.
- Analyzes results to determine how Investigative Services can expand our ability to impact business partners results.
- Possesses the ability to break down a problem down to manageable pieces and implements effective, timely solutions. Takes input from several sources, decides if all the information needed is available and moves to a decision.
- Knowledge of project management skills and the ability to set priorities that optimizes resources while meeting timelines.
- Demonstrates an ability to set direction, generate a sense of purpose, and inspire others to work in an optimum manner to achieve desired outcomes.
- Builds relationships with peers to achieve objectives. Builds relationships with other departments to work as one team. Builds relationships to secure necessary resources not under his/her personal control. Works effectively with all levels. Balances team and individual responsibilities.
- Responsible for identifying, recruiting, interviewing, hiring, orientation, deployment and re-deployment of a diverse staff to maximize efficiency and performance.
- Provides constructive feedback; coaches and manages performance of staff; takes disciplinary action when necessary.
- Researches/analyzes industry trends and best practices across the country and applies this knowledge to achieve or maximize results.
- Markets Investigative Services to business partners within and outside of Claim.
- Responsible for the ongoing evaluation of the units operation, its performance and effectiveness.
- Develops a portion of an overall divisional budget, subject to review, and is responsible for cost-effective expense control for assigned units.
Qualifications, Requisite Skills, and Competencies- Work Experience Background: Advanced knowledge of analytical methodologies, investigative techniques, insurance and claim operations (e.g., Commercial, Personal, Workers' Compensation insurance products or litigation management). Experience in managing and developing of a highly technical staff required. Medical fraud experience strongly desired.
- Educational Background: Minimum 4-year college degree required. Prefer college degree with additional law enforcement, insurance claim or research focused experience.
- Investigative and Analytical Skills: Logical and sequential thinker; evaluates alternative courses of action; ability to assess situations and make reliable decisions with limited information. Ability to identify relationships between facts and circumstances, objectively evaluate the pros, cons, and implications of various courses of action.
- Technical Skills: Highly proficient in SAS statistical analysis. Computer, database, and Internet proficient. Ability to self-teach new and emerging work-related technological advances. Knowledge of available resources (internal and external) to assist in investigations. Displays initiative and innovation to find what is needed.
- Influencing Skills: Ability to present arguments logically and tactfully when influencing a course of action to gain support. Ability to present a variety of options, and anticipate and plan for objections. Ability to work for mutually acceptable solutions that benefit all parties involved.
- Flexibility, Organizational and Time Management Skills: Ability to remain open minded and change opinions on the basis of new information. Make transitions easily from task to task; change focus quickly as demands change. Adept at developing and maintaining a written diary or record keeping system to manage individual projects and achieve results.
- Communication Skills: Ability to read and interpret complex information and explain it to others; listen actively; stay focused; identify hidden messages and draw out underlying issues. Adept presentation skills that tail the communications to situations and audiences. Ability to communicate simple to complex written information clearly and concisely in formal and informal documents to convey the right message.
- Familiarity with fair claim practices, tort law and legal terminology.
Performance Measured By- Quality, Logic and Thoroughness of Analysis
- Timeliness of Analysis
- Customer Service
- Workload Management
- Communication Skills
To apply: http://www.datashaping.com/jobs18321x.shtml
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