Abstract
This qualitative, grounded theory case study explored the role of leaders in two different claims units, the Commercial Claims and Government Claims, within the claims department operating under the Department of Human Services (DHS) and the Center for Medicare and Medicaid Services (CMS) regulations. Specifically, the study examined the role of the claims leaders in maintaining motivation, engagement, and satisfaction of the claims unit employees and examiners. Using convenience sampling, the study gathered data from twenty participants, ten from each claims unit. This study used interviews, virtual field observations, and analysis of official and other relevant documents to collect data from the twenty participants. Two major themes emerged from data analysis: 1) the impact of leadership styles on the work environment and 2) the effect of leadership styles on workers. Goleman (2000) identified those styles as coaching, commanding, visionary, and democratic leadership. Each leadership style influenced participants' engagement and satisfaction to some degree, thus impacting their overall productivity and performance. Goffman's (1961) framework of Moral Career, Wenger's (1998) Community of Practice, and path-goal theory of leadership (Northouse, 2022) can explain how healthcare claims authorities' leadership styles positively impact the motivations of employees. The conclusions of this research support other studies that maintain that the relationship between the leader and their employees plays an essential role in overall employee satisfaction and engagement. However, further study of the qualitative and quantitative nature is recommended to explore the leadership styles that most motivate specific healthcare claims unit employees.