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Vice President of Medical Cost Management

Job in Stockton, San Joaquin County, California, 95202, USA
Listing for: Confidential
Full Time position
Listed on 2026-02-06
Job specializations:
  • Management
Job Description & How to Apply Below

Vice President of Medical Cost Management About the Company

Join a respected insurance brokerage and risk management consulting firm dedicated to excellence in the insurance industry.

Industry
Insurance

Type
Public Company

Founded
1927

Employees
10,001+

Categories
  • Insurance
  • Risk Management
  • Consulting & Professional Services
  • Agents and Marketers
  • Employee Benefits
  • Group Insurance
  • Consulting
  • Management Consulting
  • Financial Services
Specialties
  • Insurance
  • Risk Management
  • Consulting
Business Classifications
  • B2B
  • Enterprise
About the Role

The Company is on the lookout for a dynamic Vice President of Medical Cost Management to lead the development, integration, and oversight of our medical cost containment program. In this pivotal role, you will differentiate our services in the marketplace, manage bill review operations and nurse case management, and ensure adherence to compliance standards with our business partners. Additionally, you'll design and implement training programs in medical case management.

Your expertise will be essential in tackling complex issues and providing technical support to case managers, all while keeping abreast of competitive intelligence on program fees. You will take the lead as a key management liaison, assist in crafting client proposals, and play a crucial role in branding and establishing industry best practices.

The ideal candidate will possess a Bachelor's degree and a minimum of 10 years of experience in the claims line of business, with at least 5 years dedicated to claims management roles. A comprehensive understanding of industry best practices is essential, along with an active California RN license. Preference will be given to candidates with over 15 years of claims experience and relevant certifications.

This role requires exceptional communication, negotiation, and influence management skills, enabling you to make strategic decisions and manage high-impact projects with ease. The successful candidate will be a strategic thinker, dedicated to service excellence, and capable of multitasking and working independently. Experience with RMIS systems and data mining is an added advantage.

Travel Percent
Less than 10%

Functions
  • Finance
  • Medical Care/Hospital Administration
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