2762 medical case manager 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...

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...

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...

FCCI is guided by our core values of Loyalty, Integrity, Vision, Excellence and Service. These are the principles and behaviors that guide how we support and trust one another, build our teams, cultivate leaders and create a company that feels like family. If these are your values, we’d like you to join our team. We are seeking a licensed Registered Nurse to provide telephonic case management on assigned workers’ compensation claims. The selected new hire will provide coordination and evaluation of medical care to assigned caseload for the purpose of expediting claims handling. He/she will assist with oversight of necessary cost-effective quality medical treatment and work collaboratively with the adjuster for resolution of injury and/or return to work. In addition, this person will develop an initial plan outlining the action the case manager will take to ensure timely resolution of injury(s) through utilization of established guidelines to determine appropriate medical...

Overview AmTrust Financial Services, a fast-growing commercial insurance company, has an opportunity for a Manager, RN Branch Manager of Telephonic Case Management for Workers Compensation where your clinical talent and leadership abilities contribute to our competitive edge.    PRIMARY PURPOSE: The RN Branch Manager for telephonic case management services will oversee operations as well as a team of experienced worker’s compensation nurse case managers. The ideal candidate will have a minimum of three (3) or more years’ experience overseeing a nursing claims management program as well as in-depth understanding of worker’s compensation injury claims and utilization management review programs. The Manager will lead the nurse case management team to strategize with claim professionals in management of medical and disability exposure, delivering quality telephonic case management to proactively drive best in class outcomes including appropriate medical...

Overview AmTrust Financial Services, a fast-growing commercial insurance company, has an opportunity for a Manager, RN Branch Manager of Telephonic Case Management for Workers Compensation where  your clinical talent and leadership abilities contribute to our competitive edge.  T his is an office-based position in our Salt Lake City, UT office.   PRIMARY PURPOSE: The RN Branch Manager for telephonic case management services will oversee operations as well as a team of experienced worker’s compensation nurse case managers. The ideal candidate will have a minimum of three (3) or more years’ experience overseeing a nursing claims management program as well as in-depth understanding of worker’s compensation injury claims and utilization management review programs. The Manager will lead the nurse case management team to strategize with claim professionals in management of medical and disability exposure, delivering quality telephonic case management...

Overview AmTrust Financial Services, a fast-growing commercial insurance company, has an opportunity for a Manager, RN Branch Manager of Telephonic Case Management for Workers Compensation where  your clinical talent and leadership abilities contribute to our competitive edge.  T his is an office-based position in our Salt Lake City, UT office.   PRIMARY PURPOSE: The RN Branch Manager for telephonic case management services will oversee operations as well as a team of experienced worker’s compensation nurse case managers. The ideal candidate will have a minimum of three (3) or more years’ experience overseeing a nursing claims management program as well as in-depth understanding of worker’s compensation injury claims and utilization management review programs. The Manager will lead the nurse case management team to strategize with claim professionals in management of medical and disability exposure, delivering quality telephonic case management...

Who Are We? Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Job Category Claim Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees...

Medical Stop Loss Underwriting Practice Lead – Accident & Health Who we are: American International Group, Inc. (AIG) is a leading global insurance organization. Building on 100 years of experience, today AIG member companies provide a wide range of property casualty insurance, life insurance, retirement solutions, and other financial services to customers in more than 80 countries and jurisdictions. These diverse offerings include products and services that help businesses and individuals protect their assets, manage risks and provide for retirement security. Get to know the business: AIG underwriting teams help to find insurance solutions in areas including Financial Lines, Property, Casualty, Specialty Lines, Cyber, Multinational Clients, and High Net Worth individuals. We are reimagining how we help customers to manage risk, transforming our operating model, and reshaping our role responsibilities and career pathways. The goal is to unlock the full potential...

The next part of your journey is right around the corner — with The Standard. A genuine desire to make a difference in the lives of others is the foundation for everything we do. With a customer-first mindset and an intentional focus on building strong teams, we’ve been able to uphold our legacy of financial stability while investing in new, innovative technologies that support the needs of our customers. Our high-performance culture focused on operational excellence thrives thanks to remarkable people united by compassion and a customer-first commitment. Are you ready to make a difference? **To be considered for this role you will need to live in the Midwest (Kentucky, Indiana, Ohio, Michigan) area.   Job Summary  As a Regional Client Manager on the Employee Benefits team, you will provide exceptional support and customer service to your assigned caseload (Employer Groups of 100 to 499 lives), through daily guidance and education of their benefit...

Crum & Forster Company Overview Crum & Forster (C&F) provides market leading property & casualty, accident & health, specialty and standard commercial lines insurance solutions. A true underwriting company, we have a 200-year history of helping our customers manage risk with laser-focused expertise, integrity and discipline. Our people are empowered to make decisions and problem-solve with you smartly and swiftly. Our annual gross written premium is 6.2 billion. C&F enjoys a financial strength rating of "A+" (Superior) by AM Best.   Our most valuable asset is our people. We have 3000 employees, and locations throughout the United States and India. With our employee-first focus, the Company is consistently recognized as a great place to work, earning multiple workplace and wellness awards, including the Great Place to Work® Award, Fortune 100 Best Companies to Work For, Fortune Best Workplaces for Parents, Fortune Best...

If you’re passionate about being part of a dynamic organization that enables a Fortune 100 company with nearly $70 billion in annual sales to drive innovation and adopt new technologies that deliver business results, then Nationwide’s Technology team could be the place for you! At Nationwide®, “on your side” goes beyond just words. Our customers are at the center of everything we do and we’re looking for associates who are passionate about delivering extraordinary care. This role will work a hybrid schedule coming into the Columbus, Ohio office 2 days per week on Wednesdays & Thursdays. Supports program governance and PMO operations within Nationwide Financial Technology's Annuity Modernization Program, a strategic transformation initiative focused on modernizing the technology platforms and capabilities that support Nationwide's annuity business. This role plays a critical part in enabling effective program execution through meeting coordination, action tracking,...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. We are proud to support active-duty military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with applicable policy and business needs. The Opportunity As a dedicated Manager, Claims Operations , you will manage and be accountable for auto and other claims operations member service employees who are responsible for serving our members, and providing appropriate solutions as they investigate, evaluate and negotiate the claim. Develops engaged employees through regular...

If you’re passionate about being part of a dynamic organization that enables a Fortune 100 company with nearly $70 billion in annual sales to drive innovation and adopt new technologies that deliver business results, then Nationwide’s Technology team could be the place for you! At Nationwide®, “on your side” goes beyond just words. Our customers are at the center of everything we do and we’re looking for associates who are passionate about delivering extraordinary care. This role will work a hybrid schedule coming into the Columbus, Ohio, Des Moines, Iowa, or Scottsdale, Arizona office 2 days (Mondays & Wednesdays) per week. Remote internal associates may also be considered. The Cyber Security Operations Center’s Innovation and Integration (CSOC-INI) team transforms emerging ideas into secure, production-ready capabilities that advance cyber defense. Across agentic solutions, modern application engineering, platform foundations, and security data engineering, we...

If you’re passionate about being part of a dynamic organization that enables a Fortune 100 company with nearly $70 billion in annual sales to drive innovation and adopt new technologies that deliver business results, then Nationwide’s Technology team could be the place for you! At Nationwide®, “on your side” goes beyond just words. Our customers are at the center of everything we do and we’re looking for associates who are passionate about delivering extraordinary care. This role will work a hybrid schedule coming into the Columbus, Ohio, Des Moines, Iowa, or Scottsdale, Arizona office 2 days (Mondays & Wednesdays) per week. Remote internal associates may also be considered. The Cyber Security Operations Center’s Innovation and Integration (CSOC-INI) team transforms emerging ideas into secure, production-ready capabilities that advance cyber defense. Across agentic solutions, modern application engineering, platform foundations, and security data engineering, we...

SUMMARY:     Claim Representative II:  This is the intermediate level of the claim handler career path. Handles moderate difficult claims. Exercises progressively more discretion in the determination of compensability of claims. Considers many factors in the determination claim reserves. Negotiates and settles claims within given authority.  RESPONSIBILITIES/TASKS: Claim Representative Ii: Verifies workers’ compensation coverage of employers and injured employees.  Determines compensability under workers’ compensation by thorough investigation of the claim. Determines causal relationship between the reported injury and the incident to ensure appropriate payment of benefits. Facilitate return to work for the injured employee. Establishes timely and appropriate reserves based on the profile of the claim within given authority based on anticipated financial exposure. Documents specifics of claims with potential for subrogation recovery,...

Company: NICO National Indemnity Company Want to work for a company with unparalleled financial strength and stability that offers “large company” benefits with an exciting, friendly, and “small company” atmosphere?  Our companies, as members of the Berkshire Hathaway group of Insurance Companies, provides opportunities for professionals interested in just that.   A Brief Overview   Investigate, evaluate, provide defense if appropriate, negotiate and resolve assigned property damage and bodily injury claims reported under affiliated Companies' insurance contracts, in accordance with those contracts and applicable law, within documented authority. What will you do? CLAIM INVESTIGATION: Investigate assigned claims reported under insurance contracts provided by affiliated Companies, including identification of information and documents needed to evaluate claims, assignment and direction of independent adjusters and review of public and other records and documents....

Company: NICO National Indemnity Company Want to work for a company with unparalleled financial strength and stability that offers “large company” benefits with an exciting, friendly, and “small company” atmosphere?  Our companies, as members of the Berkshire Hathaway group of Insurance Companies, provides opportunities for professionals interested in just that.   A Brief Overview   Investigate, evaluate, provide defense if appropriate, negotiate and resolve assigned property damage and bodily injury claims reported under affiliated Companies' insurance contracts, in accordance with those contracts and applicable law, within documented authority. What will you do? CLAIM INVESTIGATION: Investigate assigned claims reported under insurance contracts provided by affiliated Companies, including identification of information and documents needed to evaluate claims, assignment and direction of independent adjusters and review of public and other records and documents....