4 nurse medical case manager jobs found

Behavioral Health Case Mgr - CT08IE We’re determined to make a difference and are proud to be an insurance company that goes well beyond coverages and policies. Working here means having every opportunity to achieve your goals – and to help others accomplish theirs, too. Join our team as we help shape the future.              Monitors the medical treatment to ensure quality, effective, and cost-efficient care. Conducts comprehensive evaluations of disability claimants' functionality via functional assessments. Independently reviews and interprets clinical information and utilizes established clinical guidelines and protocols .Drives the crisis support initiative for the disability organization by assessing crisis situations and initiating the threat protocol process when deemed clinically appropriate. Advises on highly complex claims at multidisciplinary clinical review roundtables to ensure optimal outcomes. Determines when claims contain quality of care issues...

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...

Overview The Director of Pharmacy is responsible for supporting the AVP of Medical Cost Containment in the implementation, process improvement, and optimization of clinical programs. The Director of Pharmacy will be responsible for analytic measurement and improvement of medical management of their assigned programs. These programs may include pharmacy and other associated operational processes and interventions. This role will achieve outcomes by focusing on analytics, clinical operations, and development of new programs to support organizational vision, and cost savings. Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of the AmTrust organization. Responsibilities Serve as a business owner for medical product management needs specific to pharmacy program and establishing key performance indicators, identifying opportunities, and driving business goals Manage a team of 8...

Overview AmTrust Financial Services, a fast-growing commercial insurance company, has an opportunity for a Claim Assistant I within our Managed Care organization where your talent and abilities contribute to our competitive edge. The Managed Care Claims Assistant I will perform a variety of support services to our Worker’s Compensation Managed Care department as described below, with oversight from Clerical Supervisor. The Managed Care Claims Assistant I maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of the AmTrust and Claims organization.  Responsibilities Processes treatment requests, referrals, and other activities as needed for Managed Care department following established methods to ensure compliance and privacy.   Reviewing records with high attention to detail regarding documentation and accuracy to determine eligibility of requests.  Generates letters from system...