Clinical Services Assistant Manager

🔥 17 hours ago

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EMC Insurance Companies

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1911

Insurance

EMC Insurance Companies is a mutual insurance firm providing specialized business insurance solutions. They focus on commercial property insurance, liability insurance, workers' compensation, and business owners' policies. With a strong emphasis on personalized service, EMC collaborates closely with local agents to deliver comprehensive and tailored coverage. EMC is committed to understanding the unique challenges faced by its policyholders, offering risk management and loss control resources to help businesses safeguard their assets. Known for their dedicated partnerships and exceptional customer service, EMC ensures that businesses are prepared for the unexpected with their superior insurance solutions.

📋 Description

• Lead daily clinical services operations including nurse case management, pharmacy, nurse review, and bill review functions. • Evaluate referrals and claim complexity, assigning work to internal staff or vendor partners. • Manage team workload, priorities, turnaround times, and overall service delivery. • Ensure clinical services are effectively integrated into claims handling processes and partner closely with claim professionals. • Lead, coach, develop, and monitor the performance of the Clinical Services team. • Oversee operational reporting, recommend KPIs, and monitor vendor performance and outcomes. • Partner with Claims leadership to expand clinical services, improve consultation practices, and enhance service quality. • Support implementation of new tools, clinical programs, regulatory changes, and vendor solutions. • Identify training needs, develop educational programs, and promote clinical services throughout the organization. • Drive process improvement initiatives that enhance efficiency, quality, and claim outcomes.

🎯 Requirements

• Current Registered Nurse (RN) license • Bachelor’s degree in nursing (BSN) preferred • Eight years of nursing experience including at least four years of property and casualty clinical claim oversight • Legal Nurse Consultant Certified (LNCC) designation, Case Management (CM), or other applicable designations preferred • Experience in multiple medical specialties preferred • Previous leadership or supervisory experience preferred

🏖️ Benefits

• Health insurance • 401(k) matching • Competitive paid time off plan • Full day of volunteer time off annually • Financial incentives including pension plan and bonus plan • Professional development and growth opportunities including tuition reimbursement • Wellness initiatives to improve team member well-being and reduce health insurance costs • Flexibility to dress for your day and opportunities for alternative work arrangements