2 rn jobs found

Overview AmTrust Financial Services is seeking a Director, Medical Case Management for the Western Zone. This senior leader will oversee approximately 40 clinical professionals, including four direct-report managers, and drive proactive, data-driven workers’ compensation medical case management performance, clinical quality, operational consistency, and claim outcomes in a fast-paced, high-change environment. Responsibilities Reporting to the Head of Managed Care and Clinical, the Director, Medical Case Management will lead Western Zone workers’ compensation medical case management operations to improve claim outcomes, return-to-work results, medical management impact, quality, compliance, and team performance. This role requires a proactive leader who combines strong clinical judgment with analytical discipline, using data, dashboards, trends, and performance insights to anticipate issues, identify opportunities, drive action,...

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...