272 manager medical case management jobs found

If you’re passionate about helping people protect what matters most to them at a Fortune 100 company with nearly $70 billion in annual sales, as well as innovating and simplifying processes and operations to provide the best customer value, then Nationwide’s Property and Casualty team could be the place for you! At Nationwide®, “on your side” goes beyond just words. Our customers and partners are at the center of everything we do and we’re looking for associates who are passionate about delivering extraordinary care. Demonstrates deep subject matter expertise in environmental liability, with a strong focus on legacy policies, traditional environmental claims, and mass toxic tort exposures. Possesses a comprehensive understanding of historical policy language, long-tail liability trends, and complex allocation methodologies. Skilled in evaluating and managing high-severity, multi-party environmental losses, including contamination, pollution, and latent injury claims. Proven...

Position Title Product Modernization Manager Sr Location New York, NY 10018 Job Summary The Senior Manager, Product Modernization leads the modernization of Flagstar's consumer deposit product offers platform, setting the strategic direction, operating model, and governance standards for the systems and processes that create, configure, and deliver deposit product offers to customers. This role is accountable for ensuring Flagstar's product offers infrastructure is modern, scalable, and capable of supporting the acquisition and retention strategies the business requires, while building and leading the team responsible for delivery. The Senior Manager drives enterprise alignment across Technology, Finance, Compliance, and Marketing, translating modernization strategy into governed, high-quality execution across all customer-facing channels. Job Responsibilities: JOB RESPONSIBILITIES Product Offers Platform Modernization Define and own the multi-year product...

This is an opportunity to join Ascot - one of the World's preeminent specialty risk underwriting organizations. Designed as a modern-era company operating through an ecosystem of interconnected global operating platforms, we’re bound by a common mission and purpose. Our greatest strength is a talented team who flourishes in a collaborative, inclusive, and entrepreneurial culture, steeped in underwriting excellence, integrity, and a passion to find a better way, The Ascot Way. The Ascot Way guides our people and our organization. Our underwriting platforms collaborate to find creative ways to deploy our capital in a true cross-product and cross-platform approach. These platforms work as one, deploying our capital creatively through our Client Centric, Risk Centric and Technology Centric strategies Built to be resilient, Ascot offers clients leading financial security while delivering bespoke products and world class service — both pre- and post-claims. Ascot exists to solve our...

Position Title BSA/AML Modeling Analyst Location New York, NY 10018 Job Summary The BSA/AML & Sanctions Data & Modeling Support Analyst serves as the operational engine behind the BSA/AML Data, Systems & Models team. This is a hands-on delivery role for a data professional who is fluent in Python and SQL, comfortable managing complex ETL pipelines, and is the team's go-to resource for data quality, model monitoring, and Actimize UAT execution. Owns the day-to-day data infrastructure that keeps models running, dashboards current, and offshore work coordinated and on-track. Plays a critical enabling role in OCC MRA remediation efforts, Actimize go-live support, and the scaling of the team's GenAI and automation initiatives. Responsible to write code, own pipelines, and produce the data outputs that power everything above you. Job Responsibilities: JOB RESPONSIBILITIES Data Quality & Pipeline Engineering Own BSA/AML data quality remediation:...

The Utilization Review Case Manager gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay while supporting the goals of the Case Management department and of CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identifies the necessity of the review process and communicates issues of concern to the appropriate claims staff/customer Collects data and analyzes information to make decisions regarding certification or denial of treatment Documents all work in the appropriate manner Promotes utilization review services with stakeholders Additional duties as assigned   KNOWLEDGE & SKILLS:  Must have thorough knowledge of both CPT and ICD coding Ability to interface with claims staff, attorneys, physicians and their representatives, as well as advisors/clients and coworkers...

Company Argo Group Argo Group is an underwriter of specialty insurance products in the property and casualty market. Argo offers a full line of products and services designed to meet the unique coverage and claims-handling needs of businesses. The Argo entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc. Job Description Business Title(s):   Senior Environmental Claims Adjuster Employment Type:  Full-Time  FLSA Status : Exempt  Location:  Field   Summary:   We are looking for a highly capable Senior Environmental Claims Adjuster to join our team and work from our office in New York City.  We can also consider candidates in our Albany, Chicago, Houston, Los Angeles, Omaha, or Richmond (VA) offices. Alternatively, we can fill this role fully remote except in the states of AK, DE, HI, KY, MI, MS, MT, ND, SD, or VT. This individual will report to a manager who works in New York City and is focused on adjudicating first and third party commercial...

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...

Position Title Private Bank Deposit Product Manager Sr - Treasury Management Location New York, NY 10018 Job Summary A Treasury Management-Product Manager Sr is responsible for the research, design, development, and delivery of new value-added products to augment and enhance product lines, improve competitive position, and increase revenues while ensuring compliance with industry regulations and rules. Employs an end-to-end view of payment products across the enterprise, first taking measure of the bank’s current capabilities and then layering over these products the lens of the customer. Stays informed on evolving technologies and markets to ensure the bank is consistently on the forefront of next generation products and services, and employs that knowledge in developing and delivering products that will ensure market leadership. Collaborates with a cross functional team of professionals to ensure integration with sales, marketing, operations, technology, and customer...

Is the opportunity to join a culture where “We Do the Right Thing,” and “We Courageously Shape Our Future Together” important to you? If so, Guardian is seeking a motivated individual to join our team as a Senior Colleague Relations Specialist. This is an individual contributor who serves as a trusted advisor to People Leaders, Talent & Culture partners, and business stakeholders on complex colleague relations matters. This role leads high-impact casework, conducts sensitive and objective investigations, provides guidance on performance and conduct matters, interprets policy and employment-related requirements, and helps mitigate organizational risk while supporting a fair and respectful colleague experience. Operating with significant autonomy, this position also identifies trends, recommends proactive solutions, and helps strengthen colleague relations practices, manager capability, and organizational effectiveness. You will Serve as a trusted advisor to People...

Job Responsibilities and Requirements KEY RESPONSIBILITIES *other duties as assigned* The Claims Examiner I obtains and analyzes data for thorough, fair, objective, and timely processing of New York State statutory Short-Term Disability and Paid Family leave claims.   The goal of the position/role is to consistently pay the accurate amount for each claim in accordance with the current laws/regulations. Research Develop an understanding and working knowledge of disability and paid family leave Develop an understanding of the applicable claim definitions and relevant provisions, clauses, exclusions, riders and waivers for the necessary requirements. Develop an operating knowledge of the applicable claims system(s). Develop basic claims skills and an understanding of claim practices and procedures. Utilizes most efficient means to obtain claim information. Analysis and Adjudication Fully investigates all relevant claim issues with oversight by Manager when...

If you're passionate about being part of a diverse organization that enables a Fortune 100 company with nearly $70 billion in annual sales to deliver innovative business solutions with excellence, then Nationwide's Legal 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. *No Billable Hours. *Personal and Commercial Auto, Premises Liability, Products Liability, Property Damage, Trucking Defense, Wrongful Death, NY Labor Law, Toxic Tort. *This is a hybrid work opportunity in the Greater NYC and Tri-State Region. Nationwide Trial Division has offices in Elmsford, NY and Garden City, NY. #LI-TN1 Job Description Summary Would you thrive in an environment where you can deliver top-quality legal services to support the mission of a Fortune 100 insurance company’ to protect...

If you're passionate about being part of a diverse organization that enables a Fortune 100 company with nearly $70 billion in annual sales to deliver innovative business solutions with excellence, then Nationwide's Legal 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. *No Billable Hours. *Personal and Commercial Auto, P ersonal Injury, Bodily Injury, Wrongful Death, Premises Liability, General Liability, NY Labor Law, etc. *This is a hybrid work opportunity in the Greater NYC and Tri-State Region. Nationwide Trial Division has offices in Elmsford, NY and Garden City, NY. #LI-TN1 Job Description Summary Would you thrive in an environment where you can deliver top-quality legal services to support the mission of a Fortune 100 insurance company’ to protect people, businesses and futures...

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 role. 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 jurisdictional...

If you're passionate about being part of a diverse organization that enables a Fortune 100 company with nearly $70 billion in annual sales to deliver innovative business solutions with excellence, then Nationwide's Legal 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 is a fully remote Work-From-Home position and may be located in various upstate New York locations to allow the selected candidate to cover all the counties in Upstate New York. The preferred candidate will have 8+ years trial ( personal lines and commercial lines) insurance defense litigation (automobile) experience. No billable hours. #LI-REMOTE Job Description Summary Would you thrive in an environment where you can deliver top-quality legal services to support the mission of a Fortune 100 insurance company’...

The WC Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives Workers’ Compensation claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim Coordinates early...

Company Argo Group Argo Group is an underwriter of specialty insurance products in the property and casualty market. Argo offers a full line of products and services designed to meet the unique coverage and claims-handling needs of businesses. The Argo entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc. Job Description Business Title(s):  Senior Commercial General Liability Property Damage Claims Adjuster  Employment Type:  Full-Time  FLSA Status:  Exempt  Location:  In-Office    Summary:    We are looking for a highly capable Senior General Property Damages Claims Adjuster to join our team and work from our New York City office. This individual will report to the Director of General Property Damages Claims Manager who works in the New York office.  This role adjudicates moderately complex commercial general liability property damages claims and provides superb results for our clients.     This is a 100% in-office...

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 Princeton, NJ, Latham, NY, or Nashua, NH 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...

Company Argo Group Argo Group is an underwriter of specialty insurance products in the property and casualty market. Argo offers a full line of products and services designed to meet the unique coverage and claims-handling needs of businesses. The Argo entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc. Job Description Business Title(s):   Senior Commercial General Liability Property Damage Claims Adjuster   Employment Type:   Full-Time   FLSA Status:   Exempt   Location:   In-Office     S ummary:    We are looking for a highly capable Senior General Property Damages Claims Adjuster to join our team and work from our New York City office. This individual will report to the Director of General Property Damages Claims Manager who works in the New York office.  This role   adjudicates   moderately complex commercial general liability property damages claims and provides superb results...

The Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim Coordinates early return-to-work efforts with the...

CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in the Northern NJ and NYC, NY area. Work from home, and on the road. Monday – Friday, regular business hours.   As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and their families.  Your responsibilities include working closely with injured workers to facilitate their recovery. You will work collaboratively with the patient, their family, medical providers, members of our team, and others.  This is a heavy local travel role responsible for working with a caseload of workers compensation injured workers within a defined jurisdiction.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provides in-person and telephonic Medical Case Management to individuals, involving the patient, physician, other health care providers, the employer, and the referral source Utilizes their medical and nursing...