Case Manager jobs at BlueCross BlueShield of Tennessee - 76 jobs

Join Our Behavioral Health Transition of Care Team! We're seeking a dedicated Care Manager to support BlueCare members during critical transitions. In this role, you'll work closely with local Acute Inpatient Psychiatric facility in the Murfreesboro area, to collaborate with treatment teams and assist with discharge planning. You'll help members navigate next steps, whether finding appropriate care after discharge or accessing behavioral health resources and provide telephonic follow-up to ensure continuity of care post-discharge. It's important to note that the caseload is fluid, adapting to changes in facility admissions and referrals, and so schedule changes are a possibility. Comprehensive training and shadowing will set you up for success in this rewarding role! Please note: Due to location requirements, candidates must be within 25 miles of Murfreesboro, Tennessee. What You'll Do Conduct onsite visits to local Acute Inpatient Psychiatric facility in the Murfreesboro area. This is at a minimum of twice weekly to support discharge planning. Participate in treatment team meetings, sharing insights on member cases and collaborating on care strategies. Assist members in finding appropriate care or resources post-discharge, including behavioral health services. Provide telephonic follow-up to ensure members have what they need for successful recovery. Maintain a caseload while balancing onsite visits and remote support. Collaborate with providers and internal teams to meet member needs and resolve challenges. Ideal Preferences Ability to adapt to change in a fast-paced environment. Assertive communicator who speaks up when support or process improvements are needed. Job Responsibilities Supporting utilization management functions for more complex and non-routine cases as needed. Serving as a liaison between members, providers and internal/external customers in coordination of health care delivery and benefits programs. Overseeing highly complex cases identified through various mechanisms to ensure effective implementation of interventions, and to ensure efficient utilization of benefits. Performing the essential activities of case management: assessment: planning, implementation, coordinating, monitoring, outcomes and evaluation. Perform case management activities in community settings including face to face with members as required. Various immunizations and/or associated medical tests may be required for this position. Testing/Assessments will be required for Digital positions. Job Qualifications License Current, active unrestricted Tennessee license in Nursing (RN) or behavioral health field (Master's level or above) (Ph.D., LCSW/LMSW, LLP, MHC, LPC, etc.) required. RN may hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law. Experience 3 years - Clinical behavioral health / substance use disorder experience required 1 year - Must be knowledgeable about community care resources and levels of behavioral health care available. Skills\Certifications Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint) Independent, Sound decision-making and problem-solving skills Excellent oral and written communication skills Strong interpersonal and organizational skills Strong analytical skills Positive relationship building skills and ability to engage and motivate health behaviors in diverse populations Ability to quickly identify and prioritize member needs and provide structured and focused support and interventions Experience with Motivational Interviewing Techniques and Adult Learning Styles Number of Openings Available 1 Worker Type: Employee Company: VSHP Volunteer State Health Plan, Inc Applying for this job indicates your acknowledgement and understanding of the following statements: BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law. Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page: BCBST's EEO Policies/Notices BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.

The Telephonic Case Manager RN in Medical Oncology provides remote nursing support by coordinating patient care, educating members, and ensuring adherence to treatment plans. This role involves assessing patient health, identifying barriers, and connecting patients with necessary resources to improve health outcomes. Working primarily via telephone, the position requires strong clinical expertise, communication skills, and proficiency in healthcare technology systems. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. We're making a solid connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that's driving the health care industry forward. As a Telephone Case Manager RN with UnitedHealth Group, you'll support a diverse member population with education, advocacy and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Apply today! The Telephonic Case Manager RN Medical/Oncology will identify, coordinate, and provide appropriate levels of care. The Telephonic Case Manager RN Medical/Oncology is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. This is a full-time, Monday - Friday, 8am-5pm position in your time zone. You'll enjoy the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: Make outbound calls and receive inbound calls to assess members current health status Identify gaps or barriers in treatment plans Provide patient education to assist with self-management Make referrals to outside sources Provide a complete continuum of quality care through close communication with members via in-person or on-phone interaction Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. Solid computer and software navigation skills are critical. You should also be solidly patient-focused and adaptable to changes. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Current, unrestricted RN license in state of residence Active Compact RN License or ability to obtain upon hire 3+ years of experience in a hospital, acute care or direct care setting Proven ability to type and have the ability to navigate a Windows based environment Have access to high-speed internet (DSL or Cable) Dedicated work area established that is separated from other living areas and provides information privacy Preferred Qualifications BSN Certified Case Manager (CCM) 1+ years of experience within Medical/Oncology Case management experience Experience or exposure to discharge planning Experience in a telephonic role Background in managed care *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Keywords: telephonic case management, oncology nurse, patient education, care coordination, medical management, healthcare advocacy, remote nursing, chronic disease management, UnitedHealth Group, RN license

The Optum family of businesses, is seeking a Behavioral Health Case Manager to join our team in Missouri. As a member of the Optum Behavioral Care team, you'll be an integral part of our vision to make healthcare better for everyone. The Behavioral Health Case Manager will provide telephonic and in-person support for both direct referrals and data identified referrals. This requires clinical expertise and the ability to negotiate the complexities involved with special needs conditions such as substance use, suicidality/homicide, major depression, ADHD, eating disorders, and severe mental illness. This position may require minimal field work to meet with members at local facilities in the future. Primary Responsibilities: Facilitate member education and involvement of caregiver in the delivery of interventions Provide advocacy and support to member and family members, including caregiver support & appropriate referral to applicable / needed resources Ensure that members understand treatment options and are effectively linked to treatment resources Promote health, wellness and optimal psychosocial functioning for member (identify caregiver gaps, facilitate education and respite support) Consider the member's needs holistically to identify gaps in care requiring intervention Exhibit excellent customer service in engaging providers in collaborative planning Create and maintain appropriate clinical records Participate as directed in clinical rounds with other members of the team and other external health care management organizations / vendors, as applicable. Also participate in advancing the Quality Improvement Program Conduct condition specific research to meet member needs Maintain success stories which can be utilized to promote program Provide case management support for individuals who meet diagnostic requirements including engagement of member and/ or family making available support throughout the entire continuum of treatment Explanation of authorization process Complete discharge follow-up & if needed, discharge planning / support You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Master's degree in Psychology, Social Work, Counseling, or Marriage and Family Counseling or Licensed Ph.D. Active, unrestricted clinical license to practice independently without supervision in the state of Missouri 2+ years of post-licensure experience in a related mental health environment 1+ years of case management experience Proven intermediate level computer skills including proficiency with MS Office Suite Access to high-speed internet (Broadband Cable, DSL, Fiber) and a dedicated workspace at home Reside in Missouri Preferred Qualifications: Hospital experience including intakes, assessments, discharge planning, and/or case management Community mental health experience including case management Experience doing chart reviews Experience consulting with facility and/or hospital staff to coordinate treatment plans Dual diagnosis experience with mental health and substance abuse Experience working in an environment that required coordination of benefits and utilization of multiple groups and resources for patients Experience with government funded programs Explore opportunities at Optum Behavioral Care. We're revolutionizing behavioral health care delivery for individuals, clinicians and the entire health care system. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We're connecting care to create a seamless health journey for patients across care settings. Join our team, it's your chance to improve the lives of millions while Caring. Connecting. Growing together. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

The Year for Growth, Opportunity and Flexibility Are you ready for a career change in 2021? At American Income Life, we are searching for ambitious individuals who are ready to build a successful career while also having a positive impact on the communities around them. American Income Life currently provide supplemental insurance coverage to labor unions, credit unions and associations in 49 states, the District of Columbia, Canada and New Zealand. Why We Stand Out American Income Life provides supplemental insurance coverage to labor unions, credit unions and associations in 49 states, the District of Columbia, Canada and New Zealand. Requirements: Excellent communication skills Basic computer knowledge Work ethics Outgoing, fun & energetic with an upbeat personality Time management skills Pass a criminal background check Job Benefits: Full Benefits Paid weekly ($70,000 - $75,000 1st year average) Bonuses Health Insurance Reimbursement Life Insurance Flexible Schedule Retirement Plan American Income Life has served working class families since 1951 with life, accident, and supplemental health products to help protect members of labor unions, credit unions, associations, and their families. AIL representatives develop long-term relationships with clients and meet them where they are most comfortable: their homes Powered by JazzHR

FUNCTION OF THE JOB: The Workers' Compensation Senior Telephonic Nurse Case Manager is responsible for evaluating and expediting appropriate, cost-effective medical treatment of injured employees with the goal of optimum medical improvement. The Senior TCM is responsible for disability management, including proactive early return to work coordination. Close collaboration with the claims and medical team to achieve individual case and department goals is a critical component of the position. This is a full-time remote position. KNOWLEDGE AND SKILLS: Excellent verbal and written communication skills. This position will involve continuous personal, telephonic, and written contact. Strong interpersonal and relationship building skills. Knowledge of traumatic injuries and the resultant disabilities and medical complications. Knowledge of Workers' Compensation Acts and working knowledge of the medical providers in the assigned territory. Knowledge and expertise in use of medical treatment guidelines and disability duration guidelines. Experience using Microsoft Office products and ability to learn other technology tools. Strong time management, critical thinking, and organizational skills with the ability to work independently to manage priorities and meet deadlines. Model exceptional customer experience skills. MAJOR DUTIES/RESPONSIBILITIES OF THE JOB: Complete timely initial assessment report, case management plan, and establish disability duration timeframes. Throughout the life of an assignment review, analyze and critically assess medical records compared to evidence-based treatment guidelines; communicate findings and recommendations to the adjuster as part of the development of a medical action plan. Active participation with claims team to review, establish, and execute action plan. Develop and maintain action plan for early return to work (RTW) based on disability duration guidelines. Work collaboratively with all stakeholders to effectively manage recovery and return to work process. Meet productivity requirements. Effectively manage inventory based on guidelines. Assist with training and development of team members and broader workers' compensation team including preparation and presentation of updates on relevant medical topics. Assist Nurse Manager and leadership team as needed with triage and projects. EDUCATION AND EXPERIENCE: Registered Nurse (RN) license in good standing required and willingness to obtain additional licenses as needed. BSN preferred. Certified Case Manager (CCM) certification, CDMS and/or CRRN preferred. Compact license preferred. 7-10 years of experience in Workers' Compensation Case Management preferred. Proficiency with MS Office products. The pay range for the role is $65,900 to $111,900. The specific offer will depend on an applicant's skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program. Chubb offers a comprehensive benefits package, more details on which can be found on our careers website. The disclosed pay range estimate may be adjusted for the applicable geographic differential for the location in which the position is filled.

Charles Taylor is a highly successful global provider of professional services to the insurance industry. We are seeking an experienced Workers Compensation Field Case Manager to join our team in the Cincinnati-North Dayton-Columbus, OH area. This is a remote, contracted role. Job Summary The Field Case Manager is responsible for assisting our clients injured workers with case management and return to work services. Essential Duties and Responsibilities * Provide field case management services for our clients injured workers, including onsite attendance at doctor's appointments * Perform case assessments and develop action plans to support recovery and timely return to work * Coordinate timely access to needed medical services and maintain proactive communications * Cultivate excellent relationships with all parties (AE's, IWs, providers, clients) * Provide written reports on case status and updates (post, physician visit/weekly/monthly) and submits timely monthly billing to billing specialist. Contracted CM Requirements * Prior Field Case Management - workers' compensation experience preferred * Active Registered nurse (R.N. License and possess the ability to be licensed as a registered nurse in multiple states without restrictions) * Understanding and working knowledge of ODG Guidelines * Seasoned professional nurse with clinical nursing experience and at least 2-years case management experience with injured workers * Understanding of case management processes * Excellent interpersonal communication skills - both oral and written * Professional certifications such as: CDMS, CRRN, COHN, or CCM are a plus Values At Charles Taylor, our values define our identity, principles and conduct. This person will demonstrate and champion Charles Taylor Values by ensuring Agility, Integrity, Care, Accountability and Collaboration. AAP/EEO Statement Here at Charles Taylor we are proud to be an Inclusive Employer. We provide an environment of mutual respect with zero tolerance to discrimination of any kind regardless of age, disability, gender identity, marital/ family status, race, religion, sex, or sexual orientation. Our external partnerships and the dedicated work we do in promoting a transparent and fair recruitment and selection process all contribute to the successful, inclusive, and diverse culture and environment which we are proud to be a part of at Charles Taylor.

Charles Taylor is a highly successful global provider of professional services to the insurance industry. We are seeking an experienced Workers Compensation Field Case Manager to join our team in the Cincinnati-North Dayton-Columbus, OH area. This is a remote, contracted role. Job Summary The Field Case Manager is responsible for assisting our clients injured workers with case management and return to work services. Essential Duties and Responsibilities Provide field case management services for our clients injured workers, including onsite attendance at doctor's appointments Perform case assessments and develop action plans to support recovery and timely return to work Coordinate timely access to needed medical services and maintain proactive communications Cultivate excellent relationships with all parties (AE's, IWs, providers, clients) Provide written reports on case status and updates (post, physician visit/weekly/monthly) and submits timely monthly billing to billing specialist. Contracted CM Requirements Prior Field Case Management - workers' compensation experience preferred Active Registered nurse (R.N. License and possess the ability to be licensed as a registered nurse in multiple states without restrictions) Understanding and working knowledge of ODG Guidelines Seasoned professional nurse with clinical nursing experience and at least 2-years case management experience with injured workers Understanding of case management processes Excellent interpersonal communication skills - both oral and written Professional certifications such as: CDMS, CRRN, COHN, or CCM are a plus Values At Charles Taylor, our values define our identity, principles and conduct. This person will demonstrate and champion Charles Taylor Values by ensuring Agility, Integrity, Care, Accountability and Collaboration. AAP/EEO Statement Here at Charles Taylor we are proud to be an Inclusive Employer. We provide an environment of mutual respect with zero tolerance to discrimination of any kind regardless of age, disability, gender identity, marital/ family status, race, religion, sex, or sexual orientation. Our external partnerships and the dedicated work we do in promoting a transparent and fair recruitment and selection process all contribute to the successful, inclusive, and diverse culture and environment which we are proud to be a part of at Charles Taylor.

Now Hiring: RN Telephonic Case Manager - Remote Work from Home - Enjoy Flexibility & Balance Salary: Competitive & commensurate with experience Quarterly Bonus Opportunities Free CEUs for licenses & certificates License & Certification Reimbursement We're looking for an RN with a passion for case management to join our team! Must hold a multi-state Nursing License Residing in a compact state National Certification preferred (CCM, CRC, COHN, CRRC) Workers' Comp Case Management experience a plus Your Impact: You'll provide effective case management services in a cost‑effective manner, delivering medical case management consistent with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines. You'll support patients/employees receiving benefits under insurance lines including Workers' Compensation, Group Health, Liability, Disability, and Care Management. This is your chance to grow your career, earn great rewards, and enjoy true work-life balance. Apply today and make an impact in the community!

🚨 Now Hiring: RN Case Manager - New York 🚨 💻 Work from home + local field travel 💰 Salary: $90,000 - $92,000 annually 🎉 Quarterly Bonus Opportunities 📚 Free CEUs for licenses & certificates 💳 License & Certification Reimbursement We're looking for an RN with a passion for case management to join our team! ✨ RN degree required ✨ National Certification preferred (CCM, CRC, COHN, CRRC) ✨ Workers' Comp Case Management experience a plus 📍 Location Requirement Candidates must be based in one of these New York areas: Poughkeepsie, Newburgh, and Middletown. ✅ Your Impact: You'll provide effective case management services in a cost‑effective manner, delivering medical case management consistent with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines. You'll support patients/employees receiving benefits under insurance lines including Workers' Compensation, Group Health, Liability, Disability, and Care Management. This is your chance to grow your career, earn great rewards, and enjoy true work-life balance. 👉 Apply today and make an impact in the community! Responsibilities Reviews case records and reports, collects and analyzes data, evaluates injured worker/disabled individual's medical status, identifies needs and obstacles to medical case resolution and RTW by providing proactive case management services. Render opinions regarding case costs, treatment plan, outcome and problem areas, and makes recommendations to facilitate case management goals to include RTW. Demonstrates ability to meet administrative requirements, including productivity, time management and QA standards, with a minimum of supervisory intervention. May perform job site evaluations/summaries to facilitate case management process. Facilitates timely return to work date by establishing a professional working relationship with the injured worker/disabled individual, physician, and employer. Coordinate RTW with injured worker, employer and physicians. Maintains contact and communicates with claims adjusters to apprise them of case activity, case direction or secure authorization for services. Maintains contact with all parties involved on case, necessary for case management the injured worker/disabled individual. May obtain records from the branch claims office. May review files for claims adjusters and supervisors for appropriate referral for case management services. May meet with employers to review active files. Makes referrals for Peer reviews and IME's by obtaining and delivering medical records and diagnostic films, notifying injured worker/disabled individual and conferring with physicians. Utilizes clinical expertise and medical resources to interpret medical records and test results and provides assessment accordingly. May spend approximately 70% of their work time traveling to homes, health care providers, job sites and various offices as required facilitating RTW and resolution of cases. Meets monthly production requirements and quality assessment (QA) requirements to ensure a quality product. Reviews cases with supervisor monthly to evaluate files and obtain directions. Upholds the Crawford and Company Code of Business Conduct at all times. Demonstrates excellent customer service, and respect for customers, co-workers, and management. Independently approaches problem solving by appropriate use of research and resources. May perform other related duties as assigned. Qualifications Associate's degree or relevant course work/certification in Nursing is required; BSN Degree is preferred. Minimum of 1-3 years diverse clinical experience and one of the below: Certification as a case manager from the URAC-approved list of certifications (preferred); A registered nurse (RN) license. Must be compliant with state requirements regarding national certifications. General working knowledge of case management practices and ability to quickly learn and apply workers compensation/case management products and services. Excellent oral and written communications skills to effectively facilitate return-to-work solutions within a matrix organization and ensure timely, quality documentation. Excellent analytical and customer service skills to facilitate the resolution of case management problems. Basic computer skills including working knowledge of Microsoft Office products and Lotus Notes. Demonstrated ability to establish collaborative working relationships with claims adjusters, employers, patients, attorneys and all levels of employees. Demonstrated ability to gather and analyze data and establish plans to improve trends, processes, and outcomes. Excellent organizational skills as evidenced by proven ability to handle multiple tasks simultaneously. Demonstrated leadership ability with a basic understanding of supervisory and management principles. Active RN home state licensure in good standing without restrictions with the State Board of Nursing. Must meet specific requirements to provide medical case management services. Minimum of 1 National Certification (CCM, CDMS, CRRN, and COHN) is preferred. If not attained, must plan to take certification exam within proceeding 36 months. National certification must be obtained in order to reach Senior Medical Case Management status. Travel may entail approximately 70% of work time. Must maintain a valid driver's license in state of residence. #LI-RG1

Why Saybrus? We strive to help employees lead fulfilling professional lives. Excellence is expected and rewarded. We believe in straightforward communication and encourage employees to share opinions and ideas. Our salaries, incentive awards and comprehensive benefits provide a highly competitive total reward package based on individual and company performance. Many of our employees work from their homes, while others are based in our Hartford, CT headquarters. Job Summary Case Managers provide new permanent product business support to key business partners. They must independently manage cases by creatively resolving issues, negotiating underwriting offers (where applicable) while leveraging contacts and resources to ensure a desired outcome. Candidates must possess a strong knowledge of the life insurance process and be able to troubleshoot problems causing cycle time delays. Responsibilities also include timely communications, assistance in gathering outstanding requirements and overall superior customer service. Case Managers are expected to utilize strong communication skills (verbal and written) to ensure cases move through the new business process in a timely manner. Case managers must work well in a team environment. This role has a direct correlation to the success of the account.Job Description Duties and Responsibilities Negotiate underwriting offers with the underwriting teams of our Product Partners as appropriate to provide best opportunity for placement. Review and assess requirements, as needed. Manage the necessary components for the new business process, identifying cases that need special handling. Manage daily workload with emphasis on time management and quality standards. Proactively follow up and provide communication to support advisor/distributor satisfaction; Ensure cases progress from submission to placement in a timely/efficient manner with superior service. Ensure policy issuance within required timeline. Use expertise in Life insurance process, terminology, technology to support and enhance daily operations. Accept ownership and suggest innovative solutions to meet branch/client needs while undertaking new and different requests. Explore opportunities to add value. Ensure delivery requirements and payments for issued contracts are received in a timely manner. Serve as a single point of contact to customers. Receive and resolve complex and/or sensitive customer service inquiries, complaints and problems with quality, accuracy, and in a timely manner. Proactively resolve any issues and inquiries. Provide continuous scheduled telephone coverage as business needs dictate. May be responsible for employee training and mentoring. Perform other duties as assigned Knowledge, Skills and Abilities Minimum 5 years of experience with knowledge of the life insurance process for permanent products, including key impairments. Working knowledge of desktop applications such as Outlook, Word and Excel. Knowledge of Smart Office and Salesforce.com a plus. Critical thinking skills with the ability to identify and troubleshoot problems, and comfort with cases involving a high degree of complexity. Excellent verbal and written communication skills; clear and effective. Excellent interpersonal and relationship building skills to interact with internal and external clients. Discretion while handling confidential matters (e.g., medical records). Ability to work independently in a fast-paced, multi-faceted environment while focusing on critical deliverables. Comfortable in a team environment and supportive of corporate change. Equal Employment Opportunity Statement We are an Equal Opportunity Employer and value diversity at all levels of the organization. All employment decisions are made without regard to race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), sexual orientation, gender identity or expression, age, national origin, ancestry, disability, genetic information, marital status, veteran or military status, or any other protected characteristic under applicable federal, state, or local law. We are committed to providing an inclusive, equitable, and respectful workplace where all employees can thrive. Americans with Disabilities Act (ADA) Statement We are committed to full compliance with the Americans with Disabilities Act (ADA) and all applicable state and local disability laws. Reasonable accommodations are available to qualified applicants and employees with disabilities throughout the application and employment process. Requests for accommodation will be handled confidentially. If you require assistance or accommodation during the application process, please contact us at ****************. Pay Transparency Statement We are committed to pay transparency and equity, in accordance with applicable federal, state, and local laws. Compensation for this role will be determined based on skills, qualifications, experience, and market factors. Where required by law, the pay range for this position will be disclosed in the job posting or provided upon request. Additional compensation information, such as benefits, bonuses, and commissions, will be provided as required by law. We do not discriminate or retaliate against employees or applicants for inquiring about, discussing, or disclosing their pay or the pay of another employee or applicant, as protected under applicable law. Pay ranges are available upon request. Background Screening Statement Employment offers are contingent upon the successful completion of a background screening, which may include employment verification, education verification, criminal history check, and other job-related inquiries, as permitted by law. All screenings are conducted in accordance with applicable federal, state, and local laws, and information collected will be kept confidential. If any adverse decision is made based on the results, applicants will be notified and given an opportunity to respond.

**Join Our Behavioral Health Transition of Care Team\!** We're seeking a dedicated **Care Manager** to support BlueCare members during critical transitions\. In this role, you'll work closely with local Acute Inpatient Psychiatric facility in the Murfreesboro area, to collaborate with treatment teams and assist with discharge planning\. You'll help members navigate next steps, whether finding appropriate care after discharge or accessing behavioral health resources and provide telephonic follow\-up to ensure continuity of care post\-discharge\. It's important to note that the caseload is fluid, adapting to changes in facility admissions and referrals, and so schedule changes are a possibility\. Comprehensive training and shadowing will set you up for success in this rewarding role\! Please note: Due to location requirements, candidates must be within 25 miles of Murfreesboro, Tennessee\. **What You'll Do** + Conduct **onsite visits** to local Acute Inpatient Psychiatric facility in the Murfreesboro area\. This is at a minimum of twice weekly to support discharge planning\. + Participate in **treatment team meetings** , sharing insights on member cases and collaborating on care strategies\. + Assist members in **finding appropriate care or resources** post\-discharge, including behavioral health services\. + Provide **telephonic follow\-up** to ensure members have what they need for successful recovery\. + Maintain a caseload while balancing onsite visits and remote support\. + Collaborate with providers and internal teams to meet member needs and resolve challenges\. **Ideal Preferences** + Ability to **adapt to change** in a fast\-paced environment\. + **Assertive communicator** who speaks up when support or process improvements are needed\. **Job Responsibilities** + Supporting utilization management functions for more complex and non\-routine cases as needed\. + Serving as a liaison between members, providers and internal/external customers in coordination of health care delivery and benefits programs\. + Overseeing highly complex cases identified through various mechanisms to ensure effective implementation of interventions, and to ensure efficient utilization of benefits\. + Performing the essential activities of case management: assessment: planning, implementation, coordinating, monitoring, outcomes and evaluation\. + Perform case management activities in community settings including face to face with members as required\. + Various immunizations and/or associated medical tests may be required for this position\. + Testing/Assessments will be required for Digital positions\. **Job Qualifications** _License_ + Current, active unrestricted Tennessee license in Nursing \(RN\) or behavioral health field \(Master's level or above\) \(Ph\.D\., LCSW/LMSW, LLP, MHC, LPC, etc\.\) required\. RN may hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law\. _Experience_ + 3 years \- Clinical behavioral health / substance use disorder experience required + 1 year \- Must be knowledgeable about community care resources and levels of behavioral health care available\. _Skills\\Certifications_ + Proficient in Microsoft Office \(Outlook, Word, Excel and PowerPoint\) + Independent, Sound decision\-making and problem\-solving skills + Excellent oral and written communication skills + Strong interpersonal and organizational skills + Strong analytical skills + Positive relationship building skills and ability to engage and motivate health behaviors in diverse populations + Ability to quickly identify and prioritize member needs and provide structured and focused support and interventions + Experience with Motivational Interviewing Techniques and Adult Learning Styles **Number of Openings Available** 1 **Worker Type:** Employee **Company:** VSHP Volunteer State Health Plan, Inc **Applying for this job indicates your acknowledgement and understanding of the following statements:** BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin,citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law\. Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page: BCBST's EEO Policies/Notices \(****************************************************************** **BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity\. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via\-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered\. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means\.** As Tennessee's largest health benefit plan company, we've been helping Tennesseans find their own unique paths to good health since 1945\. More than that, we're your neighbors and friends - fellow Tennesseans with deep roots of caring tradition, a focused approach to physical, financial and community good health for today, and a bright outlook for an even healthier tomorrow\. At BCBST, we empower our employees to thrive both independently and collaboratively, creating a collective impact on the lives of our members\. We seek talented individuals who excel in a team environment, share responsibility, and embrace accountability\. We're also seeking candidates who are proficient in the Microsoft Office suite, including Microsoft Teams, organized, and capable of managing multiple assignments or projects simultaneously\. Additional, strong interpersonal abilities along with strong oral and written communication skills are important across all roles at BCBST\. BCBST is a remote\-first organization with many employees working primarily from their homes\. Each position within the company is classified as either fully remote, partially remote, or office based\. BCBST hires employees for remote positions from across the U\.S\. with the exception of the following states: California, Massachusetts, New Hampshire, New Jersey, and New York\. Applicants living in these states may move to an approved state prior to starting a position with BCBST at their own expense\.If the position requires the individual to reside in Chattanooga, TN, they may be eligible for relocation assistance\.

Why Saybrus? We strive to help employees lead fulfilling professional lives. Excellence is expected and rewarded. We believe in straightforward communication and encourage employees to share opinions and ideas. Our salaries, incentive awards and comprehensive benefits provide a highly competitive total reward package based on individual and company performance. Many of our employees work from their homes, while others are based in our Hartford, CT headquarters. Job Summary Saybrus Partners is looking for a self-motivated individual for the role of Case Manager, a critical role in the success of Saybrus' life insurance distribution strategy. Case Managers provide new business support to key business partners. They must independently manage cases by creatively resolving issues, negotiating underwriting offers (where applicable) while leveraging contacts and resources to ensure a desired outcome. Candidates must possess a strong knowledge of the life insurance process and be able to troubleshoot problems causing cycle time delays. Responsibilities also include timely communications, assistance in gathering outstanding requirements and overall superior customer service. Case Managers are expected to utilize strong communication skills (verbal and written) to ensure cases move through the new business process in a timely manner. Case managers must work well in a team environment. This role has a direct correlation to the success of the account.Job Description Principal Duties and Responsibilities Proactively follow up and provide communication to support advisor/distributor satisfaction and understanding; ensure cases progress from submission to placement in a timely/efficient manner with superior service. Manage daily workload with emphasis on time management and quality standards. Review and assess requirements, as needed. Serve as a single point of contact to customers. Receive and resolve complex and/or sensitive customer service inquiries, complaints and problems with quality, accuracy, and in a timely manner. Proactively resolve any issues and inquiries. Manage the necessary components for the new business process, identifying cases that need special handling. Accept ownership and suggest innovative solutions to meet branch/client needs while undertaking new and different requests. Explore opportunities to add value. Use expertise in life insurance process, terminology, technology to support and enhance daily operations. Negotiate underwriting offers with the underwriting teams of our Product Partners as appropriate to provide best opportunity for placement. Provide continuous scheduled telephone coverage as business needs dictate. May be responsible for employee training and mentoring. Perform other duties as assigned Knowledge, Skills and Abilities Knowledge of the life insurance process (permanent and term products), including key impairments Working knowledge of desktop applications such as Outlook, Word and Excel. Knowledge of Smart Office and Salesforce.com a plus. Critical thinking skills with the ability to identify and troubleshoot problems, and comfort with cases involving a high degree of complexity. Excellent verbal and written communication skills; clear and effective Excellent interpersonal and relationship building skills to interact with internal and external clients Discretion while handling confidential matters (e.g., medical records) Ability to work independently in a fast-paced, multi-faceted environment while focusing on critical deliverables Comfortable in a team environment and supportive of corporate change

Our Case Managers play a vital role in the satisfaction of our clients, guiding them through the insurance process, listening to them, and addressing their needs. They demonstrate knowledge and compassion and thrive in a fast-paced environment, helping clients protect their families. Why Zander? Right now, most of us are looking for stability - and that's just what you get at Zander. We're a family-and-employee-owned agency that has been in business for nearly 100 years, hold the 20-year endorsement of Dave Ramsey, and are a debt-free company. What we have to offer: Health and dental insurance paid 100% by Zander Meaningful work protecting families Employee Stock Ownership Plan after one year Industry-leading compensation including base salary plus bonuses 5% dollar-for-dollar matching on your 401(k) Generous paid time off Growth and leadership opportunities - we promote from within And much more! Your role in protecting families will include: Answering incoming calls Making outbound follow-up calls Working as the guide through the insurance process Meeting weekly metrics Who you are: You have a great attitude and the heart of a teacher You thrive in a fast-paced environment You are reliable, adaptable, and compassionate You have basic knowledge of Microsoft Office programs You have a typing speed of at least 40wpm You have inbound and outbound call experience and can handle high call volume You have the ability to work from home ESSENTIAL FUNCTIONS: These essential functions are representative of those that must be met by an employee to successfully perform the physical aspects of the job. Reasonable accommodation may be made to enable individuals with disabilities to perform these essential functions. Use of office equipment including personal computer, multiple screens, printer, fax machine, scanner and telephone; The employee is occasionally required to use hands and fingers to operate, handle, and reach; Specific vision abilities required by this job include close vision and the ability to adjust focus; Communicate effectively in English, writing and verbally in person, via email and via telephone; Communicate effectively via telephone for extended periods of time, up to 7 hours per day; Ability to pay attention, listen actively, analyze problems and evaluate options, focused on task, multi-task, decision making, and engage appropriately; Ability to appropriately handle stress in a fast-paced environment and interact appropriately with others; Sit & stand for extended periods of time up to 7 hours per day; Must be able to walk up and down stairs (there are no elevators in the 2-story main office building); Physical, consistent attendance during normal working hours within a standard 40-hour workweek, as many of the job duties are time sensitive and most effectively and efficiently resolved only through required immediate communication; additional hours may be required; The noise level in the work environment is usually moderate to loud. WE ARE AN EQUAL OPPORTUNITY EMPLOYER Applicants are considered for position and are evaluated without regard to mental or physical disability, race, religion, sexual orientation, color, gender, national origin, age, marital status, military or veteran status or any other protected local, state or federal status unrelated to the performance of the work involved. COMMUNICATION NOTICE As part of our hiring process, we may contact candidates by text message for interview reminders or scheduling updates. By applying, you consent to receiving job related text messages from Zander Insurance. If you prefer not to receive texts, you can reply STOP at any time to opt out.

The Medical Case Management Manager (Manager, Enhanced Case Management (ECM)) leads the development, delivery, and continuous improvement of the ECM program, ensuring high quality care coordination and advocacy for member with complex health needs. This role provides direct leadership and mentorship to the ECM team, evaluates and enhances departmental workflows, and fosters strong internal and external partnerships through exceptional communication and relationship building skills. The Manager maintains expertise in self funded benefits administration and government programs such as Medicare and Medicaid to guide members in understanding and optimizing their available coverage options. In addition to managing a limited caseload, the position addresses client inquiries, resolves member escalations, and collaborates with organizational leadership to strengthen program strategy, performance, and impact. ESSENTIAL FUNCTIONS Develops and directly manages Enhanced Case Management Advocates and Supervisors, while providing indirect oversight to the Case Managers through supervisory staff. Monitors department dashboards and conducts case audits to ensure teams consistently meet or exceed quality standards and KPIs. Fosters a collaborative, continuous improvement environment and supports staff in resolving challenges and enhancing performance through constructive, supportive feedback. Engage with the Client Management and Value Team to offer insight related to high-dollar claimants and provide a clear explanation of ECM strategies, efforts, and impact. Identify members from our ASO Self-Funded and Co-Sourcing Partially Self-Funded Clients based on current medical condition(s), future claim costs, and current financial assessment for Enhanced Case Management evaluation and identify strategic solutions. Maintain continuous knowledge of Medicare, Medicaid, and other government programs, including application processes, eligibility criteria, dual eligibility, and coordination of benefits (COB). Identify trends and opportunities to collaborate with Medical Management leadership to enhance processes and strategies to improve quality, efficiency, and outcomes. Manage a case load of high-complexity members to support their needs, evaluate coverages and offer resources. Promotes an environment of continuous improvement and collaboration and assists in troubleshooting and resolving escalated challenges quickly by utilizing an empathetic approach. Coordinate with Client Management and other internal departments to answer questions and resolve client challenges. Assist in selecting and building the right teams to meet long-term talent planning needs and achieve business goals. Lead, coach, motivate and develop. Responsible for one-on-one meetings, performance appraisals, growth opportunities and attracting new talent. Clearly communicate expectations, provide employees with the training, resources, and information needed to succeed. Actively engage, coach, counsel and provide timely, and constructive performance feedback. Performs other related duties as assigned. EDUCATION Bachelor's degree or equivalent work experience required. EXPERIENCE AND SKILLS At least 5 years of Case Management experience, preferably from a third-party administrator, carrier, or within the healthcare industry required. At least 3 years at a supervisor level and successfully demonstrated leadership competencies required. Demonstrated expertise in Medicaid, Medicare, eligibility processes, and coordination of benefits. Experience managing teams of employees with a variety of backgrounds and tenure. Ability to monitor and prioritize multiple deadlines and projects simultaneously. Experience reading, analyzing, and reviewing organizational metrics and data, preferred. Comfortable managing competing priorities and guiding others in a fast-paced environment. Excellent written and verbal communication skills with the ability to influence cross-functionally and present to clients/leadership Proven experience building training programs, conducting audits, and providing structured feedback. POSITION COMPETENCIES Accountability Communication Action Oriented Timely Decision Making Building Relationships/Shaping Culture Customer Focus PHYSICAL DEMAND This is a standard desk role long periods of sitting and working on a computer are required. WORK ENVIRONMENT Remote Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive. The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life & Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend. Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time. All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process. It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role. Protect Yourself from Hiring Scams Important Notice About Our Hiring Process To keep your experience safe and transparent, please note: All interviews are conducted via video. No job offer will ever be made without a video interview with Human Resources and/or the Hiring Manager. If someone contacts you claiming to represent us and offers a position without a video interview, it is not legitimate. We never ask for payment or personal financial information during the hiring process. For your security, please verify all job opportunities through our official careers page: Current Career Opportunities at Allied Benefit Systems Your security matters to us-thank you for helping us maintain a fair and trustworthy process!

An ECM Coordinator supports department staff with administrative tasks related to a member's medical condition(s), department case work, communication with internal and external stakeholders, and manage audits. This role will engage with members to offer support and resources related to their medical condition(s) through Allied Care. ESSENTIAL FUNCTIONS Facilitate reviews, referrals, and outreach for referral-based proprietary strategies as well as engaging with members across Medical Management products Document all engagement accurately and concisely within the Microsoft Customer Relationship Management (CRM) system Manage escalated and time sensitive case management questions received from members, broker relationships, and internal and external Allied stakeholders Collaborate with strategic vendor partners to provide supportive services and support to members Lead and facilitate claims auditing in conjunction with ECM Coordinators. Complete department auditing related to daily tasks to ensure accuracy and identify escalations Identify impactful scenarios through appropriate closing summaries in timely fashion. Share impactful scenarios with the department's leadership team to deliver to internal departments, such as Sales, Operations, and Executive leadership Identifying escalations for department leadership team, as appropriate Other duties as assigned EDUCATION Bachelor's Degree or equivalent work experience, required EXPERIENCE AND SKILLS At least 3-5 years of administrative support experience required. Focus on patient-provider engagement, needs assessments, coordination of care, and or patient treatment adherence within the healthcare or social service industry preferred Understanding of intermittent medical terminology such as CPT, HCPC, and diagnostic codes Understanding of basic benefit plan design terminology such as deductible, out-of-pocket, prescription drugs, physical medicine services, etc. Strong verbal and written communication skills Strong analytical and problem-solving skills COMPETENCIES Communication Customer Focus Accountability Functional/Technical Job Skills PHYSICAL DEMANDS This is a standard desk role - long periods of sitting and working on a computer are required. WORK ENVIROMENT Remote Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive. The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life & Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend. Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time. All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process. It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role. Protect Yourself from Hiring Scams Important Notice About Our Hiring Process To keep your experience safe and transparent, please note: All interviews are conducted via video. No job offer will ever be made without a video interview with Human Resources and/or the Hiring Manager. If someone contacts you claiming to represent us and offers a position without a video interview, it is not legitimate. We never ask for payment or personal financial information during the hiring process. For your security, please verify all job opportunities through our official careers page: Current Career Opportunities at Allied Benefit Systems Your security matters to us-thank you for helping us maintain a fair and trustworthy process!

Hi, we're Oscar. We're hiring a Case Management Nurse to join our Case Mangement team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves-one that behaves like a doctor in the family. About the role: You will educate members on improving health outcomes, assist with transitions from care settings, participate in process improvement and other pilot programs as they arise, and work with support teams to ensure exceptional care for our members. You will report into the Associate Director, Clinical. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role is: $39.28 - $45.94 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year. Responsibilities: Assist in the coordination of care across a variety of settings (inpatient, outpatient, post acute, ER, home care) Actively reach out to members undergoing difficult health challenges and develop care plans Proactively reach out to hospital case managers to assist with discharge planning Communicate with members via phone or secure messaging to provide education on health conditions, new medications, and procedures. Compliance with all applicable laws and regulations Other duties as assigned Requirements: Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate unrestricted RN license Ability to obtain additional state licenses to meet business needs 2+ years of clinical experience to include payer, hospital, outpatient or community based care management 1+ years of experience in Care Coordination and Navigation Bonus points: CCM Certification Bilingual in Spanish and/or creole reading, writing, speaking BSN Working knowledge of Milliman Guidelines This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

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 170 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 and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. Salary Range $104,000.00 - $171,700.00 Target Openings 1 What Is the Opportunity? This role is eligible for a sign on bonus up to $20,000. Be the Hero in Someone's Story When life throws curveballs - storms, accidents, unexpected challenges - YOU become the beacon of hope that guides our customers back to stability. At Travelers, our Claims Organization isn't just a department; it's the beating heart of our promise to be there when our customers need us most. As a Major Case Specialist, you are responsible for investigating, evaluating, reserving, negotiating, and resolving complex, serious and severe claims typically with full damage value for average claim $500,000 to over a multi-million dollar value. You will serve as an expert technical resource to claim professionals, business partners, customers, and other stakeholders. What Will You Do? * Oversee major General Liability claims from initiation to resolution, ensuring compliance with company policies and industry regulations. * Conduct detailed investigations to gather evidence, assess liability and determine extent of damages. * Evaluate claim information and documentation to make informed decisions regarding coverage and settlement. * Engage in negotiations with claimants, legal representatives, and other parties to achieve fair and equitable settlements. * Maintain comprehensive and accurate records of all claim activities, communications, and decisions. * Prepare and present detailed reports on claim status, trends and outcomes to senior management. * Work closely with legal, underwriting, and other departments to ensure coordinated claim handling. * Apply litigation management strategies through the selection of counsel and evaluation. * In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated. What Will Our Ideal Candidate Have? * Bachelor's Degree. * Ten years of experience in handling major General Liability claims and managing litigation and complex negotiations. * Extensive claim and/or legal experience and technical expertise to evaluate severe and complex claims. * Able to make independent decisions on most assigned cases without involvement of management. * Thorough understanding of business line products, policy language, exclusions, and ISO forms. * Demonstrated ability of strategic claims handling practices. * Strong written and verbal communication skills with the ability to understand, synthesize, interpret, and convey information in a simplified manner. * Familiarity with industry regulations and legal requirements specific to XX insurance. * Ability to work independently and manage multiple high-value claims simultaneously. What is a Must Have? * High School Degree or GED required with a minimum of 4 years bodily injury litigation claim handling or comparable claim litigation experience. What Is in It for You? * Health Insurance: Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment. * Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers. * Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. * Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs. * Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice. Employment Practices Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit *********************************************************

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide. Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities. Job Description: The opportunity Short-Term Disability insurance provides an income to employees who cannot work due to an illness or injury. As a Case Specialist, you will review claims for Short-Term Disability and decide if the person applying for benefits are eligible to receive them. Some claims are easy, some are more complex. But all claims give you the opportunity to interact and make a difference for our Clients daily. How you will contribute * Review claim forms to make sure the person applying for benefits meets all the requirements to receive benefits, including their medical condition, the recommendations of their health care providers, and the details of the short-term disability contract. * Approve the benefits if the person meets all these requirements. * Process these claims in a timely manner with accuracy. * Serve our clients in a caring and empathetic manner, communicating clearly with them the decisions you make. * Reach out to employees, employers, health care providers, attorneys, and anyone else as needed to get the paperwork or information you need to make a decision. * Make sure all your claim decisions match the insurance contract and follow all laws, regulations, and procedures. What you will bring with you * Passion for helping people, especially in times of need due to illness or injury. * Your desire and ability to provide superior service and build positive relationships. * Independent thinking and decision-making skills to support payment of benefits. * Your energy to thrive in a fast-paced environment. * Drive to continuously learn, build, and grow professionally. * The ability to adapts well to change and execute on new concepts. * Insurance claims experience is not a requirement. Salary Range: $49,400 - $66,700 At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions. Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you! We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds. Life is brighter when you work at Sun Life At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities. We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email ************************* to request an accommodation. For applicants residing in California, please read our employee California Privacy Policy and Notice. We do not require or administer lie detector tests as a condition of employment or continued employment. Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Job Category: Claims - Life & Disability Posting End Date: 29/01/2026

Organization Description No Cold Calling Unique Sales Opportunity Are you someone who has the ambition and drive to earn 100000year but lacks the right opportunity Are you accountable coachable and possess a positive mental attitude If you are that person then we are looking for you OurAgency specializes in selling mortgage protection life insurance to homeowners final expense and retirement planning Job DetailsFull Time or Part Time Commission Only We are actively hiring LICENSED and NON LICENSED AGENTS who have strong SALES andor TEAM BUILDING backgrounds to join our team We will train you from beginning to end on how to be successful in our industry using our simple step by step selling system Many of our top agents are currently on track to make over 200000as a licensed agent If you are not licensed yet we can help point you in the right direction to become a licensed agent before you can be officially hired You must be a US citizen in order to apply Responsibilities We provide The ability to build your own business and earn a PASSIVE INCOME Ability to transfer ownership of your business & passive income to loved ones in the event of death An Equity Bonus in which you receive a percentage of our total monthly net sales The Best Compensation in the Industry with Performance Based Increases MARKETOur niche marketing company is a national agency that specializes in the sale of needed life insurance products designed to protect mortgages for families with average incomes and health We serve middle class Hawaii and mainland families who would like us to show them options for mortgage protection life insurance that will pay off their mortgage in the event of a death disability or illness Our firm specializes in producing the highest quality real time direct mail exclusive leads These homeowners provide us with some personal information such as height weight home number cell number who to call and when to call in order for us to better assist them As a matter of fact on average our agents currently close 50 of the leads they purchase These respondents are the gold mine of insurance sales Imagine having a steady stream of clients to contact who are expecting your call and know why you are calling At our Agency we generate our own high quality direct mail leads coupled with high compensation But we are not just about leads We have a myriad of lead systems training platforms and advanced training for our valued Agents We work with over 40 TOP rated insurance companies that have a variety of high quality products that will position you for a GREAT long termcareer with us Your success is as good as our leads and system We provide the best REAL time leads and customized mailings for ALL agents Leads are exclusively provided to oursales force Our leads average a 50 conversion ratio Superior training utilizing a selling system that has been validated over and over Daily and weekly support that consist of conference calls webinars conferences and local training RequirementsRequiredLicense we will help you get your license You must have your own life insurance license and E&O coverage or be able to pass a state exam to obtain one If you are confident passionate personable and coachable then this is an opportunity that will exceed all expectations Sales experience is always welcomed; however its not a must as our free training and coaches are all part of the system This is a commission based job If you are interested you will be expected to schedule a phone interview as soon as you apply and be on time for that appointment Once you apply you will receive an email and a text with instructions as to what we want you to do before you click on the link to schedule your phone interview We normally fill our positions within 48 hours of posting so if you feel this is for you please apply now by using this link httpscalendlycomnicholaskeahiho15min I look forward to our call Nicholas Keahi Ho Agency Owner & Recruiter No agents success earnings or production results should be viewed as typical average or expected Not all agents achieve the same or similar results and no particular results are guaranteed Your level of success will be determined by several factors including the amount of work you put in your ability to successfully follow and implement our training and sales system and engage with our lead system and the insurance needs of the customers in the geographic areas in which you choose to work