Gallagher · 1 week ago
Vice President, Bill Review and Managed Care
Torrance, CA
Full-time
Hybrid
Senior Level, Lead/Staff
$142K/yr - $278K/yr
10+ years expGallagher is a global leader in insurance, risk management, and consulting, committed to helping clients face risk with confidence. The Vice President will be responsible for the development, integration, and operation of the medical cost containment program, managing bill review and nurse case managers, ensuring compliance, and conducting training programs.
ConsultingFinancial ServicesInsuranceManagement ConsultingRisk Management
Responsibilities
Manage Bill Review and Managed Care units
Review and report on monthly financials for case management and bill review
Management liaison with Enlyte / Genex, Harbor Health, One Call
Review of medical management impact reports to all Mangers and Account Executives
Maintain competitive intelligence on all PRIME fees
Develop pricing matrixes to determine revenue for PRIME
Complete analysis of fees with based on information from competitive intelligence
Review pricing on an annual basis to determine if increases are needed, and provide analysis to the field with notification to the clients
Monitor copy service vendors/contracts and negotiate fees
Collaborate with vendor partners to improve programs
Assist with Client proposals and workshops
Completion of request for proposals
Provide overview presentations to potential partner carriers/on-site client visits
Assist Account Executives in program education/client interface
Coordinate bill review comparisons for new clients
Development of branding/differentiation and best practices
Initiate and develop innovative, quality alternatives to traditional treatment plans and patient care services
Review complex cases that are referred by case management or claims personnel to identify and resolve problems
Design, develop and conduct training programs
Ensure that all training manuals, Policy and Procedure Manuals and other departmental manuals used by clinical and non-clinical staff are current
Keep current with medical technology and corresponding updates to medical practices and procedures
Other duties as assigned
Qualification
Required
Bachelors Degree with a minimum of 10 years experience in claims line of business required
A minimum 5 years experience in claims management positions required
Comprehensive knowledge of industry best practices and procedures
Active California RN license required
Preferred
15 plus years claims experience highly preferred
Relevant industry designations preferred
Benefits
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
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...
Company
Gallagher
Gallagher is an international insurance brokerage and risk management services firm.
10001+ employees
H1B Sponsorship
Gallagher has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (58)
2024 (31)
2023 (32)
2022 (45)
2021 (36)
2020 (15)
Funding
Current Stage
Public CompanyTotal Funding
$9.7B2024-12-09Post Ipo Equity· $8.5B
2023-06-22Post Ipo Debt· $1.2B
1984-06-29IPO
Leadership Team
Alec Herring
Area Senior Vice President
Mark Gresser
Executive Vice President
Recent News
Life Insurance International
2026-01-07
2025-12-04
2025-11-19
Company data provided by crunchbase