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Form of workDescription:
MetLife Legal Plans is currently hiring an Assistant VP, Attorney Network & Claims Management for our growing Panel Management Department.This position will report directly into our VP of Customer Experience.
A day in the life of an AVP, Attorney Network and Claims Management at MetLife Legal Plans:
The Assistant Vice President is responsible for managing and supporting multiple business processes across the MetLife Legal Plans organization to ensure operational success and meeting of strategic objectives and service level agreements. The AVP also supports and maintains network attorney and claims processing compliance by ensuring escalated complaints and data requests for audits are met and addressed in a timely manner.
Responsibilities (Essential Duties and Responsibilities):
Sales Support:
Minimum Qualifications (Knowledge, skills, and abilities required):
What Will Make You Special (Preferred knowledge, skills, and abilities):
Characteristics of our Director of Panel Operations (Competencies):
This position will be a hybrid position, with roughly two days in the Cleveland, OH office and three days remote.
A day in the life of an AVP, Attorney Network and Claims Management at MetLife Legal Plans:
The Assistant Vice President is responsible for managing and supporting multiple business processes across the MetLife Legal Plans organization to ensure operational success and meeting of strategic objectives and service level agreements. The AVP also supports and maintains network attorney and claims processing compliance by ensuring escalated complaints and data requests for audits are met and addressed in a timely manner.
Responsibilities (Essential Duties and Responsibilities):
Sales Support:
- Support Sales department in completing RFP (request for proposal) responses, plan comparisons, and competitor comparisons.
- Participate in finalist meetings, customer facing sales calls/presentations as requested by the sales/marketing organization.
- Partner with our Sales and Legal departments in creating new coverages and/or updating coverage definitions and establish alignment of these changes throughout the organization.
- Partner with Finance and Legal departments in establishing network and out of network attorney fees for new coverage offerings.
- Approve special fee requests at firm level during recruitment to our network.
- Support coverage reviews including coverage determinations and coverage appeals.
- Manage Attorney Network communication.
- Manage annual review of network attorney fees to determine if adjustments need to be made to existing fee schedules.
- Manage attorney panel including recruiting, training, supervising, evaluating and re-credentialing and communicating with PLFs and visiting PLF offices as appropriate
- Maintain and update fee schedules.
- Maintain and update Participating Law Firm manual on a regular basis.
- Support and manage E-panel offering.
- Responsible for reviewing and approving extra fee requests for services provided by network attorneys.
- Review and approve coverage issues including coverage determinations and coverage appeals
- Review attorney billings, timesheets and extra fee requests and reimbursements to insure proper payment on legal matters
- Review fee reimbursement matters to insure proper payment to clients
- Work with Accounting to review billings and all types of attorney billings
- Manage the cost of legal services by reviewing attorney billings, fees, trends in billing, extra fee requests, changes in regulations and laws that affect fees and network levels to identify and respond to issues and make certain that we are paying the right amount to balance all of our interests
- Provide final approval for claim payments, the largest expense in the MetLife Legal Plans organization, sent to panel attorneys.
- Manage attorney panel including recruiting, evaluating, and re-credentialing to including malpractice checks.
- Manage recruiting of network attorneys including: reviewing and approving all attorney applications
- Manage the attorney audit system including assisting accounting with audit standards and cases, determining PLF status related to audit issues and managing training related audit issues
- Support and manage responses for member complaints relating to coverage, claims processing and network attorneys.
- Support and respond to any litigation which may arise from items directly related to position's management responsibilities.
- Support company litigation by researching legal issues and/or coaching members of the organization in their responses.
- Support and manage audit activity and responses related to the panel and claims departments.
- Obtain and maintain adjustor licenses as deemed necessary for role responsibilities.
- Manage, coach, train, supervise and develop direct reports.
- Manage departmental staffing levels, paid time off, performance reviews and compensation
- Support budget planning by ensuring staffing and capacity models are kept up to date and reflects work responsibilities across the Attorney Network and Claims Management teams.
- Participate in user acceptance testing for any changes in process/technology for the Panel Management and Claims departments.
- Support training of new team members in the Panel Management and Claims departments.
- Serve as a resource and provide training for other departments on coverage and Attorney Network issues
- Manage the client inquiry system including: review and resolution of difficult inquiries; review allegations of attorney misconduct or poor service; review of attorney status; and categorization of inquiries
- Support Strategic Planning efforts and deliver on the organization's objectives and key results.
- Support organization with achieving Service Level Agreements and NPS goals.
- Manage SLA report out requests for Sponsors
- Assist Legal, Panel, and Claims organization with other items as required.
- Ensure that all employees are adhering to and modeling after company Success Principles.
- Bachelor's degree from an accredited university
- J.D. from an accredited law school
- Must be licensed in good standing in the State of Ohio or have the ability to sit for the State of Ohio bar
- Possess a minimum of 8 years of experience as a practicing attorney
- Strong leadership skills and ability to work with internal and external partners at all levels
- Strong time management skills and an ability to prioritize tasks
- Ability to motivate a team to work together to achieve and support organizational goals
- Ability to manage team and support the individual goals and objectives of team members
- Detail-oriented and well-organized, with the ability to handle a high-volume workload
- Self-motivated with the ability to take initiative
- Ability to communicate effectively, both verbally and in writing
- Ability to analyze and manage client service issues
- Ability to handle confidential and sensitive situations and documents
- Experience in all aspects of the general practice of law and litigation matters
- Strong business acumen
- Prior experience managing a team
- Prior client relationship management experience
- Knowledge of the industry, business and product
- Strong interpersonal skills
- Strong mediation/conflict resolution skills
- Ability to coach, mentor and train team members
- Ability to think outside the box to resolve issues
- Customer/client-focused
- Detail-oriented
- Communication proficiency
- Business acumen
- Ability to thrive in both a team atmosphere and an independent work environment
- Problem-solving/analytical skills
- Demonstrated leadership skills
- Ability to meet deadlines and deliver results
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