Sr Mgr, Incident Management

Oversees case management activities across teams or regions to ensure compliance with rules and regulations. Plans strategies to address process inefficiencies in case management. Develops and implements long-term strategies to improve case research and investigation. Forecasts incident resolution needs and oversees processes for incident resolution. Designs data collection and documentation processes to identify trends and ensure quality and regulatory standards are being met. Updates communication processes and coaches teams or regions to provide exceptional customer service and ensure information provided is accurate and timely. Identifies operational problems and advocates for solutions to improve incident processing and satisfaction metrics. Develops and implements procedures to reflect enterprise level operational changes and ensure effective change management. Evaluates data and trends across teams or regions to conduct root cause analysis and identify operational solutions.

• Creates and advocates for developmental opportunities for others; builds collaborative, cross-functional relationships. Solicits and acts on performance feedback; works with leaders and employees to set goals and provide open feedback and coaching to drive performance improvement. Pursues professional growth; hires, trains, and develops talent for growth opportunities; strategically evaluates talent for succession planning; sets performance management guidelines and expectations across teams / units. Oversees implementation, adapts, and stays up to date with organizational change, challenges, feedback, best practices, processes, and industry trends; shares best practices within and across teams. Fosters open dialogue amongst team members, engages, motivates, and promotes collaboration within and across teams; motivates teams to meet business objectives. Delegates tasks and decisions as appropriate; provides appropriate support, guidance and scope; encourages development and consideration of options in decision making; fosters access to stakeholders.


• Manages designated units or teams by translating business plans into tactical action items; oversees the completion of work assignments and identifies opportunities for improvement; ensures all policies and procedures are followed; partners with key stakeholders and business leaders to ensure products and/or services meet requirements and expectations while aligning with departmental strategies. Aligns team efforts; builds accountability for and measuring progress in achieving results; assumes responsibility for decision making; fosters direct reports to resolve escalated issues as appropriate. Communicates goals and objectives; incorporates resources, costs, and forecasts into team and unit plans; ensures matrixed resources are fulfilling service or performance requirements across reporting lines. Removes obstacles that impact performance; identifies and addresses improvement opportunities; guides performance and develops contingency plans accordingly; influences teams and units to operate in alignment with operational and business objectives.


• Oversees member, customer, or employee incident case management by: developing long-term strategic initiatives for incidence case management using data and trends from the case tracking database across multiple teams or regions; planning and implementing objectives and strategies for addressing process inefficiencies in case management, such as case volumes that are too high or low, across multiple teams or regions, as well as processing highly complex or high risk cases and managing highly complex teams across all lines of business; and maintaining compliance of case management activities with internal and external rules and regulations across multiple teams or regions.


• Promotes member or employee incident case research by: developing and implementing long-term strategies to improve incident case research activities across multiple teams and regions.


• Determines strategies for the resolution of member or employee incident cases by: forecasting incident resolution needs and priorities to inform strategic planning across all lines of business; and overseeing processes for incident resolution across multiple teams or regions to ensure effectiveness and compliance with internal and external rules.


• Encourages customer service by: overseeing multiple teams or regions to ensure information provided to members, customers, employees, or other stakeholders from staff related to concerns/incidents is accurate and timely; and coaching and guiding team members to provide exceptional customer and member service in cases involving highly charged, sometimes emotional situations and updating communication processes for incident resolution across multiple teams or regions to ensure effectiveness and compliance with internal and external rules and regulations.


• Improves case documentation efforts by: developing data collections processes to ensure that all relevant information to address cases is being gathered and to identify trends through data analysis; and managing and designing documentation processes for multiple teams or regions to ensure that all quality and regulatory standards are being met.


• Serves as a leader for operational improvement by: integrating highly advanced knowledge of the incident management process and an understanding of organization-wide initiatives to identify operational gaps that contribute to member customer, employee, or provider dissatisfaction, avoidable incident cases, or member or customer retention issues; developing, implementing, and updating detailed procedures to reflect enterprise-level operational changes and ensure effective change management across multiple teams or regions; and evaluating data and identifying trends across multiple teams or regions to conduct root cause analysis and identify operational solutions across multiple teams or regions.