94 director of pharmacy services jobs found

Overview AmTrust Financial Services, a fast growing commercial insurance company, has a need for a Telephonic Medical Case Manager, RN.   PRIMARY PURPOSE:  To provide comprehensive quality telephonic case management to proactively drive a medically appropriate return to work through engagement with the injured employee, provider and employer.  Our nurses will be empathetic informative medical resources for our injured employees and they will partner with our adjusters to develop a personalized holistic approach for each claim.  These responsibilities may include utilization review, pharmacy oversight and care coordination.    This position is remote in Pennsylvania ! Responsibilities Uses clinical/nursing skills to determine whether all aspects of a patient’s care, at every level, are medically necessary and appropriately delivered. Perform Utilization Review activities prospectively, concurrently or...

As a   Health and Benefits Director, you will be a leader on the client service team and will be responsible for fostering relationships cross the client organization. You will be responsible for managing a wide array of projects, leveraging your experience to make recommendations on plan design and management for the full array of health and benefits programs. You will have the opportunity to generate business by participating in new business activities and expanding existing client engagements.  You will have the opportunity to position yourself to grow into a senior relationship management and/or leadership role by serving as the pivotal point of contact on all projects and working alongside industry experts on cutting edge solutions. The Role Lead the design/management of group medical, dental, wellbeing, disability and time off plans for clients. Responsibilities include: Serving as lead project manager for clients; materially contributing to project plan creation and...

As a   Health and Benefits Director, you will be a leader on the client service team and will be responsible for fostering relationships cross the client organization. You will be responsible for managing a wide array of projects, leveraging your experience to make recommendations on plan design and management for the full array of health and benefits programs. You will have the opportunity to generate business by participating in new business activities and expanding existing client engagements.  You will have the opportunity to position yourself to grow into a senior relationship management and/or leadership role by serving as the pivotal point of contact on all projects and working alongside industry experts on cutting edge solutions. The Role Lead the design/management of group medical, dental, wellbeing, disability and time off plans for clients. Responsibilities include: Serving as lead project manager for clients; materially contributing to project plan creation and...

As a   Health and Benefits Director, you will be a leader on the client service team and will be responsible for fostering relationships cross the client organization. You will be responsible for managing a wide array of projects, leveraging your experience to make recommendations on plan design and management for the full array of health and benefits programs. You will have the opportunity to generate business by participating in new business activities and expanding existing client engagements.  You will have the opportunity to position yourself to grow into a senior relationship management and/or leadership role by serving as the pivotal point of contact on all projects and working alongside industry experts on cutting edge solutions. The Role Lead the design/management of group medical, dental, wellbeing, disability and time off plans for clients. Responsibilities include: Serving as lead project manager for clients; materially contributing to project plan creation and...

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide. Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.   Job Description: Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work in the contiguous states plus AK. The opportunity: We are seeking a Senior Manager, Claims Services to lead a high-performing team supporting Stop Loss & Health Claims Services....

Job Description Sompo has a unique opportunity for a VP, Audit Director, to join our North America Internal Audit team. The VP, Audit Director is the assurance leader responsible for the oversight, execution, and continuous evolution of Internal Audit coverage across the North America Insurance business, aligned with Sompo International’s global Internal Audit strategy, standards, and methodology. This role plays a critical leadership position within the Internal Audit function, with accountability for risk assessment, audit planning, execution quality, stakeholder engagement, and Audit Committee reporting across U.S.-based insurance operations. The Audit Director partners closely with business leadership, risk and compliance functions, and global Internal Audit peers to deliver risk-based, forward-looking assurance over governance, risk management, and internal controls. This role is instrumental in ensuring Internal Audit remains independent, value-added,...

Overview AmTrust Financial Services, a fast growing commercial insurance company, has a need for a Telephonic Medical Case Manager, RN.   PRIMARY PURPOSE:  To provide comprehensive quality telephonic case management to proactively drive a medically appropriate return to work through engagement with the injured employee, provider and employer.  Our nurses will be empathetic informative medical resources for our injured employees and they will partner with our adjusters to develop a personalized holistic approach for each claim.  These responsibilities may include utilization review, pharmacy oversight and care coordination.   This position is hybrid out of Irvine, CA, Scottsdale, AZ or Salt Lake City, UT.  Responsibilities Uses clinical/nursing skills to determine whether all aspects of a patient’s care, at every level, are medically necessary and appropriately delivered. Perform Utilization Review activities...

Overview AmTrust Financial Services, a fast growing commercial insurance company, has a need for a Telephonic Medical Case Manager, RN.   PRIMARY PURPOSE: To provide comprehensive quality telephonic case management to proactively drive a medically appropriate return to work through engagement with the injured employee, provider and employer.  Our nurses will be empathetic informative medical resources for our injured employees and they will partner with our adjusters to develop a personalized holistic approach for each claim.  These responsibilities may include utilization review, pharmacy oversight and care coordination.    This position will be hybrid out of our Dallas, TX or Overland Park, KS office. Responsibilities Uses clinical/nursing skills to determine whether all aspects of a patient’s care, at every level, are medically necessary and appropriately delivered. Perform Utilization Review activities...

The CERIS Implementation Director is responsible for providing strategic leadership and oversight for the implementation of new and existing client programs, product enhancements, and service expansions. This role ensures the successful execution of complex implementations while aligning implementation strategy with organizational objectives, operational readiness, and long‑term client success. The CERIS Implementation Director works closely with executive leadership, Account Management, Implementation Managers and Coordinators, IT, Operations, Product, and Sales to ensure consistent, high‑quality delivery and a seamless transition to ongoing account management and field operations. This role is also accountable for leading and developing the Implementation team and continuously improving implementation processes across the organization. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provides overall leadership and accountability for the...

Overview AmTrust Financial Services, a fast growing commercial insurance company, has a need for a Telephonic Medical Case Manager, RN.   PRIMARY PURPOSE: To provide comprehensive quality telephonic case management to proactively drive a medically appropriate return to work through engagement with the injured employee, provider and employer.  Our nurses will be empathetic informative medical resources for our injured employees and they will partner with our adjusters to develop a personalized holistic approach for each claim.  These responsibilities may include utilization review, pharmacy oversight and care coordination.    This position will be hybrid out of Maitland, FL or Boca Raton, FL office.  Responsibilities Uses clinical/nursing skills to determine whether all aspects of a patient’s care, at every level, are medically necessary and appropriately delivered. Perform Utilization Review activities prospectively,...

Overview AmTrust Financial Services, a fast growing commercial insurance company, has a need for a Telephonic Medical Case Manager, RN.   PRIMARY PURPOSE:  To provide comprehensive quality telephonic case management to proactively drive a medically appropriate return to work through engagement with the injured employee, provider and employer.  Our nurses will be empathetic informative medical resources for our injured employees and they will partner with our adjusters to develop a personalized holistic approach for each claim.  These responsibilities may include utilization review, pharmacy oversight and care coordination.   This position is hybrid out of Irvine, CA, Scottsdale, AZ or Salt Lake City, UT.  Responsibilities Uses clinical/nursing skills to determine whether all aspects of a patient’s care, at every level, are medically necessary and appropriately delivered. Perform Utilization Review activities...

Overview AmTrust Financial Services, a  fast growing  commercial insurance company, has a need for a Complex Care Case Manager, RN for Workers Compensation managed care team.     PRIMARY PURPOSE :   The  complex care case manager will provide comprehensive and quality telephonic case management for our injured employees with complex diagnoses and often catastrophic injuries. Our nurses will  be responsible for  proactively applying clinical  expertise  ensuring our injured employees receive medically  appropriate healthcare  to achieve a safe return to work or best  optimal  level of function through engagement with the injured employee,  provider  and employer. Our nurses will be empathetic informative medical resources for our injured employees, and they will partner with our adjusters to develop a personalized  holistic approach  for each claim.  These responsibilities may include  utilization  review, pharmacy oversight...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance RN Utilization Review As a nurse at Sedgwick, you can build a meaningful and rewarding career while advocating for patients in a nontraditional clinical setting. Apply your RN clinical knowledge and experience to assist in the management of complex medical conditions, treatment planning and recovery from illness or injury. Work in the best of both worlds - a rewarding career making an impact on the health and well-being of others in a remote work...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Pharmacy RN As a nurse at Sedgwick, you can build a meaningful and rewarding career while advocating for patients in a nontraditional clinical setting. Apply your medical/clinical or rehabilitation knowledge and experience to assist in the management of complex medical conditions, treatment planning and recovery from illness or injury.  Work in the best of both worlds - a rewarding career making an impact on the health and lives of others, and a remote work...

Job Description Are you looking for your next opportunity? Sompo has a unique opportunity for a Sr Claims Specialist to join our Casualty Construction Claims team. This position primarily focuses on the execution of claim handling responsibilities for a complex primary and excess casualty portfolio with specific emphasis on Construction Defect, Job Site Bodily Injury, OCIP/CCIP and/or New York Labor Law matters. We seek a claims professional with strong construction casualty and excess insurance claims experience. The candidate must possess technical claims knowledge, legal insight, accuracy, responsiveness and display a high degree of customer service. The ability to manage a pending of significant exposure cases while providing insight and analysis on claim exposures to management and our underwriting partners is also required for success in this role. Location: This position will be based out of any of our US Sompo Offices . We strive for collaboration...

The Workers’ Compensation Claims Supervisor is responsible for supervising a team of direct reports, ensuring all quality, productivity and customer service criteria are met while adhering to company policies and procedures. The WC Claims Supervisor position is integral to the success of the company and requires regular and consistent attendance, supporting the goals of the claims department and CorVel. This is a remote work arrangement. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Supervises WC claims staff in their day-to-day operations Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring proficiency in procedures and job functions Ensures staff compliance with Workers’ Compensation laws and mandated regulatory reporting requirements Ensures optimal team performance through ongoing training, coaching, and regular performance evaluations; recommends merit-based actions (subject to managerial approval) Provides technical and...

*Please Note: This is remote position but based out of Tampa, FL * The Senior Employee Benefits Analyst serves as a lead analytical resource for public sector clients, responsible for delivering advanced financial analysis, strategic reporting, and data‑driven insights across complex employee benefit programs. Building upon foundational analyst responsibilities, this role provides deeper evaluation of renewal and proposal data, identifies trends and risks, and develops actionable recommendations that support long‑term benefits strategy and cost management. Working under the direction of the Senior Manager, the Senior Analyst manages a portfolio of clients with complex benefit structures, including group medical, dental, vision, pharmacy, life, and disability programs. This individual plays a key role in leading renewal analyses, RFP processes, and carrier evaluations, while partnering closely with Senior Benefit Consultants, Client Services, and external vendors. In...

As a Health and Benefits Manager, you will be a key member of the client service team, engaging directly with clients and establishing relationships across all levels of the client organization. You will substantially contribute to the management of projects, leveraging your experience as a benefits expert to make recommendations on plan design and management for the full array of health and benefits programs. You will have the opportunity to position yourself to grow into a senior relationship management and/or leadership role by serving as a pivotal point of contact on projects and working alongside industry experts on cutting edge solutions. The Role: Play a lead role in the design and management of group medical, dental, wellbeing, life, disability and absence management benefits for clients. Responsibilities include:  Materially contributing to and/or leading project management; monitoring progress against established objectives, budgets, timelines, deliverables and...

As one of the leading writers of Federal Crop Insurance, AgriSompo North America combines industry experience, resources, capital and talent to deliver both traditional and innovative crop insurance and productivity tools to farmers, ranchers, insurers and agribusinesses in the United States. Our organization operates within a culture rooted in ethics, integrity and a belief that accountability, collaboration and agility are crucial to long-term success.  AgriSompo North America is a part of AgriSompo, Sompo International’s global agriculture platform. This platform is an integrated underwriting, technology and distribution platform delivering innovate insurance and reinsurance solutions to agriculture partners worldwide.  Sompo International, AgriSompo’s parent company, is a global organization driven by its core values, a carrier that holds promise, trust and the commitment to protect.  Through operating subsidiaries, Sompo International writes agriculture, casualty and...

The Care Advocate Nurse oversees initiatives surrounding assessing the severity of the injured workers’ reported injury(ies), reviews medical data in CareMC, validates and secures medical information, assesses and evaluates prescribed treatment of work related injury. The Care Advocate Nurse functions as a nurse consultant, supporting the goals of the Claims Management department and of CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Initiates and receives telephonic contact with reported injured worker, employer and medical providers to obtain treatment plan, secures medical documentation, and assesses if injured worker has returned to work Responsible for detailed documentation within the claim system focusing on medical condition, treatment plan and return to work status Directs callers to appropriate medical and/or claim resources Identifies and communicates urgent situations related to treatment or patient condition directly to the...