Current jobs related to Director, Managed Care - Princeton - AmTrust Financial
-
Director, Managed Care
3 weeks ago
Princeton, United States AmTrust Financial Services Full timeOverviewPRIMARY 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...
-
Child Care Associate Center Director
2 weeks ago
Princeton Township, United States BrightPath Early Learning & Child Care Full timeChild Care Associate Center Director BrightPath Early Learning & Child Care – Liberty, OH We are looking for a dedicated Associate Center Director to work alongside our Center Director, teachers, and families to provide a nurturing environment for children ages 6 weeks to 12 years. This full‑time role is a key part of our mission to offer quality early...
-
Medical Director
3 weeks ago
Princeton, United States WVU Medicine Full timeAdditional Job Description Welcome! We’re excited you’re considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you’ll find other important information about this position. The West Virginia University Health System, the state’s...
-
Medical Director
7 days ago
Princeton, WV, United States WVUHS Medical Group Full timeWelcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position. The West Virginia University Health System, the state's largest health system and largest...
-
Medical Director
17 hours ago
Princeton, WV, United States WVUHS Medical Group Full timeWelcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position. The West Virginia University Health System, the state's largest health system and largest...
-
Medical Director
2 weeks ago
Princeton, WV, United States WVUHS Medical Group Full timeWelcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position. The West Virginia University Health System, the state's largest health system and largest...
-
Director, Training Management Operations
6 days ago
Princeton, United States Otsuka Pharmaceutical Full timeDirector, Training Management Operations Lead Experience, qualification, and soft skills, have you got everything required to succeed in this opportunity Find out below. The Director, Training Management Operations Lead, is a senior leader within the Learning Center of Excellence (CoE) under Global Quality. This role is responsible for overseeing the...
-
Director, Specialty Account Management
4 days ago
Princeton, New Jersey, United States Kyowa Kirin, Inc.- U.S. Full time $185,600 - $242,600 per yearKyowa Kirin is a fast-growing global specialty pharmaceutical company that applies state-of-the-art biotechnologies to discover and deliver novel medicines in four disease areas: bone and mineral; intractable hematologic; hematology oncology; and rare disease. A Japan-based company, our goal is to make people smile by delivering breakthroughs where no...
-
Asset Management Director/Manager
2 weeks ago
Princeton, United States NRG Energy Full timeAsset Management Director/Manager - EASTNRG Energy is seeking a Director or Manager of Asset Management to provide professional business services to optimize the financial and operating performance of generation assets primarily within the East Region. This is accomplished by providing strategic recommendations and analysis of power plant operation,...
-
Princeton, United States Staffing Full timeHead Of Customer Identity And Access ManagementRole: Head of Customer Identity and Access Management, Managing Director Location: Princeton or Clifton NJ or Berwyn PA or Quincy or Boston MA or Atlanta Georgia or Stamford Conn or Austin TX Hybrid (candidate Must be from these area only) MoI: Video and Inperson possible since this is a senior level role. About...
Director, Managed Care
2 weeks ago
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 managementMonitor and analyze significant legal developments and legislative changes that may affect medical management. Collaborate with Director of Medical Strategy and Clinical Optimization to address changes.Participate in the effective selection, coaching, medical education and clinical development of nurse case managers.Manages project development/enhancements through coordination with WC operationsEmploy performance management and performance review processes to maximize performance of employees, correct performance problems, provide development opportunities and promote effective communication with employees.Ensure claim quality in accordance with best practices and company guidelines.Maintain appropriate staffing levels in conjunction with workloads.Select, train and manage staff. Plan staff responsibilities and manage activities, utilizing staff resources effectively.Ensure appropriate execution of quality assurance processes, inclusive of identification of strengths, deficiencies and implementation of action plans focused on improved results.Lead by example in effectively supervising, coaching, developing, motivating, and evaluating staff.Analyze and report on field claim activities and initiatives.Ensure regulatory compliance with jurisdictional workers' compensation rules and statutes. Qualifications Education & Licensing Active unrestricted RN license in a state or territory of the United States with eligibility to get and/or renew a multistate license required. Bachelor's degree in nursing (BSN) from accredited college or university or equivalent work experience preferred. Certification in case management, pharmacy, rehabilitation nursing or a related specialty is highly preferred. ExperienceSeven (7) years of related experience or equivalent combination of education and experience required to include two (2) years of direct clinical care OR two (2) years of case management/utilization management required. Five to seven years of direct nurse management experience.Skills & Knowledge Knowledge of pharmaceuticals used to treat pain Knowledge of behavioral health Knowledge of pain management process Knowledge of drug rehabilitation process Knowledge of workers' compensation laws and regulations Excellent oral and written communication,Ability to prepare presentation documents and present to senior leadershipAdvanced computer skills to include Microsoft ProductsProven ability to manage organizational change, to involve and influence others to accept new ideas or innovative approaches, to lead in a team-based organizationAbility to manage a diverse team including clinical professionals in multiple locationsAbility to develop reports, metrics and improvement plansAbility to interact collaboratively and work effectively with a multi-functional team and throughout the organization; fosters an environment of shared responsibility and accountabilityExperience applying medical management treatment guidelines Experience with writing and implementing program level policy and proceduresAnalytic and interpretive skills Strong organizational skills Excellent interpersonal skills Excellent negotiation skills Ability to work in a team environment Ability to meet or exceed Performance Competencies Experience with State and external accreditation managed care audits and reviewsPrior experience developing and leading nurse case management, medical director and clinical teamsDemonstrated results in developing strategic plans and executing key initiatives Ability to collaborate across functional lines and leadersStrong communication and analytical skillsThe salary range for this role is $85-95K per year. This range is only applicable for jobs to be performed in New York.Base pay offered may vary depending on, but not limited to education, experience, skills, geographic location, travel requirements, sales or revenue-based metrics. This range may be modified in the future.#AmTrust 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.AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities.AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain and develop the best talent available. We see diversity as more than just policies and practices. It is an integral part of who we are as a company, how we operate and how we see our future.
