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medical director

3450 medical director jobs found

Pacific Life
05/16/2025  
AVP Medical Director
  Job Description:   Providing for loved ones, planning rewarding retirements, saving enough for whatever lies ahead – our policyholders count on us to be there when it matters most. It’s a big ask, but it’s one that we have the power to deliver when we work together. We collaborate and innovate – pushing one another to transform not just Pacific Life, but the entire industry for the better. Why? Because it’s the right thing to do. Pacific Life is more than a job, it’s a career with purpose. It’s a career where you have the support, balance, and resources to make a positive impact on the future – including your own. We’re actively seeking a talented AVP Medical Director to join our Underwriting Team. This role can be based out of our Newport Beach, CA office or be remote. How you’ll help move us forward: • Provide consultative expertise to underwriting staff on mortality and morbidity...
Pacific Life Remote (Newport Beach, CA, USA) Full Time
Texas Mutual
04/24/2025  
Workers' Compensation Medical Director
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. Texas Mutual takes care of our injured workers by providing top-notch medical care when an accident occurs. Join us as a Workers’ Compensation Medical Director and play a pivotal role in transforming medical care quality! In this dynamic position, you will help...
Texas Mutual Austin, TX, USA Full Time
Great American Insurance Group
03/25/2025  
Medical Director
Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers’ comp, we strive to provide an atmosphere of constant growth and development for our employees.   Summit provides workers’ compensation programs and services to thousands of employers throughout the Southeast.   Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it’s underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise. It’s one thing to know workers’ comp. It’s another to know people. But knowing both? That creates an altogether different experience. So, if you’re ready for an altogether different workplace...
Great American Insurance Group Lakeland, FL, USA Full Time
Travelers
03/25/2025  
VP & Medical Director
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 160 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...
Travelers Hartford, CT, USA Full Time
Summit
02/13/2025  
Medical Director
Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers’ comp, we strive to provide an atmosphere of constant growth and development for our employees.   Summit provides workers’ compensation programs and services to thousands of employers throughout the Southeast.   Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it’s underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise. It’s one thing to know workers’ comp. It’s another to know people. But knowing both? That creates an altogether different experience. So, if you’re ready for an altogether different workplace...
Summit Lakeland, FL, USA Full Time
Great American Insurance Group
02/13/2025  
Medical Director
Headquartered in the Central Florida city of Lakeland, Summit employs over 700 office and field associates at its main location and regional offices in Baton Rouge, Louisiana, and Gainesville, Georgia. As the people who know workers’ comp, we strive to provide an atmosphere of constant growth and development for our employees.   Summit provides workers’ compensation programs and services to thousands of employers throughout the Southeast.   Summit is a member of Great American Insurance Group, a company that focuses on building relationships and linking people to various career paths. Whether it’s underwriting, claims, accounting, IT, legal, or customer service, Great American Insurance Group combines a small-company entrepreneurial atmosphere with big- company expertise. It’s one thing to know workers’ comp. It’s another to know people. But knowing both? That creates an altogether different experience. So, if you’re ready for an altogether different workplace...
Great American Insurance Group Lakeland, FL, USA Full Time
AmTrust Financial
06/10/2025  
Telephonic Nurse Case Manager
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.  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 prospectively, concurrently or retrospectively in accordance with the appropriate...
AmTrust Financial Dallas, TX, USA Full Time
AmTrust Financial
06/10/2025  
Telephonic Nurse Case Manager
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.  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 prospectively, concurrently or retrospectively in accordance with the appropriate...
AmTrust Financial Chicago, IL, USA Full Time
AmTrust Financial
06/10/2025  
Telephonic Nurse Case Manager
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.  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 prospectively, concurrently or retrospectively in accordance with the appropriate...
AmTrust Financial Alpharetta, GA, USA Full Time
AmTrust Financial
06/04/2025  
Medical Case Manager
Overview AmTrust Financial Services, a fast growing commercial insurance company, has a need for a 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 our Scottsdale or Salt Lake City office. Responsibilities Responsibilities: 1. Uses clinical/nursing skills to determine whether all aspects of a patient’s care, at every level, are medically necessary and appropriately delivered. 2. Perform Utilization...
AmTrust Financial Scottsdale, AZ, USA Full Time
Ryan Specialty
06/04/2025  
Utilization Review Manager
Position Summary Provides comprehensive medical management services including utilization management, education, recommendations, hospital notification, and health care cost projections for a select group of clients. Performs services within the scope of licensure for individuals with complex and chronic care needs by assessing, planning, facilitating, advocating, and monitoring services designed to optimize patient health care across the care continuum. Ensures patient satisfaction and access to services appropriate to meet health care needs. What will your job entail? Job Responsibilities: • Performs all utilization review functions within the scope of licensure. • Conducts comprehensive utilization review with members as identified by evidence-based guidelines and specific account plan language. • Provides timely follow up, monitoring, advocacy, referral, discharge and transition coordination in accordance evidence-based guidelines and account benefit structure. •...
Ryan Specialty Hartland, WI, USA Full Time
Nationwide
05/29/2025  
Life Underwriting Specialist (Remote)
Are you passionate about being part of a team that delivers extraordinary care to help individuals and businesses prepare for and protect their retirement? If so, then Nationwide Financial 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. Internal Compensation Grade: F4 Location: This position can be filled as Hybrid or Remote Must have experience in Life Underwriting. This role does not qualify for employer-sponsored work authorization.  Nationwide does not participate in the Stem OPT Extension program. #LI-LP1 Job Description Summary Our underwriters work hard to provide the exceptional customer experience for which Nationwide is known. Actively engaging with our firms and financial professionals to get to know their clients and their needs builds our understanding of the market, what...
Nationwide OH, USA Full Time
AmTrust Financial
05/28/2025  
Director, Managed Care
Overview PRIMARY PURPOSE:   Reporting to the Head of Managed Care and Clinical, the Director of Managed Care will have responsibility for managing the performance, productivity, and medical management outcomes of AmTrust’s managed care operations. This role will have oversight of telephonic nurse case management, catastrophic case management and clinical review nurse program to deliver optimal claim results. Responsibilities Provide leadership and guidance for field managed care operations in assigned zone. Execute medical management strategy; analyze medical management results and create annual operational goals and objectives for claim handling operation. Plan, organize, and monitor the daily activities of managed care operations in assigned zone. Ensure all Managed Care processes and protocols are effective executed. Serve as a technical and business resource for nurse case management Monitor and analyze...
AmTrust Financial Princeton, NJ, USA Full Time
Ryan Specialty
05/28/2025  
Utilization Review Manager
Position Summary Provides comprehensive medical management services including utilization management, education, recommendations, hospital notification, and health care cost projections for a select group of clients. Performs services within the scope of licensure for individuals with complex and chronic care needs by assessing, planning, facilitating, advocating, and monitoring services designed to optimize patient health care across the care continuum. Ensures patient satisfaction and access to services appropriate to meet health care needs. What will your job entail? Job Responsibilities: • Performs all utilization review functions within the scope of licensure. • Conducts comprehensive utilization review with members as identified by evidence-based guidelines and specific account plan language. • Provides timely follow up, monitoring, advocacy, referral, discharge and transition coordination in accordance evidence-based guidelines and account benefit structure. •...
Ryan Specialty Hartland, WI, USA Full Time
CorVel
05/16/2025  
Clinical Review Auditor
The Diagnostic Related Groups (DRG) Clinical Auditor will be responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation to determine correct DRG/coding and clinically supported as defined by review methodologies specific to the type of review. This involves completing medical records review, accurately documenting findings and non-findings and providing clinical/policy/regulatory support for the determination. Experience using ICD-10-CM & PCS coding guidelines, the ability to understand modern pharmacology, disease management and clinical intervention procedures.  The ideal DRG Clinical Auditor candidate will have strong oral and written communication skills, clinical knowledge of disease process, and knowledge of medical necessity rules. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: The Clinical Auditor will review medical records to determine accuracy of billing through verification of...
CorVel Fort Worth, TX, USA Full Time
MEM - Missouri Employers Mutual
04/30/2025  
Onsite Nurse Case Manager (Hybrid/Remote)
Are you driven to keep people safe? That’s what we do every day at MEM Insurance.    We’ve created a casual, values-driven work culture that’s making a positive impact on the way people live and work. This is a place where you can grow with confidence — because that’s what safety and success really mean to us. SUMMARY:   The role of the Case Manager is to assure that patients have access to quality, cost effective heath care, and to assist in the assessment, development, and coordination of a proactive plan to ensure the best outcome for the work injury. The role of case manager addresses early return to work and coordinates the return to work with the policyholder, the treating physician, and the claims representative.  The nurse case manager will facilitate a safe, effective, early return to work. These job duties are accomplished primarily through ongoing personal contact with all parties. Discretion may be used to...
MEM - Missouri Employers Mutual Omaha, NE, USA
CorVel
04/17/2025  
Clinical Review Auditor
CERIS is seeking a DRG Coder/Clinical Auditor. The Diagnostic Related Groups (DRG) Clinical Auditor will be responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation to determine correct DRG/coding and clinically supported as defined by review methodologies specific to the type of review. This involves completing medical records review, accurately documenting findings and non-findings and providing clinical/policy/regulatory support for the determination. Experience using ICD-10-CM & PCS coding guidelines, the ability to understand modern pharmacology, disease management and clinical intervention procedures.  The ideal DRG Clinical Auditor candidate will have strong oral and written communication skills, clinical knowledge of disease process, and knowledge of medical necessity rules. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: The Clinical Auditor will review medical records to...
CorVel Fort Worth, TX, USA Full Time
Genworth
04/09/2025  
Chief Underwriter and Operations Director
About CareScout Join us on a mission to simplify and dignify the aging experience. We are the children, siblings, neighbors, and friends of those navigating the fragmented and confusing system of long-term care. Our team is ferociously curious and relentless in our pursuit of a better system – enabling individuals to move gracefully along the aging continuum on their own terms. We’re creating a new experience for consumers, offering long-term care insurance options and other funding mechanisms to help them as they age, along with education, resources and comprehensive support services as they seek care.  We work hard; we have fun; we care about each other; and we share a common mission - we care about care .  If this sounds like a place where you can thrive, join us!   CareScout Insurance is a division of Genworth Financial, Inc, a Fortune 500 provider of products, services and solutions that help families address the financial challenges of aging. POSITION TITLE...
Genworth VA, USA Full Time
EMC Insurance
06/12/2025  
Bond Director - Northeast Featured
At EMC, we’re all about working together to make an impact. As part of our team, you’ll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts—always supporting each other to do our best work. Join us, and let’s improve lives together.    Essential Functions: Makes underwriting decisions regarding contract surety, non-contract surety and fidelity business within authority Collaborates with Corporate Office Bond to develop guidelines and procedures for department.  Enforces guidelines and procedures Answers questions, shares recommendations for complex situations, such as difficult accounts, communication strategies or problematic agency relationships and explains the rationale for recommendations Collaborates with the branch marketing team to determine bond opportunities Meets with agents to assist in the acquisition and underwriting of fidelity and surety business...
EMC Insurance ME, USA Full Time
Encova Insurance
06/05/2025  
Director, Workers' Compensation Claims Featured
The salary range for this job posting is $108,812.00 - $174,099.00 annually + bonus + benefits. Pay Type: Salary The above represents the full salary range for this job requisition. Ultimately, in determining your pay and job title, we'll consider your location, education, experience, and other job-related factors, and will fall within the stated range. Your recruiter can share more information about the specific salary range during the hiring process. This role will manage the Large Atlantic and New England Workers' Compensation claims team and report to a Regional Vice President, Commercial Lines.  While we prefer candidates who reside in the Charlotte, NC area, we may consider those who reside within our listed payroll states. Are you a Referral? If you know a current Encova Insurance associate and would like to apply as a referral, please encourage them to submit your referral information before you submit your application. You will receive an email with a...
Encova Insurance Charlotte, NC, USA Full Time

 

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