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  • Experienced Claims Specialist

    Geico 4.1company rating

    Remote or Tampa, FL job

    At GEICO, we offer a rewarding career where your ambitions are met with endless possibilities. Every day we honor our iconic brand by offering quality coverage to millions of customers and being there when they need us most. We thrive through relentless innovation to exceed our customers' expectations while making a real impact for our company through our shared purpose. When you join our company, we want you to feel valued, supported and proud to work here. That's why we offer The GEICO Pledge: Great Company, Great Culture, Great Rewards and Great Careers. What Makes This Opportunity Exciting? Are you a seasoned professional with a track record in insurance claims? As an Experienced Claims Specialist at GEICO, you'll leverage your expertise to manage cases and contribute to your team's success. You'll be at the heart of our commitment to outstanding customer service. You'll manage multiple steps impacting the claims life cycle, providing guidance, support, and solutions to policyholders during times of uncertainty. Your expertise and compassion will make a meaningful impact on their lives while contributing to GEICO's reputation for excellence. Claims Processing: Efficiently and accurately handle insurance claims, ensuring adherence to company policies and procedures. Customer Service: Communicate professionally and empathetically with customers, addressing concerns and questions about their claims. Investigation: Conduct thorough investigations to determine the extent of coverage and assess any potential fraud. Meaningful Impact: Make a real difference by resolving issues and enhancing customer satisfaction. Workplace Flexibility: After completing a comprehensive 5-month in-office training and orientation, transition to a hybrid work model with the best of both worlds-spend 80% of your time in the office and 20% working remotely. Plus, take advantage of the GEICO Flex Program, which offers up to four additional weeks of remote work annually for even greater flexibility. Professional Growth: Access GEICO's industry-leading training programs and development opportunities: Continuing education at no cost to you. Leadership development programs and hundreds of eLearning courses to enhance your skills. Access to GEICO Strive Program, providing associates with tuition assistance and access to high-quality education to advance their career. Incentives and Recognition: Pay Transparency: The starting salary for an Experienced Claims Specialist is between $31.62 per hour / $63,714 annually and $33.11 per hour / $66,736 annually. Sign-On Bonuses: $1,500 for active Florida All-Lines Adjuster License (6-20). Evening Shift Differentials: Earn a +10% pay differential for eligible shifts. Weekend Shift Differentials: Earn a +20% pay differential for eligible shifts. Additional Perks: Health & Wellness: Comprehensive healthcare and well-being support available on Day 1. 401(k) Match: From day one, you'll be automatically enrolled in our 401(k) plan with a 6% pre-tax contribution. We match 100% of your contributions, up to 6% of your eligible earnings, with employer contributions added to your account each paycheck and vesting immediately. What We're Looking For: A passion for providing outstanding customer service. Strong interpersonal, communication, and problem-solving skills. Adaptability and attention to detail in a dynamic environment. 2+ years of prior claims experience in the insurance industry. Active Florida All-Lines Adjuster License (6-20) required. High School Diploma required, College degree (2-4 year) preferred. Ability to prioritize and multi-task, while navigating through multiple business applications. Computer proficiency, including familiarity with Microsoft Office Suite. Flexibility to work evenings, weekends, and holidays as needed. #geico600 At this time, GEICO will not sponsor a new applicant for employment authorization for this position. The GEICO Pledge: Great Company: At GEICO, we help our customers through life's twists and turns. Our mission is to protect people when they need it most and we're constantly evolving to stay ahead of their needs. We're an iconic brand that thrives on innovation, exceeding our customers' expectations and enabling our collective success. From day one, you'll take on exciting challenges that help you grow and collaborate with dynamic teams who want to make a positive impact on people's lives. Great Careers: We offer a career where you can learn, grow, and thrive through personalized development programs, created with your career - and your potential - in mind. You'll have access to industry leading training, certification assistance, career mentorship and coaching with supportive leaders at all levels. Great Culture: We foster an inclusive culture of shared success, rooted in integrity, a bias for action and a winning mindset. Grounded by our core values, we have an an established culture of caring, inclusion, and belonging, that values different perspectives. Our teams are led by dynamic, multi-faceted teams led by supportive leaders, driven by performance excellence and unified under a shared purpose. As part of our culture, we also offer employee engagement and recognition programs that reward the positive impact our work makes on the lives of our customers. Great Rewards: We offer compensation and benefits built to enhance your physical well-being, mental and emotional health and financial future. Comprehensive Total Rewards program that offers personalized coverage tailor-made for you and your family's overall well-being. Financial benefits including market-competitive compensation; a 401K savings plan vested from day one that offers a 6% match; performance and recognition-based incentives; and tuition assistance. Access to additional benefits like mental healthcare as well as fertility and adoption assistance. Supports flexibility- We provide workplace flexibility as well as our GEICO Flex program, which offers the ability to work from anywhere in the US for up to four weeks per year. The equal employment opportunity policy of the GEICO Companies provides for a fair and equal employment opportunity for all associates and job applicants regardless of race, color, religious creed, national origin, ancestry, age, gender, pregnancy, sexual orientation, gender identity, marital status, familial status, disability or genetic information, in compliance with applicable federal, state and local law. GEICO hires and promotes individuals solely on the basis of their qualifications for the job to be filled. GEICO reasonably accommodates qualified individuals with disabilities to enable them to receive equal employment opportunity and/or perform the essential functions of the job, unless the accommodation would impose an undue hardship to the Company. This applies to all applicants and associates. GEICO also provides a work environment in which each associate is able to be productive and work to the best of their ability. We do not condone or tolerate an atmosphere of intimidation or harassment. We expect and require the cooperation of all associates in maintaining an atmosphere free from discrimination and harassment with mutual respect by and for all associates and applicants.
    $63.7k-66.7k yearly Auto-Apply 3d ago
  • Director of Microsoft Service Engagement

    Oscar 4.6company rating

    Remote or Phoenix, AZ job

    Oscar is working with a leading IT consulting organization that is looking for an experienced Director of Microsoft Engagement to join their team. We are looking for an energetic, visionary leader to oversee and expand our Microsoft services portfolio, with an emphasis on Azure and Microsoft 365. This Director-level position is responsible for elevating our Microsoft practice-driving revenue growth, increasing certification attainment, advancing technical capabilities, and strengthening our standing within the Microsoft partner ecosystem. The ideal candidate combines strategic thinking, business development expertise, marketing awareness, and technical fluency to transform a growing practice into a top-tier Microsoft partnership. Key Responsibilities: Guide the overall direction, expansion, and operational success of the Azure and M365 services practice. Create and execute 1-year and 3-year plans that align with corporate goals and market opportunities. Identify new service opportunities and emerging trends within the Microsoft ecosystem. Partner with Sales and Marketing to develop targeted go-to-market strategies. Work closely with prospects to understand their business objectives and translate them into clear solution requirements and product specifications. Offer expert guidance on solution architecture, implementation strategies, and integration of our software and blockchain-driven technologies. Partner with product, engineering, and sales teams to design tailored solutions that meet customer needs. Respond to technical RFPs, develop solution proposals, and assist in planning and executing proof-of-concept (POC) engagements. Streamline and enhance presales and service delivery processes. Qualifications: 7+ years of leadership experience within a technology services or consulting environment. Demonstrated success scaling an Azure and/or Microsoft 365 practice. Strong understanding of Microsoft Partner Center, CSP programs, and managed services operations. Proven ability to develop business, build client relationships, and influence stakeholders. Experience creating and implementing sales enablement and training programs. Strong foundation of Microsoft certifications (personally or within teams). Strong analytical and reporting skills, with experience presenting to executive leadership. Ability to travel for client meetings and Microsoft events. Recap: Location: Fully Remote Type: Full time Permanent Rate: $150k - $170k annual base salary dependent on relevant experience If you think you're a good fit for the role, we'd love to hear from you!
    $150k-170k yearly 3d ago
  • Product Configuration Analyst

    Tokio Marine Highland 4.5company rating

    Remote or Chicago, IL job

    Product Configuration Analyst: Sapiens Products The Configuration Analyst will be responsible for configuring, maintaining, and supporting Sapiens PolicyPro, BillingPro, ProducerPro, AuthorityPro, and ClaimsPro software solutions to meet business requirements. This role serves as a key liaison between business users, IT, and the Sapiens technical team, ensuring that system configurations deliver optimal performance and align with organizational objectives. The ideal candidate will possess a strong understanding of insurance processes, excellent analytical skills, and hands-on experience with Sapiens platforms. Key Responsibilities In collaboration with the Director of Solutions Delivery, analyze business requirements and translate them into Sapiens system configurations and solutions. Work closely with business stakeholders, Solutions Delivery Leads, and the broader IT team to document configuration specifications based on documented business requirements. Design, test, implement, and maintain configuration changes in Sapiens software to support business operations and process improvements. Troubleshoot and resolve configuration-related issues, providing timely support to end-users and technical teams. Document configuration procedures, changes, and system enhancements for future reference and compliance. Assist in system upgrades and integration projects as needed. Stay updated with Sapiens product improvements, best practices, and industry trends to ensure system configurations remain current and effective. Required Qualifications Bachelor's degree in Information Technology, Computer Science, Business, or a related field (or equivalent experience). At least five(5) years experience working in a technical capacity with Sapiens CoreSuite for North America or a similar application, including an understanding of the data model, configuration version management principles, and familiarity with co-configuration/co-development practices. Strong XSLT experience and comfort working with application integrations and external APIs. Creative problem-solving skills and a drive to examine the end-to-end impacts when analyzing reported issues and requested enhancements. Understanding of insurance or financial services processes and terminology. Proficiency in analyzing business needs and configuring enterprise software solutions. Excellent problem-solving, analytical, and communication skills, including the ability to communicate not just the “what,” but the “how” and the “why” of system behaviors. Ability to work collaboratively in a team environment and manage multiple priorities. Willingness to complete configuration/design reviews and provide guidance to junior configurators and other members of the Solutions Delivery team. Preferred Qualifications Experience with business process mapping and documentation. Solid understanding of the BillingPro and/or ClaimsPro application architecture and core functionality, including asynchronous processing. Knowledge of SQL, XML, or other data management/query tools. Comfort acting in a consultative role when working with stakeholders; a willingness to challenge assumptions and ensure the implications of changes are fully understood before implementing. Work Environment & Reporting This hybrid position is based in Chicago, IL or Frisco, TX, and reports to the Director of Solutions Delivery. A fully remote arrangement based outside of these areas may be considered for the right candidate. The role may require occasional travel or after-hours support during critical deployments or issue resolution. About Tokio Marine Highland Tokio Marine Highland Insurance Services (TMH) is a leading property and casualty underwriting agency. We offer a broad suite of tailored specialty risk management solutions, including private flood, fine art and lender-placed products. At TMH, it's all about our clients. Nationwide, our customers rely on our trusted, industry-leading coverages, supported by compliance expertise, superior claims management and the highest caliber of service. Founded in 1962, TMH is a wholly owned company of Tokio Marine Kiln, one of the largest carriers in the Lloyd's of London insurance market and a member of the Tokio Marine Group. TMH has operating centers in Chicago, Il, Frisco, Texas, Miami, Fla., and South Pasadena, Calif. If you're looking to advance your career, TMH is the perfect professional home. At TMH, you'll have a chance to innovate with the world's leading businesses, put your expertise into action on major projects, and work on game-changing initiatives. You'll also make long-lasting professional connections through sharing different perspectives, and you'll be inspired by the best. Tokio Marine Highland, LLC (TMH) is an Equal Opportunity Employer. TMH's success depends heavily on the effective utilization of qualified people, regardless of their race, ancestry, religion, color, sex, national origin, sexual orientation, gender identity and/or expression, disability, veteran status, or any characteristic protected by law. As a company, we adhere to and promote equal employment opportunities for all. Consistent with the Americans with Disabilities Act (ADA) and applicable state and local laws, it is TMH's policy to provide reasonable accommodation when requested by qualified individuals with disabilities during the recruitment process, unless such accommodation would cause an undue hardship. To make an accommodation request, please contact *****************************.
    $84k-120k yearly est. 2d ago
  • Lead Distribution Sales Consultant - Supplemental Health Products - Remote

    Mutual of Omaha 4.7company rating

    Remote or Omaha, NE job

    Work Type: Full Time Regular Application Closes: Open Until Filled 2025-08-19 SHARE The Lead Distribution Sales Consultant will identify strategies to promote the sale and positioning of Group Supplemental Health Insurance products and services, partnering with Mutual of Omaha Group Sales offices to provide ongoing support and distribution management. Execute field initiatives to ensure competitive standing across both individual client and market levels. WHAT WE CAN OFFER YOU: Estimated Salary: $95,000 - $115,000 plus annual bonus opportunity. 401(k) plan with a 2% company contribution and 6% company match. Work-life balance with vacation, personal time and paid holidays. See our benefits and perks page for details. Applicants for this position must not now, nor at any point in the future, require sponsorship for employment. WHAT YOU'LL DO: Support the sale of Supplemental Health products by highlighting benefits, services, pricing, competitive advantages, and operations. Partner with assigned Mutual of Omaha Group Sales Representatives to meet performance standards and achieve voluntary sales goals, including new business, cross-selling opportunities, and renewal activity. Develop competitor strategies by creating tools and analyses to strengthen sales positioning. Identify, coordinate, and deliver field training for each product in collaboration with sales offices and internal departments. Create and execute sales support materials such as competitor comparisons, presentations, and marketing content. Lead office and broker visits as needed to support product sales. Assist with the development of finalist presentations to secure new business opportunities. Partner with internal departments to identify and implement product and process enhancements. Develop and maintain current knowledge of company's products, policies and services. WHAT YOU'LL BRING: Strong experience and extensive knowledge of Group Supplemental Health Insurance products, design, administration, and marketing. Specifically, Accident, Critical Illness, and Hospital Indemnity. Demonstrated success and ability to build relationships with sales personnel. Strong oral and written communication skills, presentation and negotiation skills, and ability to collaborate with teams. At least 3-5 years of Group Supplemental Health sales support or sales experience. Ability to travel up to 15% of the work period and a valid driver's license. Knowledge of competitors' products and positioning. PREFERRED: Accident and Health Insurance License We value diverse experience, skills, and passion for innovation. If your experience aligns with the listed requirements, please apply! If you have questions about your application or the hiring process , email our Talent Acquisition area at . Please allow at least one week from time of applying if you are checking on the status. Stay Safe from Job Scams Mutual of Omaha only accepts applications from . Legitimate communications will come from We never request sensitive information or extend job offers without conducting interviews. For more details, check our Hiring FAQs . Stay alert for scams and apply securely! Fair Chance Notices Need help? Email Us Apply Now Great place to work Together we achieve greatness. Not only is this a core value, but it's also representative of the kind of place we are - built by the strength and integrity of our employees. It's why we're named a "Great Place to Work". See All Awards An inclusive culture Surround yourself with an authentic and inclusive culture. Your strengths and differences will be valued and celebrated by a diverse community of co workers. Discover Our Culture Related Job Openings Financial Representative Trainee (Sales) - Springfield, MO Missouri 503751 Advisor Sales Manager - Houston, TX Texas 503932 Lead Distribution Sales Consultant - Dental/Vision Product - Remote Remote 504139
    $95k-115k yearly 2h ago
  • Bilingual Behavioral Health Care Manager

    Heritage Health Network 3.9company rating

    Remote or Riverside, CA job

    This role works closely with Care Team Operations, Clinical Operations, Behavioral Health clinicians (LMFT/LCSW/LPCC), Community Health Workers (CHWs), Compliance, Finance (for authorizations), Care Operations Associates, and external partners including hospitals, primary care providers, behavioral health agencies, housing providers, and community-based organizations. Responsibilities Serve as the primary point of contact for assigned members with behavioral health and psychosocial complexity, building trust through consistent, trauma-informed engagement. Conduct comprehensive, holistic assessments addressing behavioral health, substance use, functional status, social determinants of health, safety risks, and care gaps. Develop, implement, and maintain person-centered care plans that integrate behavioral, medical, and social goals; update plans following transitions of care or changes in condition. Coordinate services across the continuum of care, including behavioral health providers, primary care, hospitals, housing supports, transportation, social services, and community-based organizations. Conduct required in-person home or community visits based on acuity, risk stratification, and payer requirements. Support Transitions of Care (TOCs) by completing timely follow-up, coordinating post-discharge services, and reinforcing discharge instructions and medication understanding. Utilize motivational interviewing, behavioral coaching, and health education to promote engagement, adherence, self-management, and long-term member stability. Identify, escalate, and address behavioral health risks, safety concerns, service delays, benefit lapses, and environmental barriers using HHN escalation protocols. Coordinate and track referrals, appointments, transportation, and follow-ups to ensure continuity and timeliness of care. Maintain accurate, timely, and audit-ready documentation of all assessments, encounters, and interventions in eClinicalWorks (ECW) and other HHN systems. Meet or exceed HHN and health plan productivity standards, including outreach cadence, encounter requirements, documentation timeliness, TOC completion, and quality measures. Actively participate in multidisciplinary case reviews, care conferences, team huddles, and escalations with nurses, behavioral health clinicians, CHWs, care operations, and compliance. Assist members with plan navigation, eligibility redeterminations, social service applications, housing resources, and crisis intervention support. Communicate professionally with members and care partners using HHN-approved channels, including phone, RingCentral, secure messaging, and SMS workflows. Contribute to continuous quality improvement efforts by identifying workflow gaps, documenting barriers, and sharing insights to improve care delivery. Uphold confidentiality and comply with all HIPAA, Medi-Cal, ECM, and payer regulatory requirements. Remain flexible and responsive to member needs, including field-based work and engagement in community settings. Skills Required Bilingual (English/Spanish) proficiency required to support member engagement and care coordination. Strong ability to build rapport and trust with diverse, high-need member populations. Proficiency in using eClinicalWorks (ECW), Google Suite (Docs, Sheets, Drive), RingCentral, and virtual communication tools. Ability to interpret and use PowerBI dashboards, reporting tools, and payer portals. Demonstrated skill in conducting holistic assessments and developing person-centered care plans. Experience with motivational interviewing, trauma-informed care, or health coaching. Strong organizational and time-management skills, with the ability to manage a complex caseload. Excellent written and verbal communication skills across in-person, telephonic, and digital channels. Ability to work independently, make sound decisions, and escalate appropriately. Knowledge of Medi-Cal, SDOH, community resources, and social service navigation. High attention to detail and commitment to accurate, audit-ready documentation. Ability to remain calm, patient, and professional while supporting members facing instability or crisis. Comfortable with field-based work, home visits, and interacting in diverse community environments. Cultural humility and demonstrated ability to work effectively across populations with varied lived experiences. Competencies Member Advocacy: Champions member needs with urgency and integrity. Operational Effectiveness: Executes workflows consistently and flags process gaps. Interpersonal Effectiveness: Builds rapport with diverse populations. Collaboration: Works effectively within an interdisciplinary care model. Decision Making: Uses judgment to escalate or intervene appropriately. Problem Solving: Identifies issues and creates practical, timely solutions. Adaptability: Thrives in a fast-growing, startup-style environment with evolving processes. Cultural Competence: Engages members with respect for their lived experiences. Documentation Excellence: Produces accurate, timely, audit-ready notes every time. Strong empathy, cultural competence, and commitment to providing individualized care. Ability to work effectively within a multidisciplinary team environment. Exceptional interpersonal and communication skills, with a focus on building trust and rapport with diverse populations. Job Requirements Education: Bachelor's degree in Social Work, Psychology, Public Health, Human Services, or related field. Licensure: Licensed LMFT, LCSW, LPCC.; certification in care coordination or CHW training is a plus. Experience: 1-3 years of care management or case management experience, preferably with high-need Medi-Cal populations. Experience in community-based work, homelessness services, behavioral health, or SUD settings strongly preferred. Familiarity with Medi-Cal, ECM, and community resource navigation. Travel Requirements: Regular travel for in-person home or community visits (up to 45%). Physical Requirements: Ability to perform home visits, climb stairs, sit/stand for prolonged periods, and lift up to 20 lbs if needed.
    $61k-76k yearly est. 1d ago
  • Associate Underwriter

    Burns & Wilcox 4.6company rating

    Remote or Fresno, CA job

    When someone needs insurance coverage for the unique, the unusual, or the unconventional, they come to Burns & Wilcox. Our Associate Underwriters directly service a book of business under the supervision of an Underwriter, offering the opportunity to learn the specialty insurance business and career advancements into an Underwriter role. Interested? Join our team! Responsibilities: Service a book of business under the direct supervision of an underwriter Log applications, prepare binders, and process policies and endorsements Bind risk, post the invoice, and process technical data Screen renewal applications and send out renewal letters; perform some of the underwriting and prepare quotes for underwriter approval Assist with new business development Order and follow up on inspections and handle endorsement requests and referrals for the underwriter Manage relationships with retail agents and follow up on any outstanding information needed to complete the underwriting file Qualifications: Bachelor's degree or equivalent combination of education and work experience Insurance experience in underwriting and/or brokerage support with excess & surplus lines preferred Sales & marketing experience preferred Be technologically savvy and data driven Compensation Package Competitive overall compensation package with base salary + discretionary bonus. Base salary range of $60,000-$70,000. Flexible, hybrid, and remote work options Health benefits & 401K with employer match Employer paid continuing education courses and designations Many opportunities for career advancement About our Company Burns & Wilcox, the flagship organization of H.W. Kaufman Group, is North America's leading wholesale insurance broker and underwriting manager. Burns & Wilcox offers wide ranging and comprehensive solutions to serve retail insurance brokers and agents of all sizes, from the large houses to the more than 30,000 independent brokers and agents worldwide. Fueled by its freedom from Wall Street and private equity, Burns & Wilcox is a privately owned company whose standards of service, depth of market relationships and outstanding talent are unsurpassed in the specialty insurance sector. Equal Opportunity Employer The H.W. Kaufman Group of companies is an equal opportunity employer. All employment decisions are based on business needs, job requirements and individual qualifications, without regard to race, color, religion, gender, gender identity, age, national origin, disability, veteran status, marital status, sexual orientation, genetic information or any other status or condition protected by the laws or regulations in the locations where we operate.
    $60k-70k yearly 5d ago
  • Owners Rep Project Manager

    Oscar 4.6company rating

    Remote or Philadelphia, PA job

    Project Manager - Owner's Rep / IPP (Project Execution) - Fully Remote - 20-25% Travel Travel: 20-25 percent for site visits Employment Type: Full-Time About the Role We are seeking an experienced Project Manager with a strong background in Owner's Representative or IPP (Independent Power Producer) environments. This position is fully remote with periodic job-site travel and is heavily focused on project execution, overseeing projects from NTP through COD. You will lead the owner-side delivery of utility-scale renewable energy projects by managing EPCs, monitoring construction progress, and ensuring all scope, budget, safety, and schedule expectations are met. A minimum of 3 years of direct IPP or Owner's Rep experience is an absolute must. Key Responsibilities Oversee execution of utility-scale renewable energy projects (solar, BESS, wind, or hybrid) from NTP through COD. Manage EPC contractors, ensuring contract compliance, schedule adherence, safety practices, and QA/QC standards. Act as the primary owner-side contact for field activities, contractor coordination, and execution oversight. Lead and maintain project schedules, budgets, risks, change orders, and reporting. Conduct regular site travel (20-25 percent) to monitor progress, resolve issues, and ensure alignment with design and safety requirements. Coordinate across development, engineering, procurement, construction, and asset management teams. Review and approve RFIs, submittals, commissioning plans, and progress documentation. Interface with utilities, permitting agencies, landowners, and other external stakeholders as needed. Drive projects through mechanical completion, commissioning, testing, and final turnover. Required Qualifications A minimum of 3 years of direct IPP or Owner's Rep experience managing utility-scale renewable energy projects. Strict requirement. Proven experience overseeing EPC contractors and managing owner-side project execution. Strong understanding of construction sequencing, project controls, contracts, and risk mitigation. Knowledge of interconnection, commissioning, and testing processes. Ability to communicate effectively across cross-functional and external stakeholder groups. Demonstrated success delivering projects on time and within budget. Willingness to travel 20-25 percent for site visits. Preferred Qualifications Experience with solar + storage or large-scale renewable portfolios. Background managing projects from NTP to COD. Engineering, construction management, or PMP certification preferred. Why Join Fully remote role with flexible travel. High-impact position driving major renewable energy projects. Strong execution-focused team with opportunities for growth. Desired Skills and Experience Solar, IPP, Owners Rep, Utility Scale, PV, Project Management. Oscar Associates Limited (US) is acting as an Employment Agency in relation to this vacancy.
    $95k-130k yearly est. 5d ago
  • Automotive Claims Representative - Training Provided!

    Plymouth Rock Assurance 4.7company rating

    Remote or Boston, MA job

    At Plymouth Rock Assurance, our Claims team embodies the traits of Understanding, Engaging, and Energetic, serving as the first point of contact for our policyholders who have experienced an automobile incident. As a Claims Representative, you will become part of a fast paced, rewarding, and diverse team that appreciates the importance of a healthy work/life balance. We are looking for high potential individuals to join our fast-track claims unit with an in-depth training program, so no prior insurance experience is needed for this role. Many of our Claims Representatives have benefited from internal growth opportunities and have secured more senior Claims or Supervisor level roles within our company. Apply now and start your career at Plymouth Rock! We are currently a Hybrid work environment- 4 days in the Boston office and 1 day work from home. Here Is What You Will Do Customer-centric employee: Conveying a calm, caring attitude, you will provide best-in-class service to customers while processing new claims. Understanding and providing Empathy is key to this role. Collaborative partner: Working with internal and external partners, you'll support policyholders while their claims are being processed. Energetic worker: In our fast-paced environment, you will handle customers' needs-quickly, effectively and in a friendly, caring manner. Problem solver: No day is predictable; you'll utilize out-of-the-box, creative thinking to resolve a wide variety of claims challenges and customer issues. Clear communicator: You'll provide policyholders with the information they need by clearly setting expectations and outlining next steps. Accessibility: Being available for customers via email, text, or phone to walk them step-by-step through the auto claim process and explain existing coverage. Here Is What You Will Bring To The Table A history of working customer service facing roles, hospitality, or retail, with previous call center experience a plus. Being on the phone consistently throughout the day is a requirement of the role. Excellent organizational and time management skills. Being able to pivot through different applications throughout the day. Prioritizing your day and staying organized is key. An associate or bachelor's degree preferred. Willingness to continue learning about products, procedures, and technical systems as you grow in this role. Why work for us Grow personally and professionally through our collaborative team environment Gain support and guidance to expedite proficiency through our mentor program 4 weeks accrued paid time off + 9 paid national holidays per year Onsite Free Parking LinkedIn Learning Courses 12-week Training Program Tuition Reimbursement Low cost and excellent coverage health insurance options (medical, dental, vision) Robust health and wellness program and fitness reimbursements Auto and home insurance discounts 2:1 Matching gift opportunities Annual 401(k) Employer Contribution (up to 7.5% of your base salary) Company sponsored social events Various Paid Family leave options including Paid Parental Leave Salary Range: The pay range for this position is $45,000 to $50,500 annually. Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity. About The Company The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner's insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,900 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of “A-/Excellent”.
    $45k-50.5k yearly 2d ago
  • Loss Control Consultant - Fresno, CA

    Regional Reporting 3.6company rating

    Remote or Fresno, CA job

    Regional Reporting, Inc. (RRI) is one of the largest independently owned providers of Loss Control to the property and casualty Insurance industry. We specialize in Property, General Liability, Products Liability, Fleet, Inland Marine, and Workers' Compensation. RRI is seeking an experienced Insurance Loss Control Consultant throughout our coverage territory to conduct commercial insurance loss control inspections. Insurance Loss Control Consultant An Insurance Loss Control Consultant is primarily responsible for performing commercial insurance inspections and completing insurance underwriting reports. Insurance Companies use these reports to properly underwrite insurance policies. Insurance Loss Control Consultants drive to locations, take photos and visually observe the interior and exterior of facilities. They note the business operations to determine insurance exposures and identify potential improvements. Finally they document their findings in an insurance underwriting report via our website online. Work is assigned on a daily or weekly basis, depending on location. Insurance Loss Control Consultant Position Duties and Responsibilities: Recording onsite observations, taking measurements and photos in accordance with carrier-specific requirements Identifying building and roof construction type, square footage, potential hazards Timely completion of assignments/reports according to due dates Communicating regularly with Field Manager to complete inspections in the most cost effective and efficient manner Coordinating the time and date of the inspection meeting the insured representative onsite Preparing and reporting inspection results, uploading photos and preparing diagrams on an ongoing basis Drive to and from insured locations, some overnight travel may be required Insurance Loss Control Consultant Job Requirements: Minimum 2 years' experience working with other Loss Control Service Providers or Major Insurance Carriers Comprehensive understanding of commercial insurance lines - primarily Property, General Liability and Inland Marine Ability to identify building construction and ISO classes Broad understanding of NFPA codes Solid communication and time management skills Exceptional writing ability, organizational skills and computer skills Ability to work from home with a PC, high-speed internet connection and a cell/smart phone An automobile and valid driver's license, with acceptable driving record Ability to climb a ladder up to 6 feet Digital camera or smart phone with picture capability Measuring wheel, or similar tool, and camera pole Insurance Loss Control Consultant Compensation: Reports that are completed and reviewed for accuracy are paid per assignment starting at $110. Become part of a growing industry! This is an excellent opportunity for individuals who want to set their own schedules and work independently in a growing segment of a vital industry. EOE
    $87k-111k yearly est. 16d ago
  • Product Configuration Analyst

    Tokio Marine Highland 4.5company rating

    Remote or Frisco, TX job

    Product Configuration Analyst: Sapiens Products The Configuration Analyst will be responsible for configuring, maintaining, and supporting Sapiens PolicyPro, BillingPro, ProducerPro, AuthorityPro, and ClaimsPro software solutions to meet business requirements. This role serves as a key liaison between business users, IT, and the Sapiens technical team, ensuring that system configurations deliver optimal performance and align with organizational objectives. The ideal candidate will possess a strong understanding of insurance processes, excellent analytical skills, and hands-on experience with Sapiens platforms. Key Responsibilities In collaboration with the Director of Solutions Delivery, analyze business requirements and translate them into Sapiens system configurations and solutions. Work closely with business stakeholders, Solutions Delivery Leads, and the broader IT team to document configuration specifications based on documented business requirements. Design, test, implement, and maintain configuration changes in Sapiens software to support business operations and process improvements. Troubleshoot and resolve configuration-related issues, providing timely support to end-users and technical teams. Document configuration procedures, changes, and system enhancements for future reference and compliance. Assist in system upgrades and integration projects as needed. Stay updated with Sapiens product improvements, best practices, and industry trends to ensure system configurations remain current and effective. Required Qualifications Bachelor's degree in Information Technology, Computer Science, Business, or a related field (or equivalent experience). At least five(5) years experience working in a technical capacity with Sapiens CoreSuite for North America or a similar application, including an understanding of the data model, configuration version management principles, and familiarity with co-configuration/co-development practices. Strong XSLT experience and comfort working with application integrations and external APIs. Creative problem-solving skills and a drive to examine the end-to-end impacts when analyzing reported issues and requested enhancements. Understanding of insurance or financial services processes and terminology. Proficiency in analyzing business needs and configuring enterprise software solutions. Excellent problem-solving, analytical, and communication skills, including the ability to communicate not just the “what,” but the “how” and the “why” of system behaviors. Ability to work collaboratively in a team environment and manage multiple priorities. Willingness to complete configuration/design reviews and provide guidance to junior configurators and other members of the Solutions Delivery team. Preferred Qualifications Experience with business process mapping and documentation. Solid understanding of the BillingPro and/or ClaimsPro application architecture and core functionality, including asynchronous processing. Knowledge of SQL, XML, or other data management/query tools. Comfort acting in a consultative role when working with stakeholders; a willingness to challenge assumptions and ensure the implications of changes are fully understood before implementing. Work Environment & Reporting This hybrid position is based in Chicago, IL or Frisco, TX, and reports to the Director of Solutions Delivery. A fully remote arrangement based outside of these areas may be considered for the right candidate. The role may require occasional travel or after-hours support during critical deployments or issue resolution. About Tokio Marine Highland Tokio Marine Highland Insurance Services (TMH) is a leading property and casualty underwriting agency. We offer a broad suite of tailored specialty risk management solutions, including private flood, fine art and lender-placed products. At TMH, it's all about our clients. Nationwide, our customers rely on our trusted, industry-leading coverages, supported by compliance expertise, superior claims management and the highest caliber of service. Founded in 1962, TMH is a wholly owned company of Tokio Marine Kiln, one of the largest carriers in the Lloyd's of London insurance market and a member of the Tokio Marine Group. TMH has operating centers in Chicago, Il, Frisco, Texas, Miami, Fla., and South Pasadena, Calif. If you're looking to advance your career, TMH is the perfect professional home. At TMH, you'll have a chance to innovate with the world's leading businesses, put your expertise into action on major projects, and work on game-changing initiatives. You'll also make long-lasting professional connections through sharing different perspectives, and you'll be inspired by the best. Tokio Marine Highland, LLC (TMH) is an Equal Opportunity Employer. TMH's success depends heavily on the effective utilization of qualified people, regardless of their race, ancestry, religion, color, sex, national origin, sexual orientation, gender identity and/or expression, disability, veteran status, or any characteristic protected by law. As a company, we adhere to and promote equal employment opportunities for all. Consistent with the Americans with Disabilities Act (ADA) and applicable state and local laws, it is TMH's policy to provide reasonable accommodation when requested by qualified individuals with disabilities during the recruitment process, unless such accommodation would cause an undue hardship. To make an accommodation request, please contact *****************************.
    $72k-103k yearly est. 2d ago
  • Lead Care Manager (LCM)

    Heritage Health Network 3.9company rating

    Remote or Riverside, CA job

    The Bilingual Lead Care Manager partners with Care Team Operations, Clinical Operations, Compliance, Community Health Workers, Behavioral Health staff, and external providers (medical, housing, and social services) to ensure seamless, culturally responsive, member-centered care coordination. The bilingual LCM additionally supports members with limited English proficiency by facilitating communication, translation, and cultural interpretation as needed. Responsibilities Serve as the primary point of contact for assigned members, building trust and maintaining active engagement through consistent outreach, relationship-based strategies, and a trauma-informed approach. Provide all communication in the member's preferred language. Conduct comprehensive assessments (physical, behavioral, functional, social) and develop person-centered care plans that reflect the member's goals, risks, preferences, cultural needs, and social determinants of health. Implement, monitor, and update care plans following transitions of care, significant changes in condition, or required reassessments; ensure timely and compliant submission of all care plans. Coordinate services across the continuum-including medical, behavioral health, housing, transportation, social services, and community programs-to reduce fragmentation and remove barriers to care. Conduct required in-person home or community visits based on member need and risk stratification and maintain a compliant monthly visit structure. Utilize motivational interviewing, coaching, and health education to promote behavioral change, self-management, and long-term member stability. Identify gaps in care, service delays, lapses in benefits, unmet needs, and environmental risks; collaborate with internal and external partners to resolve issues quickly and effectively. Maintain accurate, timely, audit-ready documentation of all interactions, assessments, and interventions using required HHN platforms, including eClinicalWorks (ECW), Google Suite, RingCentral, PowerBI dashboards, and payer portals. Meet or exceed HHN and payer productivity standards, including encounter metrics, outreach requirements, documentation timelines, and quality measures. Actively participate in multidisciplinary case reviews, team huddles, care conferences, and escalations with nurses, behavioral health staff, CHWs, care operations, and compliance. Coordinate and schedule appointments with primary care, specialists, behavioral health providers, and community partners; manage referrals, transportation, and follow-ups to ensure continuity of care. Support hospital discharge (TOC) planning through follow-up scheduling, care transitions, medication reconciliation support, and education on discharge instructions. Assist members in navigating plan eligibility, redeterminations, documentation, social service applications, housing resources, and crisis interventions. Maintain active and professional communication with members and care partners through HHN-approved channels, including RingCentral, secure messaging, SMS workflows, and phone. Participate in HHN's continuous quality improvement efforts, identifying workflow gaps, documenting barriers, sharing insights, and contributing to best-practice development. Uphold confidentiality and adhere to all HIPAA and payer regulatory requirements across all areas of care delivery. Open to seeing patients in their home or their location of preference. Provide real-time interpretation and translation support (verbal and written) for members and families with limited English proficiency. Help bridge cultural gaps that may impact communication, trust, adherence, or engagement. Skills Required Fluency in English and another language (Spanish preferred); ability to read, write, and speak at a professional level. Strong ability to build rapport and trust with diverse, high-need member populations. Proficiency in using eClinicalWorks (ECW), Google Suite (Docs, Sheets, Drive), RingCentral, and virtual communication tools. Ability to interpret and use PowerBI dashboards, reporting tools, and payer portals. Demonstrated skill in conducting holistic assessments and developing person-centered care plans. Experience with motivational interviewing, trauma-informed care, or health coaching. Strong organizational and time-management skills, with the ability to manage a complex caseload. Excellent written and verbal communication skills across in-person, telephonic, and digital channels. Ability to work independently, make sound decisions, and escalate appropriately. Knowledge of Medi-Cal, SDOH, community resources, and social service navigation. High attention to detail and commitment to accurate, audit-ready documentation. Ability to remain calm, patient, and professional while supporting members facing instability or crisis. Comfortable with field-based work, home visits, and interacting in diverse community environments. Cultural humility and demonstrated ability to work effectively across populations with varied lived experiences. Competencies Member Advocacy: Champions member needs with urgency and integrity. Operational Effectiveness: Executes workflows consistently and flags process gaps. Interpersonal Effectiveness: Builds rapport with diverse populations. Collaboration: Works effectively within an interdisciplinary care model. Decision Making: Uses judgment to escalate or intervene appropriately. Problem Solving: Identifies issues and creates practical, timely solutions. Adaptability: Thrives in a fast-growing, startup-style environment with evolving processes. Cultural Competence: Engages members with respect for their lived experiences. Documentation Excellence: Produces accurate, timely, audit-ready notes every time. Strong empathy, cultural competence, and commitment to providing individualized care. Ability to work effectively within a multidisciplinary team environment. Exceptional interpersonal and communication skills, with a focus on building trust and rapport with diverse populations. Bilingual Communication (interpretation + translation) Job Requirements Education: Bachelor's degree in Social Work, Psychology, Public Health, Human Services, or related field preferred; equivalent experience considered. Licensure: Not required; certification in care coordination or CHW training is a plus. Experience: 1-3 years of care management or case management experience, preferably with high-need Medi-Cal populations. Experience in community-based work, homelessness services, behavioral health, or SUD settings strongly preferred. Familiarity with Medi-Cal, ECM, and community resource navigation. Travel Requirements: Regular travel for in-person home or community visits (up to 45%). Physical Requirements: Ability to perform home visits, climb stairs, sit/stand for prolonged periods, and lift up to 20 lbs if needed.
    $36k-47k yearly est. 5d ago
  • Claims Specialist/Senior Claims Specialist

    Mid-Continent Group 3.8company rating

    Remote or Tulsa, OK job

    Mid-Continent Group - Tulsa, OK or Cincinnati, OH (Hybrid) Empower Your Career. Make an Impact. Grow with Us. Mid-Continent Group, a proud member of the Great American Insurance Group, specializes in commercial casualty coverages with a strong focus on general liability for construction, energy, and other complex industries. We offer a broad portfolio of General Liability, Commercial Auto, Inland Marine, and Umbrella products. Why Join Us? Fortune 500 Stability + Entrepreneurial Spirit: Be part of a company that combines the agility of a small business with the resources of a Fortune 500 leader. Hybrid Work Environment: Enjoy the flexibility of working from home and collaborating in our vibrant downtown offices in Tulsa or Cincinnati. Culture: We celebrate diverse perspectives and foster a workplace where everyone feels empowered to thrive. Career Growth: With over 35 specialty operations within the Great American Insurance Group, your opportunities to learn, lead, and grow are limitless. Responsibilities Manage a portfolio of complex, high-value commercial general liability and auto claims across the U.S. Lead investigations, evaluate coverage and liability, and drive resolution strategies. Represent the company in mediations, depositions, and trials. Collaborate with underwriting and marketing teams to identify trends and improve outcomes. Serve as a technical expert and strategic advisor within your line of business. Ensure compliance with all legal and regulatory standards. Offer expert advice to other members of your team on complex claim file management and demonstrate leadership across the organization. Qualifications 9+ years of experience handling general liability and/or commercial auto claims. Strong analytical skills and deep understanding of policy coverage. Excellent communication, negotiation, and organizational abilities. Bachelor's degree in Business, Risk Management, Insurance, or related field (or equivalent experience). Professional designations (e.g., CPCU) are a plus. Benefits Competitive compensation and performance-based incentives. Comprehensive benefits including health, dental, vision, and retirement plans. Generous paid time off and wellness programs. Support for continuing education and professional development. Ready to Make a Difference? Join a team where your expertise is valued, your voice is heard, and your career can flourish. Apply today and be part of something great.
    $46k-70k yearly est. 2d ago
  • Associate Underwriter

    Burns & Wilcox 4.6company rating

    Remote or Centennial, CO job

    When someone needs insurance coverage for the unique, the unusual, or the unconventional, they come to Burns & Wilcox. Our Associate Underwriters directly service a book of business under the supervision of an Underwriter, offering the opportunity to learn the specialty insurance business and career advancements into an Underwriter role. Interested? Join our team! Responsibilities: Service a book of business under the direct supervision of an underwriter Log applications, prepare binders, and process policies and endorsements Bind risk, post the invoice, and process technical data Screen renewal applications and send out renewal letters; perform some of the underwriting and prepare quotes for underwriter approval Assist with new business development Order and follow up on inspections and handle endorsement requests and referrals for the underwriter Manage relationships with retail agents and follow up on any outstanding information needed to complete the underwriting file Qualifications: Bachelor's degree or equivalent combination of education and work experience Insurance experience in underwriting and/or brokerage support with excess & surplus lines preferred Sales & marketing experience preferred Be technologically savvy and data driven Compensation Package Competitive overall compensation package with base salary + discretionary bonus. Base salary range of $65,000-$75,000. Flexible, hybrid, and remote work options Health benefits & 401K with employer match Employer paid continuing education courses and designations Many opportunities for career advancement About our Company Burns & Wilcox, the flagship organization of H.W. Kaufman Group, is North America's leading wholesale insurance broker and underwriting manager. Burns & Wilcox offers wide ranging and comprehensive solutions to serve retail insurance brokers and agents of all sizes, from the large houses to the more than 30,000 independent brokers and agents worldwide. Fueled by its freedom from Wall Street and private equity, Burns & Wilcox is a privately owned company whose standards of service, depth of market relationships and outstanding talent are unsurpassed in the specialty insurance sector. Equal Opportunity Employer The H.W. Kaufman Group of companies is an equal opportunity employer. All employment decisions are based on business needs, job requirements and individual qualifications, without regard to race, color, religion, gender, gender identity, age, national origin, disability, veteran status, marital status, sexual orientation, genetic information or any other status or condition protected by the laws or regulations in the locations where we operate.
    $65k-75k yearly 4d ago
  • Loss Control Consultant - San Francisco, CA

    Regional Reporting 3.6company rating

    Remote or San Francisco, CA job

    Regional Reporting, Inc. (RRI) is one of the largest independently owned providers of Loss Control to the property and casualty Insurance industry. We specialize in Property, General Liability, Products Liability, Fleet, Inland Marine, and Workers' Compensation. RRI is seeking an experienced Insurance Loss Control Consultant throughout our coverage territory to conduct commercial insurance loss control inspections. Insurance Loss Control Consultant An Insurance Loss Control Consultant is primarily responsible for performing commercial insurance inspections and completing insurance underwriting reports. Insurance Companies use these reports to properly underwrite insurance policies. Insurance Loss Control Consultants drive to locations, take photos and visually observe the interior and exterior of facilities. They note the business operations to determine insurance exposures and identify potential improvements. Finally they document their findings in an insurance underwriting report via our website online. Work is assigned on a daily or weekly basis, depending on location. Insurance Loss Control Consultant Position Duties and Responsibilities: Recording onsite observations, taking measurements and photos in accordance with carrier-specific requirements Identifying building and roof construction type, square footage, potential hazards Timely completion of assignments/reports according to due dates Communicating regularly with Field Manager to complete inspections in the most cost effective and efficient manner Coordinating the time and date of the inspection meeting the insured representative onsite Preparing and reporting inspection results, uploading photos and preparing diagrams on an ongoing basis Drive to and from insured locations, some overnight travel may be required Insurance Loss Control Consultant Job Requirements: Minimum 2 years' experience working with other Loss Control Service Providers or Major Insurance Carriers Comprehensive understanding of commercial insurance lines - primarily Property, General Liability and Inland Marine Ability to identify building construction and ISO classes Broad understanding of NFPA codes Solid communication and time management skills Exceptional writing ability, organizational skills and computer skills Ability to work from home with a PC, high-speed internet connection and a cell/smart phone An automobile and valid driver's license, with acceptable driving record Ability to climb a ladder up to 6 feet Digital camera or smart phone with picture capability Measuring wheel, or similar tool, and camera pole Insurance Loss Control Consultant Compensation: Reports that are completed and reviewed for accuracy are paid per assignment starting at $110. Become part of a growing industry! This is an excellent opportunity for individuals who want to set their own schedules and work independently in a growing segment of a vital industry. EOE
    $87k-112k yearly est. 60d+ ago
  • Lead Care Manager (LCM)

    Heritage Health Network 3.9company rating

    Remote or Santa Ana, CA job

    The Bilingual Lead Care Manager partners with Care Team Operations, Clinical Operations, Compliance, Community Health Workers, Behavioral Health staff, and external providers (medical, housing, and social services) to ensure seamless, culturally responsive, member-centered care coordination. The bilingual LCM additionally supports members with limited English proficiency by facilitating communication, translation, and cultural interpretation as needed. Responsibilities Serve as the primary point of contact for assigned members, building trust and maintaining active engagement through consistent outreach, relationship-based strategies, and a trauma-informed approach. Provide all communication in the member's preferred language. Conduct comprehensive assessments (physical, behavioral, functional, social) and develop person-centered care plans that reflect the member's goals, risks, preferences, cultural needs, and social determinants of health. Implement, monitor, and update care plans following transitions of care, significant changes in condition, or required reassessments; ensure timely and compliant submission of all care plans. Coordinate services across the continuum-including medical, behavioral health, housing, transportation, social services, and community programs-to reduce fragmentation and remove barriers to care. Conduct required in-person home or community visits based on member need and risk stratification and maintain a compliant monthly visit structure. Utilize motivational interviewing, coaching, and health education to promote behavioral change, self-management, and long-term member stability. Identify gaps in care, service delays, lapses in benefits, unmet needs, and environmental risks; collaborate with internal and external partners to resolve issues quickly and effectively. Maintain accurate, timely, audit-ready documentation of all interactions, assessments, and interventions using required HHN platforms, including eClinicalWorks (ECW), Google Suite, RingCentral, PowerBI dashboards, and payer portals. Meet or exceed HHN and payer productivity standards, including encounter metrics, outreach requirements, documentation timelines, and quality measures. Actively participate in multidisciplinary case reviews, team huddles, care conferences, and escalations with nurses, behavioral health staff, CHWs, care operations, and compliance. Coordinate and schedule appointments with primary care, specialists, behavioral health providers, and community partners; manage referrals, transportation, and follow-ups to ensure continuity of care. Support hospital discharge (TOC) planning through follow-up scheduling, care transitions, medication reconciliation support, and education on discharge instructions. Assist members in navigating plan eligibility, redeterminations, documentation, social service applications, housing resources, and crisis interventions. Maintain active and professional communication with members and care partners through HHN-approved channels, including RingCentral, secure messaging, SMS workflows, and phone. Participate in HHN's continuous quality improvement efforts, identifying workflow gaps, documenting barriers, sharing insights, and contributing to best-practice development. Uphold confidentiality and adhere to all HIPAA and payer regulatory requirements across all areas of care delivery. Open to seeing patients in their home or their location of preference. Provide real-time interpretation and translation support (verbal and written) for members and families with limited English proficiency. Help bridge cultural gaps that may impact communication, trust, adherence, or engagement. Skills Required Fluency in English and another language (Spanish preferred); ability to read, write, and speak at a professional level. Strong ability to build rapport and trust with diverse, high-need member populations. Proficiency in using eClinicalWorks (ECW), Google Suite (Docs, Sheets, Drive), RingCentral, and virtual communication tools. Ability to interpret and use PowerBI dashboards, reporting tools, and payer portals. Demonstrated skill in conducting holistic assessments and developing person-centered care plans. Experience with motivational interviewing, trauma-informed care, or health coaching. Strong organizational and time-management skills, with the ability to manage a complex caseload. Excellent written and verbal communication skills across in-person, telephonic, and digital channels. Ability to work independently, make sound decisions, and escalate appropriately. Knowledge of Medi-Cal, SDOH, community resources, and social service navigation. High attention to detail and commitment to accurate, audit-ready documentation. Ability to remain calm, patient, and professional while supporting members facing instability or crisis. Comfortable with field-based work, home visits, and interacting in diverse community environments. Cultural humility and demonstrated ability to work effectively across populations with varied lived experiences. Competencies Member Advocacy: Champions member needs with urgency and integrity. Operational Effectiveness: Executes workflows consistently and flags process gaps. Interpersonal Effectiveness: Builds rapport with diverse populations. Collaboration: Works effectively within an interdisciplinary care model. Decision Making: Uses judgment to escalate or intervene appropriately. Problem Solving: Identifies issues and creates practical, timely solutions. Adaptability: Thrives in a fast-growing, startup-style environment with evolving processes. Cultural Competence: Engages members with respect for their lived experiences. Documentation Excellence: Produces accurate, timely, audit-ready notes every time. Strong empathy, cultural competence, and commitment to providing individualized care. Ability to work effectively within a multidisciplinary team environment. Exceptional interpersonal and communication skills, with a focus on building trust and rapport with diverse populations. Bilingual Communication (interpretation + translation) Job Requirements Education: Bachelor's degree in Social Work, Psychology, Public Health, Human Services, or related field preferred; equivalent experience considered. Licensure: Not required; certification in care coordination or CHW training is a plus. Experience: 1-3 years of care management or case management experience, preferably with high-need Medi-Cal populations. Experience in community-based work, homelessness services, behavioral health, or SUD settings strongly preferred. Familiarity with Medi-Cal, ECM, and community resource navigation. Travel Requirements: Regular travel for in-person home or community visits (up to 45%). Physical Requirements: Ability to perform home visits, climb stairs, sit/stand for prolonged periods, and lift up to 20 lbs if needed.
    $36k-47k yearly est. 3d ago
  • Loss Control Consultant - San Jose, CA

    Regional Reporting 3.6company rating

    Remote or San Jose, CA job

    Regional Reporting, Inc. (RRI) is one of the largest independently owned providers of Loss Control to the property and casualty Insurance industry. We specialize in Property, General Liability, Products Liability, Fleet, Inland Marine, and Workers' Compensation. RRI is seeking an experienced Insurance Loss Control Consultant throughout our coverage territory to conduct commercial insurance loss control inspections. Insurance Loss Control Consultant An Insurance Loss Control Consultant is primarily responsible for performing commercial insurance inspections and completing insurance underwriting reports. Insurance Companies use these reports to properly underwrite insurance policies. Insurance Loss Control Consultants drive to locations, take photos and visually observe the interior and exterior of facilities. They note the business operations to determine insurance exposures and identify potential improvements. Finally they document their findings in an insurance underwriting report via our website online. Work is assigned on a daily or weekly basis, depending on location. Insurance Loss Control Consultant Position Duties and Responsibilities: Recording onsite observations, taking measurements and photos in accordance with carrier-specific requirements Identifying building and roof construction type, square footage, potential hazards Timely completion of assignments/reports according to due dates Communicating regularly with Field Manager to complete inspections in the most cost effective and efficient manner Coordinating the time and date of the inspection meeting the insured representative onsite Preparing and reporting inspection results, uploading photos and preparing diagrams on an ongoing basis Drive to and from insured locations, some overnight travel may be required Insurance Loss Control Consultant Job Requirements: Minimum 2 years' experience working with other Loss Control Service Providers or Major Insurance Carriers Comprehensive understanding of commercial insurance lines - primarily Property, General Liability and Inland Marine Ability to identify building construction and ISO classes Broad understanding of NFPA codes Solid communication and time management skills Exceptional writing ability, organizational skills and computer skills Ability to work from home with a PC, high-speed internet connection and a cell/smart phone An automobile and valid driver's license, with acceptable driving record Ability to climb a ladder up to 6 feet Digital camera or smart phone with picture capability Measuring wheel, or similar tool, and camera pole Insurance Loss Control Consultant Compensation: Reports that are completed and reviewed for accuracy are paid per assignment starting at $110. Become part of a growing industry! This is an excellent opportunity for individuals who want to set their own schedules and work independently in a growing segment of a vital industry. EOE
    $87k-111k yearly est. 16d ago
  • Lead Care Manager (LCM)

    Heritage Health Network 3.9company rating

    Remote or Los Angeles, CA job

    The Bilingual Lead Care Manager partners with Care Team Operations, Clinical Operations, Compliance, Community Health Workers, Behavioral Health staff, and external providers (medical, housing, and social services) to ensure seamless, culturally responsive, member-centered care coordination. The bilingual LCM additionally supports members with limited English proficiency by facilitating communication, translation, and cultural interpretation as needed. Responsibilities Serve as the primary point of contact for assigned members, building trust and maintaining active engagement through consistent outreach, relationship-based strategies, and a trauma-informed approach. Provide all communication in the member's preferred language. Conduct comprehensive assessments (physical, behavioral, functional, social) and develop person-centered care plans that reflect the member's goals, risks, preferences, cultural needs, and social determinants of health. Implement, monitor, and update care plans following transitions of care, significant changes in condition, or required reassessments; ensure timely and compliant submission of all care plans. Coordinate services across the continuum-including medical, behavioral health, housing, transportation, social services, and community programs-to reduce fragmentation and remove barriers to care. Conduct required in-person home or community visits based on member need and risk stratification and maintain a compliant monthly visit structure. Utilize motivational interviewing, coaching, and health education to promote behavioral change, self-management, and long-term member stability. Identify gaps in care, service delays, lapses in benefits, unmet needs, and environmental risks; collaborate with internal and external partners to resolve issues quickly and effectively. Maintain accurate, timely, audit-ready documentation of all interactions, assessments, and interventions using required HHN platforms, including eClinicalWorks (ECW), Google Suite, RingCentral, PowerBI dashboards, and payer portals. Meet or exceed HHN and payer productivity standards, including encounter metrics, outreach requirements, documentation timelines, and quality measures. Actively participate in multidisciplinary case reviews, team huddles, care conferences, and escalations with nurses, behavioral health staff, CHWs, care operations, and compliance. Coordinate and schedule appointments with primary care, specialists, behavioral health providers, and community partners; manage referrals, transportation, and follow-ups to ensure continuity of care. Support hospital discharge (TOC) planning through follow-up scheduling, care transitions, medication reconciliation support, and education on discharge instructions. Assist members in navigating plan eligibility, redeterminations, documentation, social service applications, housing resources, and crisis interventions. Maintain active and professional communication with members and care partners through HHN-approved channels, including RingCentral, secure messaging, SMS workflows, and phone. Participate in HHN's continuous quality improvement efforts, identifying workflow gaps, documenting barriers, sharing insights, and contributing to best-practice development. Uphold confidentiality and adhere to all HIPAA and payer regulatory requirements across all areas of care delivery. Open to seeing patients in their home or their location of preference. Provide real-time interpretation and translation support (verbal and written) for members and families with limited English proficiency. Help bridge cultural gaps that may impact communication, trust, adherence, or engagement. Skills Required Fluency in English and another language (Spanish preferred); ability to read, write, and speak at a professional level. Strong ability to build rapport and trust with diverse, high-need member populations. Proficiency in using eClinicalWorks (ECW), Google Suite (Docs, Sheets, Drive), RingCentral, and virtual communication tools. Ability to interpret and use PowerBI dashboards, reporting tools, and payer portals. Demonstrated skill in conducting holistic assessments and developing person-centered care plans. Experience with motivational interviewing, trauma-informed care, or health coaching. Strong organizational and time-management skills, with the ability to manage a complex caseload. Excellent written and verbal communication skills across in-person, telephonic, and digital channels. Ability to work independently, make sound decisions, and escalate appropriately. Knowledge of Medi-Cal, SDOH, community resources, and social service navigation. High attention to detail and commitment to accurate, audit-ready documentation. Ability to remain calm, patient, and professional while supporting members facing instability or crisis. Comfortable with field-based work, home visits, and interacting in diverse community environments. Cultural humility and demonstrated ability to work effectively across populations with varied lived experiences. Competencies Member Advocacy: Champions member needs with urgency and integrity. Operational Effectiveness: Executes workflows consistently and flags process gaps. Interpersonal Effectiveness: Builds rapport with diverse populations. Collaboration: Works effectively within an interdisciplinary care model. Decision Making: Uses judgment to escalate or intervene appropriately. Problem Solving: Identifies issues and creates practical, timely solutions. Adaptability: Thrives in a fast-growing, startup-style environment with evolving processes. Cultural Competence: Engages members with respect for their lived experiences. Documentation Excellence: Produces accurate, timely, audit-ready notes every time. Strong empathy, cultural competence, and commitment to providing individualized care. Ability to work effectively within a multidisciplinary team environment. Exceptional interpersonal and communication skills, with a focus on building trust and rapport with diverse populations. Bilingual Communication (interpretation + translation) Job Requirements Education: Bachelor's degree in Social Work, Psychology, Public Health, Human Services, or related field preferred; equivalent experience considered. Licensure: Not required; certification in care coordination or CHW training is a plus. Experience: 1-3 years of care management or case management experience, preferably with high-need Medi-Cal populations. Experience in community-based work, homelessness services, behavioral health, or SUD settings strongly preferred. Familiarity with Medi-Cal, ECM, and community resource navigation. Travel Requirements: Regular travel for in-person home or community visits (up to 45%). Physical Requirements: Ability to perform home visits, climb stairs, sit/stand for prolonged periods, and lift up to 20 lbs if needed.
    $36k-47k yearly est. 3d ago
  • Loss Control Consultant - Sacramento, CA

    Regional Reporting 3.6company rating

    Remote or Sacramento, CA job

    Regional Reporting, Inc. (RRI) is one of the largest independently owned providers of Loss Control to the property and casualty Insurance industry. We specialize in Property, General Liability, Products Liability, Fleet, Inland Marine, and Workers' Compensation. RRI is seeking an experienced Insurance Loss Control Consultant throughout our coverage territory to conduct commercial insurance loss control inspections. Insurance Loss Control Consultant An Insurance Loss Control Consultant is primarily responsible for performing commercial insurance inspections and completing insurance underwriting reports. Insurance Companies use these reports to properly underwrite insurance policies. Insurance Loss Control Consultants drive to locations, take photos and visually observe the interior and exterior of facilities. They note the business operations to determine insurance exposures and identify potential improvements. Finally they document their findings in an insurance underwriting report via our website online. Work is assigned on a daily or weekly basis, depending on location. Insurance Loss Control Consultant Position Duties and Responsibilities: Recording onsite observations, taking measurements and photos in accordance with carrier-specific requirements Identifying building and roof construction type, square footage, potential hazards Timely completion of assignments/reports according to due dates Communicating regularly with Field Manager to complete inspections in the most cost effective and efficient manner Coordinating the time and date of the inspection meeting the insured representative onsite Preparing and reporting inspection results, uploading photos and preparing diagrams on an ongoing basis Drive to and from insured locations, some overnight travel may be required Insurance Loss Control Consultant Job Requirements: Minimum 2 years' experience working with other Loss Control Service Providers or Major Insurance Carriers Comprehensive understanding of commercial insurance lines - primarily Property, General Liability and Inland Marine Ability to identify building construction and ISO classes Broad understanding of NFPA codes Solid communication and time management skills Exceptional writing ability, organizational skills and computer skills Ability to work from home with a PC, high-speed internet connection and a cell/smart phone An automobile and valid driver's license, with acceptable driving record Ability to climb a ladder up to 6 feet Digital camera or smart phone with picture capability Measuring wheel, or similar tool, and camera pole Insurance Loss Control Consultant Compensation: Reports that are completed and reviewed for accuracy are paid per assignment starting at $110. Become part of a growing industry! This is an excellent opportunity for individuals who want to set their own schedules and work independently in a growing segment of a vital industry. EOE
    $87k-111k yearly est. 60d+ ago
  • Loss Control Consultant - San Diego, CA

    Regional Reporting 3.6company rating

    Remote or San Diego, CA job

    Regional Reporting, Inc. (RRI) is one of the largest independently owned providers of Loss Control to the property and casualty Insurance industry. We specialize in Property, General Liability, Products Liability, Fleet, Inland Marine, and Workers' Compensation. RRI is seeking an experienced Insurance Loss Control Consultant throughout our coverage territory to conduct commercial insurance loss control inspections. Insurance Loss Control Consultant An Insurance Loss Control Consultant is primarily responsible for performing commercial insurance inspections and completing insurance underwriting reports. Insurance Companies use these reports to properly underwrite insurance policies. Insurance Loss Control Consultants drive to locations, take photos and visually observe the interior and exterior of facilities. They note the business operations to determine insurance exposures and identify potential improvements. Finally they document their findings in an insurance underwriting report via our website online. Work is assigned on a daily or weekly basis, depending on location. Insurance Loss Control Consultant Position Duties and Responsibilities: Recording onsite observations, taking measurements and photos in accordance with carrier-specific requirements Identifying building and roof construction type, square footage, potential hazards Timely completion of assignments/reports according to due dates Communicating regularly with Field Manager to complete inspections in the most cost effective and efficient manner Coordinating the time and date of the inspection meeting the insured representative onsite Preparing and reporting inspection results, uploading photos and preparing diagrams on an ongoing basis Drive to and from insured locations, some overnight travel may be required Insurance Loss Control Consultant Job Requirements: Minimum 2 years' experience working with other Loss Control Service Providers or Major Insurance Carriers Comprehensive understanding of commercial insurance lines - primarily Property, General Liability and Inland Marine Ability to identify building construction and ISO classes Broad understanding of NFPA codes Solid communication and time management skills Exceptional writing ability, organizational skills and computer skills Ability to work from home with a PC, high-speed internet connection and a cell/smart phone An automobile and valid driver's license, with acceptable driving record Ability to climb a ladder up to 6 feet Digital camera or smart phone with picture capability Measuring wheel, or similar tool, and camera pole Insurance Loss Control Consultant Compensation: Reports that are completed and reviewed for accuracy are paid per assignment starting at $110. Become part of a growing industry! This is an excellent opportunity for individuals who want to set their own schedules and work independently in a growing segment of a vital industry. EOE
    $85k-109k yearly est. 45d ago
  • Loss Control Consultant - Portland, ME

    Regional Reporting 3.6company rating

    Remote or Portland, ME job

    Regional Reporting, Inc. (RRI) is one of the largest independently owned providers of Loss Control to the property and casualty Insurance industry. We specialize in Property, General Liability, Products Liability, Fleet, Inland Marine, and Workers' Compensation. RRI is seeking an experienced Insurance Loss Control Consultant throughout our coverage territory to conduct commercial insurance loss control inspections. Insurance Loss Control Consultant An Insurance Loss Control Consultant is primarily responsible for performing commercial insurance inspections and completing insurance underwriting reports. Insurance Companies use these reports to properly underwrite insurance policies. Insurance Loss Control Consultants drive to locations, take photos and visually observe the interior and exterior of facilities. They note the business operations to determine insurance exposures and identify potential improvements. Finally they document their findings in an insurance underwriting report via our website online. Work is assigned on a daily or weekly basis, depending on location. Insurance Loss Control Consultant Position Duties and Responsibilities: Recording onsite observations, taking measurements and photos in accordance with carrier-specific requirements Identifying building and roof construction type, square footage, potential hazards Timely completion of assignments/reports according to due dates Communicating regularly with Field Manager to complete inspections in the most cost effective and efficient manner Coordinating the time and date of the inspection meeting the insured representative onsite Preparing and reporting inspection results, uploading photos and preparing diagrams on an ongoing basis Drive to and from insured locations, some overnight travel may be required Insurance Loss Control Consultant Job Requirements: Minimum 2 years' experience working with other Loss Control Service Providers or Major Insurance Carriers Comprehensive understanding of commercial insurance lines - primarily Property, General Liability and Inland Marine Ability to identify building construction and ISO classes Broad understanding of NFPA codes Solid communication and time management skills Exceptional writing ability, organizational skills and computer skills Ability to work from home with a PC, high-speed internet connection and a cell/smart phone An automobile and valid driver's license, with acceptable driving record Ability to climb a ladder up to 6 feet Digital camera or smart phone with picture capability Measuring wheel, or similar tool, and camera pole Insurance Loss Control Consultant Compensation: Reports that are completed and reviewed for accuracy are paid per assignment starting at $110. Become part of a growing industry! This is an excellent opportunity for individuals who want to set their own schedules and work independently in a growing segment of a vital industry. EOE
    $72k-98k yearly est. 16d ago

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