18 medical case manager ii jobs found

We’re excited you’re considering joining a great place to work!  Texas Mutual is deeply committed to creating and maintaining an environment of mutual respect and is proud to be an equal opportunity employer. All qualified applicants are encouraged to apply and will receive consideration for employment without regard to age, race, color, national origin, religion, sex, gender identity, sexual orientation, genetic information, veteran status, or any other basis protected by local, state, or federal law. About this Position At Texas Mutual, we are proud to create a stronger, safer Texas. That means helping injured workers return to a productive life, empowering businesses to excel, and giving back to our communities. Our Catastrophic Claims team contributes to our mission by managing complex and severe injury claims, coordinating medical care, long-term recovery plans, and administering benefits to ensure our injured workers receive the support they need during a critical...

CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in Dallas, TX.   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 knowledge to...

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. The Opportunity As the Executive Director of Design for the Bank, you will shape the future of digital banking experiences for millions of members. You’ll lead a talented set of multidisciplinary designers—both U.S.-based and near‑shore—through every stage of the design lifecycle, from deep customer understanding and concept development to delivery of intuitive, high‑performing digital products. You will be responsible for elevating the Bank’s design vision, strengthening enterprise design systems, and ensuring the Bank’s unique...

Job Description Amazing Career Moments Happen Here      Transforming the insurance industry is ambitious, we know. That’s why at Applied, we’re building a team that shows up every day ready to learn, willing to try new things, and driven to deliver innovative software and services that make us indispensable to our customers – all within a culture built on values that make us indispensable to each other too. With 40+ years of experience in the Insurtech game, we’re not just redefining what’s achievable; we’re creating a place where amazing career moments are made possible.      Position Overview      Applied Systems, Inc., a worldwide leader in insurance technology, is currently searching for a  Sr. Associate Product Manager (Sr. AMP) to join our Product Management organization and work on the EZLynx Agency Management System. We are looking for a candidate with a proven track record for managing and implementing multiple projects...

The Account Manager is responsible for interacting with customers on an executive level and acting as an extension of the client; understanding and communicating agreed upon expectations to field offices and increasing the market share of business by providing service that meets and exceeds customer expectations, stewardship reporting, commitment to customer goals, and introducing/selling/implementing additional services. This is a hybrid position in Fort Worth, TX. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provide consultative customer services for one or more new or established accounts Introduce new services independently or with assistance as needed Handle local or regional accounts Manage accounts with revenue in one region and a minimum revenue amount of $1m per account with a combined revenue for all accounts of over $3m. Revenue growth with existing accounts Accounts Receivable - Responsible for all aspects of collections in conjunction with the...

The Account Manager is responsible for interacting with customers on an executive level and acting as an extension of the client; understanding and communicating agreed upon expectations to field offices and increasing the market share of business by providing service that meets and exceeds customer expectations, stewardship reporting, commitment to customer goals, and introducing/selling/implementing additional services. This is a hybrid position in Fort Worth, TX. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provide consultative customer services for one or more new or established accounts Introduce new services independently or with assistance as needed Handle local or regional accounts Manage accounts with revenue in one region and a minimum revenue amount of $1m per account with a combined revenue for all accounts of over $3m. Revenue growth with existing accounts Accounts Receivable - Responsible for all aspects of collections in conjunction with the...

National General is a part of The Allstate Corporation, which means we have the same innovative drive that keeps us a step ahead of our customers’ evolving needs. We offer home, auto and accident and health insurance, as well as other specialty niche insurance products, through a large network of independent insurance agents, as well as directly to consumers.  Job Description Responsible for investigating and confirming the facts of loss for advanced automobile accidents. Determines coverage, liability, damages and otherwise adjusts and negotiates claims within limit of authority. ***National General is seeking an experienced Attorney-Represented Bodily Injury Consultant with strong negotiation, communication, and organizational skills. The ideal candidate can manage multiple priorities efficiently; Handling Nevada and Washington claims experience is a plus .*** Key Responsibilities. • Applies advanced understanding of insurance policies written by the company, the...

The Implementation Manager will be responsible for enhancement to existing products and development of new products to broaden current service offerings. This role will also be accountable for project management and implementation management with new and existing clients.  The primary purpose of the role is to work closely with the assigned Account Manager, Implementation Coordinators, IT, and Operations to complete the implementation of client programs and to facilitate the transition to field operations and account management personnel for ongoing servicing.   We offer a competitive salary and benefits package. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Participates in oral presentations Prepares and manages implementation plan from prospect presentation through conclusion Identifies required resources Develops and prepares information necessary for setup of customer across all CorVel systems Coordinates all internal meetings on a...

Description At Liberty, you'll thrive in a hybrid setting that fosters in-person collaboration, innovation and growth. This approach optimizes both remote and in-person interactions, enabling you to connect and ideate with your team and deepen valuable relationships across the company, while still enjoying the flexibility of remote work for focused tasks and projects.   The Workers Compensation Claims Specialist works within a Claims Team under direct supervision, develops the knowledge and skills needed to conduct thorough investigations, make decisions about liability / compensability, evaluate losses, negotiate settlements and manage an inventory of commercial property/casualty and disability claims by participating in a comprehensive training program, one-on-one mentoring, and on-the-job training. Assists in providing service to policyholders/customers on mid-sized and/or large commercial accounts.   We are open to filling this position as...

Claim Rep, BI PDO 1 - CR09JN 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.              At The Hartford, we respect our employees for their unique perspectives, ideas, and solutions. We empower individuals and teams to invent faster, smarter ways of meeting customers’ need while improving our performance. Goals are important, but so is the way we reach them. Character and customer value are just as vital to our reputation as financial performance leading to behaviors that put the customer at the center of everything we do. Our Claims Representatives investigates and maintains workers' compensation, property/casualty claims. Determines liability, secures information, reviews coverages, arranges property damage appraisals, and settles...

Provides customer services for one or more new or established accounts. Responsible for interacting with customers on an executive level and understanding and communicating agreed upon expectations to field offices and increasing the market share of business by providing excellent service, commitment to the customer, and introducing additional services. This is a hybrid role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Facilitate and coordinate customer set-up Coordinate and attend customer meetings Discuss, understand, and meet agreed upon standards as mutually determined by CorVel and customer  Develop/maintain account service instructions and communicate to service staff and post on the CorVel Sharepoint Knowledge of CorVel's services and completion of all CorVel Product Training Modules  Manage contract renewals/price increases; coordinate with the AE and/or management team as appropriate Resolve service issues through appropriate channels; Essential...

Responsible for selling and servicing Sentry products to meet growth, retention, profit and sales objectives for Non-Standard Auto and Personal Lines. This position will be located in either our Stevens Point, WI, Goldsboro, NC, Freeport, IL, or El Paso, TX Office, or has the potential to work remotely from home. Based on qualifications and experience, this position can be filled at either a Direct Sales Agent - Personal Lines I or Direct Sales Agent - Personal Lines II level. What You'll Do: As a Personal Lines Sales Agent, you will be responsible for: Selling Dairyland and Harley Davidson products to meet growth, retention, profit and sales objectives within our business units. Promote Dairyland and Harley Davidson Insurance Services product and services to customers. Understanding of specific company products. Answer inbound customer inquiries on coverage limits, deductibles, etc. Provide quotes and bind coverage for customers in a timely fashion....

The Account Executive is responsible for interacting with customers and prospects on an executive level and acting as an extension of the client; selling new services, understanding and communicating agreed upon expectations to all teams, and increasing the market share of business by providing stellar service that meets and exceeds customer expectations, showing commitment to customer goals, and introducing/selling/implementing services. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Presenting CorVel’s services to prospective customers Knowledge of CorVel's services and the disability compensation system Attend a minimum of 10 monthly sales calls Attend monthly sales strategy meeting with manager Meet or exceed sales goals established by management for the marketplace/branch office Explore all lines of coverage and needs within existing accounts and new accounts All opportunities documented in sf.com – minimum of 25 opportunities...

Berkshire Hathaway Homestate Companies, Workers Compensation Division, has an opening for a Project Manager II in their Business Applications team to lead IT projects and coordinate cross-functional teams, driving the successful implementation of technology solutions. The ideal candidate should have strong experience in Agile, PMP (Project Management Professional), and RUP (Rational Unified Process) methodologies. They will bring expertise in project management, Agile coaching, and process improvement to ensure the time and high-quality delivery of initiatives. KEY RESPONSIBILITIES   SCRUM MASTER ROLE Facilitates scrum ceremonies (Daily Standups, Sprint Planning, Sprint Retrospective, and Sprint Reviews). Acts as a servant leader to cross-functional Agile teams, ensuring adherence to Agile principles and best practices. Removes impediments and fosters an environment for high-performing team dynamics, continuous improvement and productivity....

At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers’ evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection.  Job Description This job is responsible for executing Learning & Development strategy, programs, processes, accountabilities, and/or policies to deliver customer-centered products in an efficient and cost-effective manner that align to business unit and enterprise strategies. We’re excited to expand our team with Learning & Development Claims Trainers based in Dallas, TX! As a Trainer, you'll facilitate engaging and effective sessions for Auto Claims classes typically ranging from 13 to 24 adjusters. This is an in-office role with travel...

The Account Manager is responsible for interacting with customers on an executive level and acting as an extension of the client; understanding and communicating agreed upon expectations to field offices and increasing the market share of business by providing service that meets and exceeds customer expectations, stewardship reporting, commitment to customer goals, and introducing/selling/implementing additional services. This is a remote position, but candidate must live in Dallas/Fort Worth area. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provide consultative customer services for one or more new or established accounts Introduce new services independently or with assistance as needed Handle local or regional accounts Manage accounts with revenue in one region and a minimum revenue amount of $1m per account with a combined revenue for all accounts of over $3m. Revenue growth with existing accounts Accounts Receivable - Responsible for all aspects of...

The Policy and Payment Integrity Manager oversees the PPI team and assists with implementation of policies to perform reviews conducted by CERIS, including but not limited to itemized bill review, professional review, hospital outpatient and DRG validation. This role manages   members of the PPI team, developing team strengths and improving weaknesses, identifying team goals, and evaluating team progress. The Policy and Payment Integrity Manager provides trend analysis of internal auditing of claims for accuracy related to pre- and post-payment claims, targeted claims, high dollar claims, and any other claim or record that requires quality review. The role assists with development of internal quality assurance measures based on client policy and industry guidelines. The manager also aids in researching and implementing best practices related to (CMS) payment policies, healthcare policies, client, state, and/or policy initiatives. This is a remote role.   ESSENTIAL...

The CERIS Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills and review of medical reports to determine appropriateness of medical care.  Clinical and/or technical expertise is utilized to address the provision of medical care and to identify inappropriate billing practices and errors inclusive of, but not limited to; duplicate billing, unbundling of charges, services not rendered, mathematical and data entry errors, undocumented services, reusable instrumentation, unused services and supplies, unrelated and/or separated charges, quantity and time increment discrepancies, inconsistencies with  diagnosis, treatment frequency and duration of care, DRG validation, service/treatment vs. scope of discipline, use of appropriate billing protocols, etc. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and...