AmTrust Financial Services

Manager, Medical Case Management

AmTrust Financial Services$87K — $130K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Active unrestricted RN license with eligibility for multistate license.
  • Bachelor's degree in nursing (BSN) preferred or equivalent experience.
  • National Certification in case management or ability to obtain within 24 months required.
  • Five years of related case management experience, including three years in a leadership role.
  • Knowledge of workers' compensation laws and case management practices.

Responsibilities

  • Manage telephonic case management operations for worker’s compensation.
  • Develop and direct a team of nurse case managers for high-quality service delivery.
  • Evaluate staff performance and ensure adherence to case management protocols.
  • Recruit, train, and coach staff to enhance skills and promote talent.
  • Ensure compliance with legislative and corporate policies and procedures.

Benefits

  • Medical & Dental Plans for employees and eligible family members.
  • Life Insurance coverage, including eligible spouses and children.
  • Health Care Flexible Spending Account options.
  • Dependent Care Flexible Spending Account availability.
  • 401k Savings Plans to support retirement planning.
  • Paid Time Off to encourage work-life balance.
Full Job Description
Overview

This is an office-based position in our Salt Lake City, UT office.

 

PRIMARY PURPOSE:

The RN Branch Manager for telephonic case management services will oversee operations as well as a team of experienced worker’s compensation nurse case managers. The ideal candidate will have a minimum of three (3) or more years’ experience overseeing a nursing claims management program as well as in-depth understanding of worker’s compensation injury claims and utilization management review programs. The Manager will lead the nurse case management team to strategize with claim professionals in management of medical and disability exposure, delivering quality telephonic case management to proactively drive best in class outcomes including appropriate medical treatment and engagement of the injured worker to achieve a safe and reasonable return to work. This position requires interaction with physicians, other medical providers, claims professionals, supervision, injured employees and employers.

Responsibilities
  • Manage, develop and direct staff to ensure the delivery of high-quality managed care services involving medical and disability case management achieving best in class outcomes for our customers and their injured workers.
  • Responsible for all oversight of operational and administrative activities within the department/unit.
  • Ensure staff adheres to established standards and protocols to effectively manage assigned caseload of medical and disability cases to evaluate and assess for optimal injured worker outcomes, continuous improvement opportunities, assure key performance metrics are met and/or exceeded.
  • Recruits, coaches, develops staff to broaden and strengthen the skill sets to further promote talent within the organization both laterally and management opportunities, creating a high performing results-oriented staff.
  • Management of performance management programs including communication of objectives, providing on-going coaching and conducting performance reviews, and as applicable initiate progressive disciplinary actions.
  • Manages salary (and no-salary) budgets, makes recommendations to Zonal Director and leadership concerning promotions, terminations, and staffing authorizations.
  • Acts as a technical expert and resource for staff which includes maintaining the highest level of authority within the department/unit specific office. Technical expertise and resource knowledge for all levels of care coordination from low to high severity or complex cases. Appropriately refers issues/concerns outside of authority level to Zonal Management level.
  • Ensures appropriate compliance with all legislation, corporate policies, and programs.
  • Assist Zonal Management and other departments with new business and/or renewal presentations and periodic claims service reviews.
  • Implements new and revised policies and procedures.
  • Performs additional duties and/or is assigned special projects as requested.
Qualifications

Education & Licensing

Ability to develop, manage and direct an office/unit operation and effectively communicate operational procedures to field/unit staff. Demonstrated leadership and innovation in achieving results. Advanced knowledge of principles and methods pertaining to the specific department, knowledge of department management practices, company operations (i.e. other staff and line departments), and policies.

Active unrestricted RN license in a state or territory of the United Stateswith eligibility to get and/or renew a multistate license is required.

Bachelor's degree in nursing (BSN) from accredited college or university or equivalent work experience preferred.National Certification in case management OR the ability to obtain certification within 24 months of employment is required.

Written and verbal fluency in Spanish and English preferred.

 

Experience

Overall five (5) years of related case management experience or equivalent combination of education and case management experience required to include three (3) years of management or leadership role experience in case management.Preferred previous clinical experience orthopedic, emergency room, critical care, home care or rehab experience.

 

Skills & Knowledge:Knowledge of workers' compensation laws and regulations

Knowledge of case management practice

Knowledge of the nature and extent of injuries, periods of disability, and treatment needed

Knowledge of URAC standards, ODG, Utilization review, state workers compensation guidelines

Knowledge of pharmaceuticals to treat pain, pain management process, drug rehabilitationKnowledge of behavioral healthExcellent oral and written communication, including presentation skillsPC literate, including Microsoft Office productsLeadership/management/motivational skillsAnalytic and interpretive skillsStrong organizational skillsExcellent interpersonal and negotiationskillsAbility to work in a team environmentAbility to meet or exceed Performance CompetenciesWORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.Mental:Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlinesPhysical:Computer keyboardingAuditory/Visual:Hearing, vision and talking

 

 

The expected salary range for this role is $87,600.00-$130,000.00.

 

Pleasenotethatthesalaryinformationshownaboveisageneralguidelineonly.Salariesarebaseduponawiderangeoffactorsconsideredinmakingthecompensationdecision,including,butnotlimitedto,candidateskills,experience,educationandtraining,thescopeandresponsibilitiesoftherole,aswellasmarketandbusinessconsiderations.

 

Thisjobdescriptionisdesignedtoprovideageneraloverviewoftherequirementsofthejobanddoesnotentailacomprehensivelistingofallactivities,duties,orresponsibilitiesthatwillberequiredinthisposition.AmTrustreservestherighttorevisethisjobdescriptionatanytime.

What We Offer

AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off.

 

About AmTrust Financial Services

AmTrust Financial Services, Inc. is a multinational property and casualty insurance company. The company provides coverage for small businesses, workers' compensation insurance, extended warranty coverage, specialty risk and extended warranty coverage, and other insurance products. AmTrust Financial Services, Inc. was founded in 1998 and is headquartered in New York City. The company is publicly traded on the NASDAQ stock exchange under the ticker symbol AFSI.
Learn more about AmTrust Financial Services
Size
8,000 employees
Industry
Founded
1998

Similar Jobs

More Jobs at AmTrust Financial Services

More Healthcare Jobs

Find similar Manager, Medical Case Management jobs: