Licensed clinical social worker (lcsw) | Traverse, MI

performs the essential functions of the position, which include supporting the service needs of clients in placing and servicing new and existing business. Responsibilities include new and renewal marketing, cross selling and rounding accounts. Marketing new business is required as part of the position as well as meeting the sales, service needs of our clients.

Individuals in this position generally have 3-5 years' experience servicing clients. PRIMARY DUTIES AND RESPONSIBILITIES Sales Pre-qualifies, analyzes prospects' commercial lines coverage needs; recommends coverage and prepares rating quotes and proposals to sell new accounts Actively solicits increases in coverage or rounding

out accounts through sales to clients at every service contact Recommends excess and surplus coverage, as needed to meet client insurance needs. Educates clients as to coverage limitation and documents on the system Completes applications for insurance and has insured sign them; submits to eligible and appropriate carriers, and follows up to ensure timely receipt of policies or quotations Actively refers clients to other departments for those lines that they do not work with for solicitation of new business Retention At each service contract, reviews current client coverage and recommends changes in coverage and in markets, as needed to ensure high quality coverage Processes renewals and remarkets,

as needed Assists clients with making coverage changes and completes all service requests for clients Informs clients of policy changes, exclusions of coverage and insurance coverage needs Generates documents and produces correspondence to satisfy client service requests Underwriting Develops professional and valuable relationships with key company underwriters Perform pre-underwriting review of all applications to check for accuracy and completeness of forms including supplemental applications Interacts with others effectively by utilizing good communication skills; cooperates positively and provides information and guidance, as needed to contribute to the business efforts of the agency Maintains and updates technical manuals and understands its use to perform technical tasks and expedite entry of information into the Agency Information System Sets priorities and manages workflow to ensure efficient, timely, and accurate processing of transactions and other responsibilities Keeps informed regarding industry information, new product information, coverage and technology to continuously improve knowledge and stay current Requirements Property/Casualty License Knowledge of insurance products and usage Previous experience commercial lines insurance Ability to work side by side with producer Sets priorities and manages workflow to ensure efficient, timely, and accurate processing of transactions Keeps informed regarding industry information, new product information, coverage and technology to continuously improve knowledge and stay current Interacts with others effectively by utilizing good communication skills; cooperates positively and provides information and guidance, as needed to contribute to the business efforts of the agency Ability to communicate orally and in writing with others to explain complex issues, receive and interpret complex information and respond appropriately COMPENSATION & BENEFITS At Spire/Top O' Michigan, we encourage a work-life balance.

S alary is negotiable based on experience and production. We will nurture your learning, support your endeavors, and encourage your professional and individual growth. Other benefits you will enjoy as an Account Manager include: Medical Insurance Optional Dental & Vision 401(k) Retirement Plan (With matching) Life and Disability Plans Offered Annual Performance Reviews & Career Pathing New Business Incentives Profit Sharing PTO/Paid Holidays/Paid Volunteer Hours

shared 1:4 Single hospital coverage EMR: Cerner Loan repayment available Fellowship stipend available Community Information Live and work in a four-season vacation area offering an abundance of fresh water lakes, snow skiing, numerous country trails, championship golf courses, all types of water sports and breathtaking autumn colors.

The town has an active art and music community leading to very diverse and exciting opportunities to both watch and participate in music and theater. The historic downtown gaslight district has many top-notch restaurants, specialty shops and boutiques. The area is referred to as a ‘Mini Nantucket’ with upscale residential and resort communities that has world

class amenities. Job Benefits About the Company At AMN Healthcare, we strive to be recognized as the most trusted, innovative, and influential force in helping healthcare organizations provide quality patient care that continually evolves to make healthcare more human, more effective, and more achievable.

Internal Medicine, Gastroenterologist, Gastroenterology, Digestive Track, Digestive, Gastrointestine, Physician, Healthcare, Health Care, Patient Care, Hospital, Medical, Doctor, Md For more details: jobs-search. org/gastroenterology_petoskey-c435414/gastroenterology-petoskey_i1973377428

and extended courses of outpatient treatment. This process includes clinical judgement, utilization management, application of product benefits, understanding of regulatory requirements, and verification of medical necessity utilizing nationally recognized criteria.

In addition, discharge planning and provider education are major components of this process. Think you've got what it takes? Responsibilities Analyze submitted information including clinical backssments, treatment plan, regulatory guidelines, medical necessity, and accrediting standards for all requests Creates a case summary evaluation for requests failing medical necessity criteria, and has collaborative discussion with

the medical director or designee for review and disposition Documents due process, attempts to gain adequate clinical information to analyze for decision, reviews all denial letters for appropriate regulatory verbiage, accuracy of the member plan type and adherence to applicable policy and procedure with regards to the denial letter process Creates communication pieces to providers which meet accrediting and regulatory guidelines for clinical content and readability levels describing decision making rationale for service requests and notifies providers through written correspondence Collaborates with all disciplines within the health plan to meet goals and objectives meeting with contracting

and provider relations on routine basis Creates recommendation of direction for care planning based on projected course of treatment and prognosis analysis Creates a cost benefit analysis in situations where coverage outside of benefit s needs to be evaluated on due to unique member situation and delivers that to medical director/designee Works closely with UM Analyst staff to expedite appeals and complaint process by coordination of concurrent activity with policy and procedure requirements Qualifications Being fully vaccinated against COVID-19, including any booster dose(s) of the COVID-19 vaccine recommended by the Centers for Disease Control when eligible, is required for all employees at Texas Children's, unless approved for a medical or religious exemption Diploma in or associate's degree in Nursing, or an associate's degree in a related field accepted by the Texas Board of Nursing for the purposes of obtaining and maintaining an RN license Bachelor's degree in Nursing preferred RN license from the Texas Board of Nursing or Nursing Licensure Compact required3 years nursing experience required Experience with Utilization Management or Case Management preferred Company Profile Founded in 1996, Texas Children's Health Plan is the nation's first health maintenance organization (HMO) created just for children.

We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area. To join our community of 14,000 dedicated team members, visit texaschildrenspeople.

org for career opportunities. You can also learn more about our amazing culture at infinitepassion. org. At Texas Children's Hospital, diversity, equity, and inclusion are at the core of our values and mission for the women and children that we serve. We are committed to providing a diverse and inclusive work environment for all faculty, staff and learners throughout our organization. We believe that each member of our one amazing team provides enrichment that allows us to create a lasting legacy for future employees of this great organization. Texas Children's is proud to be an equal opportunity employer.

All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, interactionual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved. " For more details: jobs-search. org/insurance_bellaire-c435205/utilization-management-clinical-registered-nurse-rn-bellaire_i1949137579

and extended courses of outpatient treatment. This process includes clinical judgement, utilization management, application of product benefits, understanding of regulatory requirements, and verification of medical necessity utilizing nationally recognized criteria.

In addition, discharge planning and provider education are major components of this process. Think you've got what it takes? Responsibilities Analyze submitted information including clinical backssments, treatment plan, regulatory guidelines, medical necessity, and accrediting standards for all requests Creates a case summary evaluation for requests failing medical necessity criteria, and has collaborative discussion with

the medical director or designee for review and disposition Documents due process, attempts to gain adequate clinical information to analyze for decision, reviews all denial letters for appropriate regulatory verbiage, accuracy of the member plan type and adherence to applicable policy and procedure with regards to the denial letter process Creates communication pieces to providers which meet accrediting and regulatory guidelines for clinical content and readability levels describing decision making rationale for service requests and notifies providers through written correspondence Collaborates with all disciplines within the health plan to meet goals and objectives meeting with contracting

and provider relations on routine basis Creates recommendation of direction for care planning based on projected course of treatment and prognosis analysis Creates a cost benefit analysis in situations where coverage outside of benefit s needs to be evaluated on due to unique member situation and delivers that to medical director/designee Works closely with UM Analyst staff to expedite appeals and complaint process by coordination of concurrent activity with policy and procedure requirements Qualifications Being fully vaccinated against COVID-19, including any booster dose(s) of the COVID-19 vaccine recommended by the Centers for Disease Control when eligible, is required for all employees at Texas Children's, unless approved for a medical or religious exemption Diploma in or associate's degree in Nursing, or an associate's degree in a related field accepted by the Texas Board of Nursing for the purposes of obtaining and maintaining an RN license Bachelor's degree in Nursing preferred RN license from the Texas Board of Nursing or Nursing Licensure Compact required3 years nursing experience required Experience with Utilization Management or Case Management preferred Company Profile Founded in 1996, Texas Children's Health Plan is the nation's first health maintenance organization (HMO) created just for children.

We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area. To join our community of 14,000 dedicated team members, visit texaschildrenspeople.

org for career opportunities. You can also learn more about our amazing culture at infinitepassion. org. At Texas Children's Hospital, diversity, equity, and inclusion are at the core of our values and mission for the women and children that we serve. We are committed to providing a diverse and inclusive work environment for all faculty, staff and learners throughout our organization. We believe that each member of our one amazing team provides enrichment that allows us to create a lasting legacy for future employees of this great organization. Texas Children's is proud to be an equal opportunity employer.

All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, interactionual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved. " For more details: jobs-search. org/insurance_bellaire-c435205/utilization-management-clinical-registered-nurse-rn-the-health-plan-bellaire_i1949953382