Gallagher Case Management Supervisor in Richmond, Virginia

At Gallagher Bassett Services, Inc. (GB) at http://www.gallagherbassett.com/ we are constantly seeking skilled professionals who are up for a challenge and take exceptional performance to heart. The professionals we hire help us maintain our reputation as one of the most progressive property/casualty third party claims service organizations in our industry and throughout the world. Gallagher Bassett provides services to Fortune 1000companies throughout 100 offices worldwide. For the past several years GB has ranked among the largest TPA's by Business Insurance Magazine and was also a recipient of the Business Insurance Readers' Choice award for "Best Third Party Claims Administrator." If you're looking for a professional career with an industry leader then you have come to the right place. Wherever your interests lie, we're sure you will agree on one thing: our continued prosperity hinges on our greatest resource --- our people.

Position Summary:

Essential Duties and Responsibilities:

  • Manages and coordinates regulatory compliance issues of case management department and provides support and oversight of department operations/processes.

  • Develops and maintains individual state regulatory compliance to include preparing state applications, renewals, quarterly, and annual reports.

  • Maintains current and new licensure or certification requirements as mandated by state regulations, i.e. managed care organization (MCO), utilization review (UR), etc.

  • Assists in maintenance of national accreditation.

  • Complies with requested reports and audits from state regulatory entities.

  • Revises and develops policies and procedures, as appropriate.

  • Assists in annual review of departmental policies and procedures.

  • Communicates current and new regulations to all departments.

  • Interfaces with continual quality improvement programs, as appropriate.

  • Provides department services as outlined.

  • Oversees and supports staff and develops, implements, and maintains criteria for the review process.

  • Manages process and ensures efficiency, timeliness, and accuracy.

  • Maintains and monitors work distribution and workflow of staff.

  • Provides and monitors daily management reports for branch and system functions.

  • Develops unit staffing and maintains training programs.

  • Provides staff cross-training for continued operation efficiency.

  • Monitors vacation reporting and timesheets.

  • Prepares agendas and conducts staff meetings.

  • Communicates effectively with medical providers, peer advisors, adjusting staff, government agencies, customers, staff, and peers.

  • Interviews and hires with managerial approval.

  • Develops and manages staff to meet or exceed goals established.

  • Monitors and/or maintains documentation resource for verbal/written requests, inquiries, and complaints.

  • Attends training/educational classes as appropriate.

  • Participates in quality assurance auditing.

Required:

  • Bachelors Degree; Active Registered Nursing license within the state of practice; Willingness to be licensed in states requiring State specific licensure or certification.

  • Minimum of 3 years clinical experience in an acute care setting.

  • Additional experience accepted in lieu of degree, if candidate has an Active Registered Nursing License.

Recommended:

  • Prior supervisory or management experience a plus; Workers compensation experience.

US. EligibilityRequirements:

  • Interested candidates must submit an application and resume/CV online to be considered.

  • Must be 18 years of age or older.

  • Must be willing to submit to a background investigation; any offer of employment is conditioned upon the successful completion of a background investigation.

  • Must have unrestricted work authorization to work in the United States. For U.S. employment opportunities, Gallagher hires U.S. citizens, permanent residents, asylees, refugees, and temporary residents. Temporary residence does not include those with non-immigrant work authorization (F, J, H or L visas), such as students in practical training status. Exceptions to these requirements will be determined based on shortage of qualified candidates with a particular skill. Gallagher will require proof of work authorization.

  • Must be willing to execute Gallagher's Employee Agreement or Confidentiality and Non-Disclosure Agreement, which require, among other things, post-employment obligations relating to non-solicitation, confidentiality and non-disclosure.

Gallagher offers competitivesalaries and benefits, including: medical/dental/vision plans, life and accidentinsurance, 401(K), employee stock purchase plan, educational expensereimbursement, employee assistance program, flexible work hours (availabilityvaries by office and job function) training programs, matching gift program,and more.

Gallagher believes that all personsare entitled to equal employment opportunity and does not discriminate againstnor favor any applicant because of race, color, religion, sex, age, veteranstatus, disability, national origin, or any other legally protected status. Equal employment opportunity will be extended in all aspects of theemployer-employee relationship, including, but not limited to, recruitment,hiring, training, promotion, transfer, demotion, compensation, benefits,layoff, and termination. In addition, Gallagher will make reasonableaccommodations to known physical or mental limitations of an otherwisequalified applicant with a disability, unless the accommodation would impose anundue hardship on the operation of our business.

Job: Claims

Organization: GB US Operations

Title: Case Management Supervisor

Location: Virginia-Richmond

Requisition ID: 41149