400 clinical consultant jobs found

When you join the team at Unum, you become part of an organization committed to helping you thrive. Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life’s moments. And this starts with ensuring that every one of our team members enjoys opportunities to succeed both professionally and personally. To enable this, we provide:  Award-winning culture  Inclusion and diversity as a priority  Performance Based Incentive Plans Competitive benefits package that includes: Health, Vision, Dental, Short & Long-Term Disability  Generous PTO (including paid time to volunteer!)  Up to 9.5% 401(k) employer contribution  Mental health support  Career advancement opportunities  Student loan repayment options  Tuition reimbursement Flexible work environments  *All the benefits listed above are subject to the terms of their individual Plans. And that’s just...

Clinical Claim Management Accuracy ABOUT GUARDIAN Every day, Guardian gives 26 million Americans the security they deserve through our insurance and wealth management products and services. Since our founding in 1860, our long-term view has helped our customers prepare for whatever life brings whether starting a family, planning for the future or taking care of employees. Today, we’re a Fortune 250 mutual company and a leading provider of life, disability and other benefits for individuals, at the workplace and through government sponsored programs. The Guardian community of ~9000 employees and our network of over 2750 financial representatives is committed to serving with expertise when, where and how our clients need us. Our commitments rest on a strong financial foundation, which at year-end 2017 included $8.0 billion in capital and $1.6 billion in operating income. For more information, please visit guardianlife.com or follow us on  Facebook,   LinkedIn ,  Twitter  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.   DentaQuest manages dental and vision benefits for more than 33 million Americans. Our outcomes-based, cost-effective solutions are designed for Medicaid and CHIP, Medicare Advantage, small and large businesses, and individuals. With a focus on prevention and value, we aim to make quality care accessible to improve the oral health of all....

AffirmedRx is on a mission to improve health care outcomes by bringing clarity, integrity, and trust to pharmacy benefit management. We are committed to making pharmacy benefits easy to understand, straightforward to access and always in the best interest of employers and the lives they impact. We accomplish this by bringing total clarity to business practices, leading with clinical approaches, and utilizing state-of-the-art technology. Join us in improving health care outcomes for all!  We promise to do what’s right, always. Position Summary: The Clinical Client Partner serves as a pharmacy subject-matter expert who supports the Client Success team by providing clinical insights, strategic recommendations, and formulary expertise for assigned client portfolios. While this role is not the primary relationship owner, it partners closely with Client Success Partners (CSPs), who lead the client relationship, to strengthen the clinical depth and value of client engagements....

At OneAmerica Financial, our purpose is to create more certainty for our customers that leads to better moments, every day. Our commitment is to advance stability and growth in every solution and relationship.  We deliver financial strength that builds for generations, and we are always aspiring, looking ahead, and collaborating to achieve more, together.  Come be a part of this journey with us as we champion lives! The Vocational Rehabilitation Consultant is responsible for the overall success of OneAmerica’s objectives by providing timely and accurate support to our client companies and the Claims department. This individual assesses employability, promotes restoration of function, and facilitates return to work. The Vocational Rehabilitation Consultant initiates and facilitates case management and other ancillary services to assure optimum outcomes. KEY RESPONSIBILITIES: Consistently adheres to the documented workflow guidelines and established procedures. Provides...

The Role: Willis Towers Watson is looking for an energetic individual with growth, pharmacy, clinical, and client-facing expertise to join our growing team. As an Associate Manager, Pharmacy Consulting, you will be at the forefront of managing pharmacy benefits projects for large, complex clients and leverage your experience as a pharmacy benefits expert to make recommendations on plan design and management. You will participate in new business activities and the creation of new intellectual capital. You will position yourself to grow into a consultant role by serving as the pivotal point on all projects and working alongside industry experts on cutting-edge solutions. The ideal candidate is a patient-centric problem solver who possesses the ability to balance client clinical needs and business growth. You will collaborate with a strong team of highly experienced consultants within the practice as well as engage in cross-functional activities.   Responsibilities: Provide...

For more than 170 years, The Hanover has been committed to delivering on our promises and being there when it matters the most. We live our values every day, demonstrating we  CARE  through our values,  Sustainability  initiatives and  inclusive corporate culture .   Our Medical Claims team is currently seeking a Sr. Medical Claims Consultant to join out growing team. This is a Full Time / Exempt role.     POSITION OVERVIEW: Provides claims adjusters and attorneys with detailed analysis of medical records and other pertinent medical information significant to allegations in liability claims. As a Senior Medical Claims Consultant, this professional assumes a leadership and SME role on the team, and has a skill level to evaluate a variety of medical issues in claims from various lines of business.   Responsibilities/Essential Functions: Reviews, analyzes, and summarizes medical records and other pertinent documents Researches current...

For more than 170 years, The Hanover has been committed to delivering on our promises and being there when it matters the most. We live our values every day, demonstrating we  CARE  through our values,  Sustainability  initiatives and  inclusive corporate culture .   Our Medical Claims team is currently seeking a Sr. Medical Claims Consultant to join out growing team. This is a Full Time / Exempt role.     POSITION OVERVIEW: Provides claims adjusters and attorneys with detailed analysis of medical records and other pertinent medical information significant to allegations in liability claims. As a Senior Medical Claims Consultant, this professional assumes a leadership and SME role on the team, and has a skill level to evaluate a variety of medical issues in claims from various lines of business.   Responsibilities/Essential Functions: Reviews, analyzes, and summarizes medical records and other pertinent documents Researches current...

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...

The Senior Claim Consultant provides complete claim loss services for policyholders.  Investigates, evaluates, and disposes of MPL and General Liability claims with varying degrees of complexity and severity.  Essential Duties & Responsibilities Interview insureds, claimants, witnesses, and other appropriate parties to obtain information used to assess liability exposure.  Document file regarding results of investigation and negotiations.  Prepare reports to file on established diary dates and other specific reports as needed to ensure timely file documentation and plan of action. Secure records for investigation and evaluation of cases. Determine and implement negotiation strategy and negotiates settlements within authority level. Adjust reserves within level of authority and make reserve recommendations to Manager/Director for amounts over position authority level. Evaluate cases for appropriate disposition and seek authority for settlement from...

ABOUT HUB INTERNATIONAL: HUB International Limited (“HUB”) is one of the largest global insurance and employee benefits broker, providing a broad array of property, casualty, risk management, life and health, employee benefits, investment and wealth management products and services. With over 21,000 employees in 600+ offices throughout North America, HUB has grown substantially, in part due to our industry leading success in Mergers and Acquisitions. WHAT WE OFFER YOU: At HUB we believe in investing in the future of our employees.  Our entrepreneurial culture fosters an environment of open feedback and improvement that empowers our people to make the best decisions for our customers and organization.  We offer: Competitive salaries and benefits offerings Medical/dental/vision insurance and voluntary insurance options Health Savings Account funding 401k matching program Company paid Life and Short-Term Disability Plans Supplemental Life and Long-Term Disability...

For over 20 years PSG (an EPIC owned company) has been singularly focused on helping our clients navigate the complex and ever-changing challenges of drug management. Through our leading pharmacy intelligence and technologies, we save our clients billions of dollars every year with an unwavering commitment to serving as the plan’s advocate and strategic partner. Our mission is to relentlessly advocate for our clients as we partner together to develop innovative drug management solutions that deliver exceptional strategic insights, financial and clinical value. The Pharmacy Benefit Consultant - Health Plans will serve as primary and lead consultant on strategic clients’ projects with a focus on national and regional health plans. Lead and cultivate multi-level client relationships with senior executives, pharmacy department leadership and personnel, sales and product leads, clinical management and others which enable PSG to partner with clients to create, communicate and implement...

Porch Group is a leading vertical software and insurance platform and is positioned to be the best partner to help homebuyers move, maintain, and fully protect their homes. We offer differentiated products and services, with homeowners insurance at the center of this relationship. We differentiate and look to win in the massive and growing homeowners insurance opportunity by 1) providing the best services for homebuyers, 2) led by advantaged underwriting in insurance, 3) to protect the whole home. As a leader in the home services software-as-a-service (“SaaS”) space, we’ve built deep relationships with approximately 30 thousand companies that are key to the...

Would you like to take ownership in a dynamic, high-growth business that truly walks the talk? Oswald Companies seeks goal-driven professionals ready to take their career to the next level. Job Summary : We are seeking an analytical and operationally focused Pharmacy Analyst to join our pharmacy consulting team. This role supports the operational, clerical, and compliance functions of the pharmacy department to ensure smooth, efficient, and accurate workflow. This role assists with documentation, scheduling, request for proposal coordination, data entry, and communication between pharmacy benefit managers, client service teams and our pharmacy consultant and clinical pharmacist. Responsibilities include maintaining paperwork, audit documentation, processing billing and invoicing information, and supporting pharmacy leadership with reporting and administrative projects. The ideal candidate is detail‑oriented, organized, and skilled in customer service, multitasking, and...

A career at Auto-Owners is challenging and rewarding.  Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Job Description We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking motivated nursing professional to join our team. The position requires the person to: Use the case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the claimant’s health across the care continuum. Coordinate care delivery and support among claimant support systems, including providers, community-based agencies, and family. Collaborate with claims associates to provide medical expertise in the investigation, evaluation, and appropriate resolution of...

When you join the team at Unum, you become part of an organization committed to helping you thrive. Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life’s moments. And this starts with ensuring that every one of our team members enjoys opportunities to succeed both professionally and personally. To enable this, we provide:  Award-winning culture  Inclusion and diversity as a priority  Performance Based Incentive Plans Competitive benefits package that includes: Health, Vision, Dental, Short & Long-Term Disability  Generous PTO (including paid time to volunteer!)  Up to 9.5% 401(k) employer contribution  Mental health support  Career advancement opportunities  Student loan repayment options  Tuition reimbursement Flexible work environments  *All the benefits listed above are subject to the terms of their individual Plans. And that’s just...

The position is described below. If you want to apply, click the Apply button at the top or bottom of this page. You'll be required to create an account or sign in to an existing one. If you have a disability and need assistance with the application, you can request a reasonable accommodation. Send an email to Accessibility (accommodation requests only; other inquiries won't receive a response). Regular or Temporary: Regular Language Fluency:  English (Required) Work Shift: 1st Shift (United States of America) Please review the following job description: Drive sales growth and maintain strong client relationships with employee benefit brokers and consultants, stop loss carriers, and various clinical point solutions providers. Responsible for understanding client’s needs, assessing risk profiles, and recommending tailored solutions to protect their financial interests.  This is role is remote; however, it will require travel and in person meetings...

As a team member in Finance at Nationwide, a Fortune 100 company with nearly $70 billion in annual sales, the opportunities are endless! Let Nationwide help create your career journey! 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. Key Responsibilities: Develop and maintain quantitative analytics using advanced statistical, quantitative, or econometric techniques to enhance portfolio risk management and optimize portfolio construction Assist in implementation and delivery of analytics to different areas of risk and investments Perform advanced quantitative analyses and model development, proactively identify emerging risks, and develop tools & applications to enhance the investment and risk management process Research the best industry practice in risk management and portfolio management, develop insightful risk...

As a team member in Finance at Nationwide, a Fortune 100 company with nearly $70 billion in annual sales, the opportunities are endless! Let Nationwide help create your career journey! 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 does not qualify for employer sponsored work authorization. Nationwide does not participate in the STEM OPT extension program.   This position can be staffed remotely for potential applicants with critical industry skills and relevant experience. Internal Compensation Grade: G4 #LI-KD1 Position Overview As a Middle Market Actuary at Nationwide, you will play a key role in driving pricing strategy and profitability for our commercial lines products. This position supports actuarial initiatives across middle market segments, a critical area within our P&C business. In this role,...

As a team member in Finance at Nationwide, a Fortune 100 company with nearly $70 billion in annual sales, the opportunities are endless! Let Nationwide help create your career journey! 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. The Investments Finance team plays a critical role in supporting Nationwide’s Investment organization by providing financial planning support for the company's growing portfolio of assets. This role partners closely with investment leaders, finance partners, and a wide variety of key stakeholders to ensure accurate expense management and effective budgeting and forecasting reporting. This Consultant role supports all expense planning processes for the general accounts of Nationwide’s Investment department as well as Nationwide Asset Management (NWAM) clients, helping ensure financial discipline,...