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US 5w PTO

  • Establishes and implements the domestic managed care strategy for medical case management services.
  • Develops resource models, drives continuous improvement, and manages operational metrics to meet financial objectives.
  • Manages a network of providers to ensure quality and cost-effective medical management services.

Managed Care Quality Improvement

20 jobs similar to Manager, Claims-Managed Care

Jobs ranked by similarity.

$120,000–$225,000/yr
US 4w PTO

  • Responsible for performance, development, and coaching of staff.
  • Work with claims team and external attorneys to review coverages and resolve claims.
  • Partner with underwriting managers to provide excellent customer service.

Liberty Mutual is committed to delivering exceptional service and making a meaningful difference for customers. They strive to be the most trusted global brand and the best place to work, focusing on profitability and scale.

United States

  • Lead and develop a high-performing claims organization across rideshare property, auto, and bodily injury lines.
  • Own the end-to-end customer claims experience, driving service quality, efficiency, and regulatory compliance.
  • Partner with product and engineering teams to enhance claims systems and automation tools.

This company is a partner of Jobgether, offering a modern, technology-enabled claims organization focused on rideshare-related claims. They are a remote-first, high-growth firm with an inclusive culture and a focus on automation and customer-centric innovation.

US

  • Direct and oversee operations of the Enhanced Care Management program, including CalAIM performance and staff supervision.
  • Refine program policies, manage P&L, and develop KPIs to align performance with business objectives.
  • Collaborate cross-functionally with other departments and represent the organization externally.

Vynca provides comprehensive care for more quality days at home for individuals with complex needs. It is a close-knit community guided by core values of Excellence, Compassion, Curiosity, and Integrity, fostering a transformative movement.

$144,450–$192,550/yr
US

  • Lead complex, cross-functional programs with high business impact.
  • Partner with senior leaders to translate strategy into actionable programs.
  • Establish and monitor key performance indicators to measure program success.

CSAA Insurance Group, a AAA insurer, provides personal lines property and casualty insurance. With over 3,800 employees, they focus on innovation and human-centered solutions, fostering a collaborative culture where employees' strengths are valued and ideas drive impact.

US 4w PTO

  • Determines coverage, investigates, and resolves complex commercial casualty claims, including litigated bodily injury cases.
  • Manages litigation, including working with defense counsel, and ensures appropriate reserves and settlements.
  • Provides mentorship to staff and liaises with business partners such as Underwriting and Reinsurance.

Liberty Mutual is a global insurance company offering commercial casualty coverage. They have a large workforce with an inclusive culture, supporting employee development and providing comprehensive benefits.

US

  • Report, oversee, monitor, and investigate insurance claims across all jurisdictions.
  • Partner with insurance carriers to mitigate loss by evaluating and implementing tools.
  • Develop, implement, and improve scalable processes and training to build a best-in-class claims function.

Instawork's AI-powered labor marketplace helps local businesses scale and enables global technology companies to push the frontiers of robotics and AI. They connect more than 7M skilled workers with local restaurants, hotels, warehouses, stadiums, and more.

US 4w PTO

  • Lead medium- to large-sized projects and support complex cross-functional projects.
  • Own development and execution of the DRC employee mobility strategy, including design, policy creation, and ongoing measurement of effectiveness.
  • Design and implement optimization initiatives that improve how employees are moved, scheduled, and utilized across the DRC to meet service level and quality targets.

Liberty Mutual is responsible for writing over 400K net new business policies annually across the call center and online channels. They build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of company culture.

Global

  • Analyze and process workers compensation lost-time claims, investigating to determine benefits and exposure.
  • Negotiate settlement of claims within designated authority and communicate with claimants and clients.
  • Report claims to excess carrier and respond to requests in a professional and timely manner.

Sedgwick is the world’s leading risk and claims administration partner, helping clients navigate the unexpected with advanced AI-enabled technology. With over 33,000 colleagues and 10,000 clients across 80 countries, it offers a caring culture that values work-life balance and professional growth.

US

  • Provides clinical oversight and medical necessity reviews for home health, DME, and related services using evidence-based guidelines.
  • Conducts peer to peer consultations and adverse determinations when clinical criteria are not met to support quality outcomes.
  • Collaborates with health plan leadership, participates in committees, and achieves SLA metrics for client performance guarantees.

CareCentrix provides clinical oversight and utilization management for home health, DME, home infusion therapy, and sleep medicine services. The company has an award-winning culture that values care, integrity, excellence, and innovation, operating with a drug-free workplace and equal opportunity commitment.

US Unlimited PTO

  • Drive solution adoption, educating consultants and employers on the value and integration of solutions.
  • Deliver strategic education and serve as the escalation point for technical and clinical questions related to Pareto solutions.
  • Partner with Product, Clinical, and vendor partners to improve solution performance at scale through feedback.

ParetoHealth's mission is collective greatness, transforming employee health benefits since 2011. They help small and medium-sized businesses fight rising healthcare costs with financing innovations and a growing ecosystem of partners.

US 4w PTO

  • Identify, engage, build, and grow business development pipelines with ParTech partners aligned with business and financial objectives.
  • Develop a strategic, templatized go-to-market approach with each ParTech partner; set the partnership vision and strategy.
  • Organize and lead recurring partnership touch points to ensure Liberty Mutual remains a priority with the partner(s), with mutually aligned goals, and we are executing on our shared partnership strategy.

Liberty Mutual's Strategic Partnerships Group drives growth through third-party relationships. They focus on personal lines business via affinity marketing, embedded integrations, and agency relationships, playing a key role in Liberty Mutual’s omni-channel distribution strategy.

US

  • Provide senior leadership within healthcare communications, serving as a trusted advisor to major clients.
  • Oversee multiple accounts, driving strategy, business execution, and measurable results across teams.
  • Build and mentor staff while cultivating media relationships and leading new business development.

We. operates at the intersection of technology and humanity, bridging the gap between business creation and human experience. The company focuses on uncovering human needs to drive meaningful progress through communications and consulting services.

US

  • Own and grow strategic client relationships with large self-insured employers, translating healthcare claims data into actionable cost-saving strategies.
  • Lead client engagement cycles including regular check-ins, executive presentations, and strategic business reviews, collaborating with internal data science and clinical teams.
  • Oversee onboarding and implementation processes, coordinating with carriers and external data partners to ensure high-quality data intake and program enhancements.

Jobgether is an AI-powered job matching platform that connects candidates with hiring companies. They use technology to review applications and share top-fitting shortlists directly with employers, while the hiring company manages the final decision.

  • Manage a portfolio of claims presenting moderate to high complexity and exposure.
  • Conduct investigation and evaluation on coverage, liability, and damages throughout the life of the claim.
  • Positively influence claims outcomes through developing and executing action plans.

Amerisure creates exceptional value for its partners, policyholders, and employees. It is a property and casualty insurance company focusing on construction, manufacturing and healthcare, managing nearly $1 Billion of Direct Written Premium and maintaining $1.21 billion in surplus.

US

  • Develop and execute Go-to-Market strategies to drive profitable growth in North America.
  • Build relationships with C-level and VP-level executives, generate pipeline through networking and demand generation.
  • Achieve revenue targets by managing pipeline, leading negotiations, and collaborating with internal teams.

WNS is a leading Business Process Management company that combines industry knowledge with technology and analytics to create digital-led solutions. WNS Procurement, a strategic business unit, is a market leader in procurement transformation and managed services, serving leading global companies with a collaborative and innovative culture.

US

  • Partner with employer and union plan sponsors to deliver advanced primary care and improve health outcomes for members.
  • Provide care through nationwide onsite, nearsite, and virtual health centers, supporting a value-based care model.
  • Drive meaningful cost savings for plan sponsors while enhancing the healthcare experience for both members and providers.

Marathon Health is a leading advanced primary care provider partnering with employer and union plan sponsors to improve health for millions of Americans. The company is certified as a Great Place to Work® and is committed to building an inclusive, high-trust culture where all employees can thrive.

$125,000–$155,000/yr
US Unlimited PTO

  • Own the full premium audit lifecycle for WC and GL lines of business, ensuring adherence to regulatory requirements.
  • Lead, coach, and develop a high-performing organization of managers and QA staff.
  • Enhance the audit customer journey to reduce friction, improve clarity, and increase audit completion rates.

ERGO NEXT's mission is to help entrepreneurs thrive by building the only technology-led, full-stack provider of small business insurance in the industry, taking on the entire value chain and transforming the customer experience. They have helped hundreds of thousands of small business customers across the United States get fast, customized and affordable coverage.

US

  • Lead one or more client policy initiatives with a team, including policy analysis, facilitating client meetings, and deliverable development.
  • Drive your development through an annual process with your supervisor and BerryDunn's learning and development team.
  • Participate in new business development through research, supporting proposal content, or developing marketing materials.

BerryDunn is a client-centered, people-first professional services firm that helps businesses, nonprofits, and government agencies solve their greatest challenges. Founded in 1974, the firm is recognized for its diverse and inclusive workplace culture and focus on learning, development, and well-being.

US

  • Manage complex and frequently changing calendars, meeting schedules, and competing priorities.
  • Coordinate meetings, materials, and follow-ups across multiple stakeholders or functions.
  • Support cross-functional coordination and communication; act as a key point of contact within the team or function.

Kinaxis is a global leader in modern supply chain orchestration, powering complex global supply chains. With over 2000 employees around the world, they are trusted by renowned global brands to provide the agility and predictability needed to navigate today’s volatility and disruption.

US 4w PTO

  • Define and drive product strategy across care delivery infrastructure and clinical operations tooling, balancing near-term impact with foundational investment.
  • Lead through ambiguity at scale, framing and resolving complex problem spaces while aligning clinical, engineering, and operational stakeholders.
  • Deliver high-impact outcomes from discovery through launch, owning success metrics tied to patient outcomes and care team effectiveness.

Imagine Pediatrics is a tech-enabled, pediatrician-led medical group reimagining care for children with special health care needs. They deliver 24/7 virtual and in-home care, and are an equal opportunity employer with a focus on diversity and inclusion.