Clinical Services Assistant Manager

EMC Insurance Companies

Job Overview

Location

Remote in US

Job Type

Full-time

Full Job Description

📋 Description

• Lead daily clinical services operations, including nurse case management, pharmacy, nurse review, and bill review functions.
• Evaluate referrals and claim complexity, assigning work to internal staff or vendor partners.
• Manage team workload, priorities, turnaround times, and overall service delivery.
• Ensure clinical services are effectively integrated into claims handling processes and partner closely with claim professionals.
• Lead, coach, develop, and monitor the performance of the Clinical Services team.
• Oversee operational reporting, recommend KPIs, and monitor vendor performance and outcomes.
• Partner with Claims leadership to expand clinical services, improve consultation practices, and enhance service quality.
• Support implementation of new tools, clinical programs, regulatory changes, and vendor solutions.
• Identify training needs, develop educational programs, and promote clinical services throughout the organization.
• Drive process improvement initiatives that enhance efficiency, quality, and claim outcomes.

🎯 Requirements

• Current Registered Nurse (RN) license
• Bachelor’s degree in nursing (BSN) preferred
• Eight years of nursing experience, including at least four years of property and casualty clinical claim oversight
• Legal Nurse Consultant Certified (LNCC) designation, Case Management (CM), or other applicable designations preferred
• Experience in multiple medical specialties preferred
• Previous leadership or supervisory experience preferred

🏖️ Benefits

• The hiring salary range for this position will vary based on geographic location, falling within either of the following: $100,085 - $138,285 or $110,624 - $152,122
• Comprehensive rewards package, please visit www.emcins.com/careers

Skills & Technologies

Remote

$100k-138k

Degree Required

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EMC Insurance Companies

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About EMC Insurance Companies

EMC Insurance Companies is a leading provider of commercial insurance, offering a comprehensive range of products and services to businesses of all sizes. With a strong focus on customer service and risk management, EMC partners with independent agents to deliver tailored solutions that meet the unique needs of each client. Their offerings include property, casualty, workers' compensation, and umbrella insurance, backed by a commitment to financial strength and stability. EMC is dedicated to helping businesses protect their assets, manage risks effectively, and achieve their growth objectives through reliable insurance coverage and expert guidance. They strive to be a trusted advisor and partner in their clients' success.

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