2 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. 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 retrospectively in accordance with the appropriate...

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 position. 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...