CVP, GBS Appeals Director

 Job Requisition ID: 91896 

Location Designation: Fully Remote 

Group Benefit Solutions delivers comprehensive insurance and absence management solutions for mid-sized and large companies. Our work fosters a healthier, happier, and more secure workforce, contributing to New York Life’s legacy of being there when we’re needed most. Here, you'll design, implement, and support these solutions directly impacting employees’ lives. At our core, we provide financial security and peace of mind to people through our absence, accident, disability, voluntary benefits, and life insurance solutions. Click here to learn more about Group Benefits solutions.

 

 

 

 

Role Overview:

 

This role is responsible for leading the strategic direction, oversight, and day to day performances of GBS Appeal Teams. This role will manage a team of Appeals Managers and is accountable for ensuring fair, timely, and compliant resolution of appealed claims across all GBS product lines. The Appeals Lead also plays a key role in driving operational and service excellence, regulatory compliance, and continuous improvement initiatives within the appeals process.

 

What You’ll Do:

 

• Set strategic priorities for the Appeals function aligned with company goals and evolving regulations.
• Lead a team of Appeals Managers responsible for appeal reviews that are fair, thorough, expeditious and in compliance with all laws, state and federal regulatory requirements, as well as internal policies and procedures.
• Drive performance metrics and continuous improvement across teams using data, insights, trends and outcomes.
• Serve as the final escalation point for complex and sensitive claim matters.
• Partner effectively with key business partners to maintain a consistent and compliant appeals process, to deliver service excellence to customers, manage expense and drive for increased quality of claim decisions across GBS.
• Provide regular updates to executive leadership on appeal trends, impact of Continuous Improvement, regulatory risks and/or litigation exposure.
• Foster a high-performance culture focused on employee development, customer experience, and operational efficiency.
• Support the growth and development of your management team, enabling them to do the same for their teams.

 

What you'll bring:

 

• Bachelor’s degree required.
• 10+ years of experience in disability claims, with 3–5+ years in a leadership role overseeing appeals or similar functions preferred.
• Strong understanding of ERISA, DOL regulations, and disability, life and accident claim adjudication best practices.
• Demonstrated ability to lead leaders and manage high-performing teams.
• Demonstrated ability to work in a high-pressure and time-sensitive environment.
• Demonstrated ability to effectively manage issues involving ambiguity.
• Strong analytical, decision-making, and communication skills required.
• Demonstrated ability to utilize continuous improvement concepts, tools and approaches in appeal process.

 

Critical Competencies:

 

• Customer Focus
• Strategic Mindset
• Develops Talent
• Drives Results
• Manages Ambiguity
• Ensures Accountability

 

It is recommended that all qualified candidates apply to this posting as soon as possible.  Residents of Colorado are hereby notified that the deadline to apply is two weeks from the Posting Date listed above.
 

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Pay Transparency

Salary range: $110,000-$190,000 

Overtime eligible: Exempt 

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