Manager, Nurse Case Management

Boston, Massachusetts
Not Specified
Nov 20, 2020
Jan 18, 2021
Job Type
Not Specified
Career Level
Not Specified

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In this role you will lead the Workers Compensation Managed Care Nurse Case Management unit. Responsible for developing, measuring, and balancing short-term priorities with long-term strategic business plans. Plans, organizes and directs with the accountability for attaining metrics around quality, productivity, compliance and other operational objectives to meet GRS North America business goals. Actively partners and fosters a strong working relationship with other GRS NA senior management. Accountable for employee selection, development and performance management of direct and indirect reports. Leverages management team to accomplish goals and initiatives.


  • Identifies and evaluates internal and external issues of strategic importance. Contributes to the establishment of the department vision and strategy.
  • Aligns objectives, strategies, tactics and resources to best support the profitable growth of GRS NA and meet critical success factors for the department.
  • Defines and delivers measurable value. Leads the Nurse Case Management unit.
  • Manages unit activities to achieve organizational objectives related to achieve claim resolution, disposition and complex avoidance.
  • Balances outcomes and cost of delivery and service.
  • Maximize efficiencies and outcomes by ensuring that resource units and supporting groups are appropriately aligned with operating units/goals.
  • Builds and sustains culture around change, continuous improvement and innovation.
  • Develops, manages and holds unit accountable for Managed Care Unit's metrics.
  • Effectively uses data/analytics to assess and benchmark organizational performance and responds timely and appropriately to areas warranting improvement.
  • Operates the organization in a cost competitive manner.
  • Makes sound short-term and long-term decisions regarding, staffing, technology, outsourcing, investments.
  • Understands the need to shift expense dynamics to match changing business needs/factors. Prepares and monitors the budget for the Managed Care unit.
  • Monitors expense trends against existing volume and market variables. Makes adjustments as needed.
  • Makes sound expense decisions. Runs operation with an understanding of how the expense structure contributes to PTOI.
  • Identifies and evaluates internal and external issues of strategic importance. Contributes to the establishment of the department vision and strategy.
  • Defines and delivers measurable value.
  • Ensures internal controls and practices to comply with corporate requirements and state/federal statute. Responsible for implementation of new policies and procedures. Complies with or establishes and monitors process, procedures and checkpoints to ensure a high degree of effectiveness and execution of deliverables.
  • Creates a positive and highly productive environment that supports the recruitment, selection, training and ongoing development of the management team and staff.
  • Manages performance of staff including: establishment of objectives and coaching. With management team, identifies promotional opportunities for staff, performance issues, or disciplinary actions and takes appropriate action.

Technical skills: Extensive knowledge of casualty insurance, state regulatory environments, and finance/accounting practices as they apply to claims. Broad knowledge of commercial property & casualty products including competitive dynamics; insurance operations; finance acumen. Previous healthcare or health- industry experience and/or Workers Compensation knowledge is preferred. Professional/General Business skills: Proven leadership in leading a large complex workers compensation or managed care organization. Ability to set direction, create alignment and inspire/motivate and manage constant change. Ability to work cross-functionally by engaging and motivating people; negotiation; influencing others; communicating effectively (listening, verbal, written, etc.); Ability to adapt, learn quickly, and respond effectively to varied and intense challenges. Education: As normally acquired through an advanced degree or equivalent training, 12 or more years of relevant experience, several of which should be in a management capacity. Preference for professional designations.

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