VP, Managed Care
Crum & Forster
full-time
Posted on:
Location Type: Remote
Location: New Jersey • United States
Visit company websiteExplore more
Salary
💰 $119,700 - $225,100 per year
Job Level
About the role
- Primary responsibility for Workers’ Compensation vendor management with an emphasis on medical cost containment
- Lead development and implementation of the Managed Care Claim department
- Set strategy for medical management and execute improvement initiatives
- Leverage technology and AI solutions for ongoing refinements to workflows, processes and KPIs
- Monitor compliance with changing regulatory requirements
- Responsible for vendor selection, due diligence, and contracting
- Audit vendors and develop strategies for improved processes and cost savings solutions
- Oversee managed care vendor programs and develop metrics reporting
Requirements
- Bachelor’s degree or equivalent
- 15+ years of experience
- Minimum of 5 years’ experience in leading a Workers’ Compensation Managed Care operation
- 5+ years clinical experience preferred
- Extensive background in Workers’ Compensation and Managed Care within an insurance operation
- In-depth knowledge of medical bill review processes and procedures
- Strong knowledge of medical terminology and managed care operations across multiple jurisdiction states
- Ability to travel to other locations across the country and to vendors
Benefits
- Competitive compensation package
- Generous 401K employer match
- Employee Stock Purchase plan with employer matching
- Generous Paid Time Off
- Excellent benefits that go beyond health, dental & vision.
- Programs focused on whole family’s wellness, including physical, mental and financial wellbeing
- Opportunities for continuing education, tuition reimbursement, industry certifications, and professional training
- Dynamic, ambitious, fun and exciting work environment
- Spirit of social and community responsibility with matching donation program, volunteer opportunities, corporate giving program
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
vendor managementmedical cost containmentManaged Care Claim developmentmedical management strategyworkflow refinementKPI improvementvendor selectiondue diligencecontractingmedical bill review
Soft Skills
leadershipstrategic planningcompliance monitoringauditingprocess improvementcommunicationorganizational skillsanalytical skillsproblem-solvinginterpersonal skills
Certifications
Bachelor’s degree