• Managed Care Specialist

    Location US-OH-Richfield | US-NY-New York | US-NY-Syracuse | US-PA-Philadelphia | US-NY-Albany | US-NJ-Newark | US-CT-New Haven
    Posted Date 5 days ago(2/20/2020 3:30 PM)
    Job ID
    26163
    # of Positions
    1
    Division
    National Interstate
    Category
    Claims
    Position Type
    Full Time
  • Overview

    Headquartered in Fenton, Missouri, a suburb of St. Louis, Vanliner Insurance Company is a member of Great American Insurance Group. For over 30 years, Vanliner has grown to become the country’s top insurance provider for the moving and storage, parcel and home delivery industries. Our mission since day one, has been to provide first-class insurance products and unparalleled customer service to all of our customers. Our success is driven by the expertise, innovation and commitment to customer service that our employees provide. If you are ready to join an engaging and driven team such as ours, we would love to hear from you!

    Responsibilities

     

    • Facilitate, coordinate, monitor, and evaluate each claimant’s medical and rehabilitative treatment to ensure appropriate, effective, cost-efficient, and quality care. 
    • Works telephonically with claimants, employers, providers, and claim professionals to coordinate and assure proper delivery and oversight of medical services. 
    • Create care plans to address issues presented within the claim to enhance the claimant’s short and long-term treatment goals. 
    • Monitor, evaluate, and document case management activities and outcomes.
    • Communicate with medical providers to track treatment progress and modify the treatment plan as necessary to achieve maximum medical improvement. 
    • Monitor treatment for compliance to New York Medical Treatment Guidelines and address MG-2 requests for treatment timely and appropriately.
    • Perform first level formulary reviews and facilitate/monitor second level reviews as needed. 
    • Performs other duties as assigned.  Consult on claims in other venues as assigned.
    • Must have NY medical treatment experience
    • Work from Home

    Qualifications

    Education:  R.N. (Registered Nurse) Must have NY Medical Treatment experience
    Experience: 6 or more years of related experience, including Case Management experience.

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