{"id":2553047,"url":"https://alion.io/job/fglife-com-manager-life-complex-claims","title":"Manager, Life & Complex Claims","company":{"id":2159631,"name":"FGLIFE.COM","domain":"fglife.com","url":"https://alion.io/company/fglife","size_band":null,"is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Greenhouse","truth_index":{"grade":"B","score":75,"open_postings":3,"ghost_share":0,"stale_share":1,"repost_share":0,"time_to_fill_p50_days":27,"computed_at":"2026-10-23T05:54:15Z"}},"role":"Legal","role_family":"Legal","seniority":"senior","employment_type":null,"work_mode":"hybrid","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":[],"countries":[],"hiring_countries":[],"hiring_countries_total":0,"salary":null,"salary_estimate":null,"experience_years_min":5,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"HIPAA","optional":false}],"status":"live","first_seen_at":"2026-10-07T16:47:27Z","employer_posted_date":"2026-10-07","last_verified_at":"2026-10-23T17:59:58Z","board_verified":true,"closed_at":null,"days_open":16,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":16},"description":"Job Summary\nThe Life & Complex Claims Manager provides leadership and technical oversight for a specialized team of Claim Examiners handling life insurance, contestable investigations, foreign deaths, complex legal requests, and living benefit rider claims (Critical, Chronic, and Terminal Illness).This role is responsible for ensuring rigorous investigative standards, accurate contractual interpretation, and sound risk mitigation while delivering compassionate, transparent service to beneficiaries and partners.The Manager leads the operational execution of the Complex Claims Roundtables, acts as a primary liaison with Legal and Underwriting and drives continuous process optimization to reduce cycle times and mitigate risk.\nDuties & Responsibilities\nClaim Approval & Adjudication: Provide secondary review and financial approval on life claims, contestable investigations, policy rescissions and living benefit rider claims within established authority limits.\nContestable Investigation Oversight: Direct end-to-end medical investigation during the contestability period, ensuring adherence to claim guidelines, and state-specific fair claims practices.\nLead and facilitate the weekly Complex Claims Roundtable, collaborating with Underwriting, Legal, and Compliance to evaluate high-risk or litigated files and serve as the primary point of claim escalation for complex claims, appeals, contested denials, and state insurance Department/regulatory inquiries, ensuring decisions are thoroughly reasoned and documented. Occasionally communicate directly with claimants/agents on specific claim cases and escalations.\nVendor & Partner Oversight: Manage operational workflows with specialized external partners, including Independent Medical Examination (IME) providers. Partner with Functional Capacity Evaluation (FCE) vendors, retrieval services, investigation partners, and reinsurers.\nTechnical Coaching: Actively mentor and upskill specialized examiners in advanced investigative techniques, medical record analysis, fraud indicators, contractual policy provisions, and other claim technical skills.\nPerformance Management: Establish and monitor quantitative and qualitative metrics (e.g., investigative cycle time, audit quality, aged pending) through structured 1:1s, documented development plans, and timely corrective action when needed.\nCapacity & Demand Planning: Manage workload allocation and queue segmentation across complex workflows, balancing examiner caseloads to maintain SLA compliance and prevent aged inventory.\nRegularly evaluate complex claim workflows, letters, and forms (e.g., Attending Physician Statements, Living Benefit intake forms) to eliminate operational bottlenecks, reduce cycle times, and improve customer experience. Provide oversight of comprehensive standard operating procedures (SOPs), job aids, and training documentation for life, living benefit, and complex claim adjudication. Leverage claims data and Business Intelligence dashboards to identify root causes of claim delays, quality trends, and fraud patterns, presenting actionable insights to senior leadership.\nOversee all aspects of the life and complex Claims functions, ensuring operational compliance with state and industry regulations.\nModel and maintain a strong culture of accountability and transparency at all levels of the department, taking ownership of decisions, outcomes, successes, and challenges. Oversee quality review and control processes for all claims activities. Ensure appropriate claims governance, including authority levels, escalation protocols, and proactive identification and mitigation of risk issues or events to minimize impact and recurrence.\nSupervisory Responsibilities: This role has people leadership responsibilities, including managing performance, developing talent, and supporting engagement and team effectiveness.\nKnowledge, Skills & Abilities\nCritical Thinking & Analytical Rigor: Exceptional ability to synthesize dense medical records, legal documents, trust agreements, and historical application data to make sound claim decisions.\nContractual & Regulatory Acumen: Experience with state contestability statutes, unfair claims settlement practices regulations, HIPAA standards and policy rider language.\nCommunication: Ability to communicate complex medical, technical, and legal determinations clearly, professionally, and empathetically with claimants, sales partners, legal counsel, and senior leadership.\nDecisive Leadership: Proven track record of addressing performance and behavioral gaps directly, fostering a culture of ownership, continuous learning, and high accountability.\nCross Functional Collaboration: Skilled at building strong partnerships with internal stakeholders across Underwriting, Legal, Compliance, Operations Controls, and Distribution Partners.\nStrong life and/or disability claim expertise, with in-depth knowledge of contestable and accelerated benefit claims.\nAbility to establish goals, structures, and processes that translate strategic vision into clear team objectives and measurable outcomes.\nMaintains current knowledge of life and annuity regulations, including state claims handling requirements, unclaimed property laws, and evolving compliance obligations.\nMinimum Qualifications\nBachelor's degree preferred (or equivalent professional experience)\n5+ year of relevant experience\n5+ years of progressive claims adjudication experience in Life, Disability, Contestable, and/or Living Benefit Riders Claims (Critical/Chronic Illness).\n2+ years of direct people leadership or proven technical supervisory/mentorship experience within a specialized claims environment.\nCombination of education and experience considered in lieu of degree.\nProfessional designations through LOMA (e.g., FLMI, ALMI) or the International Claim Association (ICA) (e.g., FLHC) preferred.\nExperience in Lean, Six Sigma, or continuous process improvement methodologies is preferred.\nOther Requirements\nThis position primarily involves sedentary work, requiring long periods of sitting, regular use of a computer, and occasional standing or walking, with reasonable accommodations available.\nPerform other functions, duties and projects as assigned\nRegular and punctual attendance\nAbility to travel up to: 10% of the time\nAdditional Information\nWork Environments\nF&G believes in an employee-centric flexible environment, which is why we offer the ability for in-office, hybrid and remote work arrangements. During the hiring process, you'll work with your leader to decide what works best for your role.\nF&G complies with federal and state disability laws and makes reasonable accommodations for applicants and candidates with disabilities, unless such accommodation would cause an undue hardship for F&G. If reasonable accommodation is needed to participate in the job application or interview process, please contact . \nJoin our employee-centric hybrid work environment: F&G Careers\nAbout F&G\nSince 1959, Fidelity & Guaranty Life Insurance Company (F&G) has offered annuity and life insurance products to those who are seeking security in retirement and protection during life’s unexpected events.\nAs a national Top Workplace1, an Iowa Top Workplace2 and a proud equal opportunity employer, F&G team members are empowered, collaborative, dynamic and authentic. We believe that by embracing these values, we will continue to build and strengthen the company while continuing to be a great place to work.\n1Top Workplaces USA 2022 - 2023\n2Des Moines Register Top Workplaces 2018 - 2022\nNotice for all Applicants who are California residents under the California Privacy Rights Act. 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