Job Description

Indulge your passion for problem-solving and embrace the thrill of addressing risk head-on at Gallagher's global brokerage team. Join a family of diverse minds, united by a relentless pursuit of excellence. As part of our team, you'll be the architect of protection, safeguarding businesses and empowering their ambitions. Together, we'll build a legacy of trust and triumph in the dynamic world of risk management.

We believe that every candidate brings something special to the table, including you! So, even if you feel that you’re close but not an exact match, we encourage you to apply.

We are looking to add a Nurse Navigator to our growing team!  As a nurse navigator, your role will be to guide and support our members in understanding their benefits and how best to utilize them. You will serve as a clinical concierge, providing healthcare navigation, proactive outreach, and assistance with claim resolution and prior authorization. Additionally, you will offer disease management and education, acting as a liaison between healthcare professionals, vendors, and other departments or teams. Your goal will be to ensure that our members receive the best possible care and support throughout their healthcare journey.

How you'll make an impact

• Ensures effective use of services and manages costs, helping control expenses and ensure fair practices.
• Review and analyze claims to understand resources that may be needed for resolution
• Act as a liaison among referral sources, physicians, and members to facilitate cost-effective healthcare solutions and enhance communication.
• Collects and analyze data on health outcomes and program participation to assess and improve wellness initiatives, leading to better health outcomes and satisfaction.
• Identifies member for referral opportunities to integrate with other services, promoting comprehensive care.
• Collaborate with healthcare professionals, vendors, and departments to integrate health and wellness initiatives.
• Utilize understanding of case management, insurance plans, and regulations to ensure compliance and effective service delivery.
• Connect individuals with healthcare providers and community resources to address specific health needs, improving individual and community health outcomes

Skills for success:

• Strong communication: ability to effectively communicate and present to groups and individuals
• Critical thinking and problem-solving: assess health needs, identify risk factors, and develop appropriate interventions
• Organizational and time management: manage multiple tasks and prioritize workload effectively
• Flexibility and adaptability: ability to adjust approach and strategies based on the needs of individuals and groups
• Collaboration and partnership: work effectively with other healthcare professionals, groups, and community organizations to deliver comprehensive wellness services
• Professionalism and ethical conduct: adhere to ethical and legal standards in healthcare practice and maintain confidentiality
• Continued learning and adaptability: willingness to learn and adapt to new software systems and technological advancements

Required:

• Associate's degree from an accredited school of nursing
• Minimum of 3 years clinical experience in an acute care setting
• Active Registered Nursing license within the state of practice.

Preferred:

• BSN
• 3+ year utilization management/case management experience in an insurance (non-hospital) setting.
• 3+ years claims review experience including familiarity of reimbursement methodology.
• Pre- and post-pay claims review and healthcare data experience preferred.
• Experience in quality improvement related activities.

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We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. 

Below are the minimum core benefits you’ll get, depending on your job level these benefits may improve:

• Medical/dental/vision plans, which start from day one!
• Life and accident insurance
• 401(K) and Roth options
• Tax-advantaged accounts (HSA, FSA)
• Educational expense reimbursement
• Paid parental leave

Other benefits include:

• Digital mental health services (Talkspace)
• Flexible work hours (availability varies by office and job function)
• Training programs
• Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing
• Charitable matching gift program
• And more...

We value inclusion and diversity

Click Here to review our U.S. Eligibility Requirements

Inclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work.

Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest.

Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as “protected characteristics”) by applicable federal, state, or local laws.

Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.

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