A

Arthur J. Gallagher & Co.

Global insurance brokerage, risk management, consulting

Vice President of Nurse Case Management and Nurse Triage - Nurse Case Management and Nurse Triage

Medical, Clinical & VeterinaryConfirmed live in the last 24 hours
Full-timeRolling Meadows, IL, USANo salary listed

About the Job

Requirements

  • A minimum of 8 years of experience in case management or a related field is required.
  • A minimum of 5 years of supervisory experience is required.
  • A bachelor's degree is required.
  • The role requires the ability to travel approximately 50% of the time and work nontraditional hours.
  • Preferred certification in CCM, CDMS, CRRN, COHN, or CRS.
  • Significant leadership experience within Nurse Case Management and Nurse Triage, with experience in workers’ compensation, managed care, occupational health, disability management, or a related clinical environment.
  • Experience leading large, geographically dispersed clinical operations.
  • Understanding of workers’ compensation clinical management, return-to-work principles, and Nurse Triage assessment, protocols, appropriate care recommendations, and escalation practices.
  • Experience managing financial and operational performance.
  • Ability to lead organizational change and large-scale process improvement.
  • Executive communication, client presentation, and relationship-management skills.
  • Ability to operate effectively across clinical, operational, financial, technology, regulatory, and commercial functions.

Responsibilities

  • Develop and execute the national Nurse Case Management and Nurse Triage strategy in alignment with Managed Care and organizational objectives.
  • Establish the future-state operating model for Nurse Case Management and Nurse Triage, including nurse triage, field, telephonic, and specialty case management services.
  • Identify opportunities to expand Nurse Case Management and Nurse Triage capabilities, improve clinical outcomes, enhance the client experience, and drive profitable growth.
  • Partner with Claims, Sales, Account Management, Legal, Compliance, Finance, IT, and other Managed Care functions to advance strategic priorities.
  • Represent Nurse Case Management and Nurse Triage in executive, client, and cross-functional discussions.
  • Provide executive oversight of Nurse Case Management operations, ensuring consistent service delivery, clinical quality, productivity, and appropriate resource utilization.
  • Provide executive oversight and operational leadership for Nurse Triage services, including staffing, coverage, clinical protocols, timely response, documentation, escalation, and coordination with Claims and Nurse Case Management.
  • Establish standardized workflows, clinical protocols, documentation expectations, escalation processes, and performance standards for Nurse Case Management and Nurse Triage.
  • Promote effective coordination among injured workers, employers, adjusters, treating providers, and other stakeholders, including seamless handoffs from Nurse Triage to Claims and Nurse Case Management.
  • Drive return-to-work strategies and appropriate medical management through Nurse Case Management, and timely assessment and guidance to the appropriate level of care through Nurse Triage, while maintaining focus on injured workers’ needs.
  • Monitor Nurse Case Management caseloads and capacity, Nurse Triage call volumes and response times, staffing, service levels, and performance trends across both services.
  • Establish a clinical governance and quality assurance framework for Nurse Case Management and Nurse Triage.
  • Ensure Nurse Case Management and Nurse Triage operations align with applicable state-specific requirements, professional nursing standards, client requirements, and organizational policies.
  • Partner with Legal and Compliance to identify and mitigate clinical, regulatory, and operational risk.
  • Oversee quality audits, documentation standards, Nurse Triage protocol adherence and escalation reviews, corrective-action initiatives, and continuous-improvement activities across Nurse Case Management and Nurse Triage.
  • Maintain safeguards around clinical decision-making and scope of practice.
  • Own Nurse Case Management and Nurse Triage operational performance and contribute to revenue, expense, profitability, and budget objectives.
  • Develop staffing and capacity models for Nurse Case Management and Nurse Triage that balance service quality, growth, productivity, coverage, and financial performance.
  • Monitor key performance indicators and identify opportunities to increase efficiency without compromising clinical quality.
  • Support development of pricing models, business cases, client solutions, and new Nurse Case Management and Nurse Triage offerings.
  • Partner with Finance and leadership to establish forecasts and evaluate performance against plan.
  • Lead modernization of Nurse Case Management and Nurse Triage through workflow redesign, automation, data, analytics, and technology.
  • Provide business leadership for Nurse Case Management and Nurse Triage platform development and implementation, including triage call management, clinical decision support, documentation, and handoffs, ensuring technology supports clinical workflows rather than merely digitizing legacy processes.
  • Champion adoption of new tools and processes across the organization.
  • Establish dashboards and performance measures to improve transparency and facilitate data-driven decisions.
  • Identify appropriate opportunities for artificial intelligence and automation across Nurse Case Management and Nurse Triage while maintaining clinical oversight and appropriate controls.
  • Lead and develop leaders responsible for field case management, telephonic case management, and nurse triage operations.
  • Establish accountability, leadership expectations, succession planning, and professional development.
  • Develop workforce strategies addressing recruitment, retention, geographic coverage, licensing, span of control, specialized clinical capabilities, and triage staffing and coverage.
  • Build a culture of accountability, collaboration, continuous improvement, and clinical excellence.
  • Develop future leaders and strengthen organizational capabilities as the business grows.
  • Serve as an executive clinical and operational resource for strategic clients and prospects across Nurse Case Management and Nurse Triage services.
  • Participate in client presentations, stewardship meetings, requests for proposals, implementations, and solution-development activities.
  • Translate client needs and market trends into service enhancements and new solutions.
  • Partner with Sales and Account Management to articulate the value and measurable impact of Nurse Case Management and Nurse Triage.
  • Support growth of Nurse Case Management and Nurse Triage into new jurisdictions, client segments, and delivery models.

About the Company

Arthur J. Gallagher & Co.

Global insurance brokerage, risk management, consulting

Arthur J. Gallagher & Co. is a global insurance brokerage and risk management firm. It helps businesses, public entities, and individuals manage risk and obtain insurance through three segments: brokerage, risk management, and corporate. The brokerage unit offers a full range of retail and wholesale insurance brokerage and consulting services to match clients with coverage. The risk management unit handles contract claim settlements, claim administration, loss control consulting, and risk management information services to reduce exposures. The corporate unit oversees the company’s clean energy and other investments. The firm differentiates itself by providing end-to-end risk solutions across insurance placement, claims handling, risk counseling, and investment activities, rather than focusing on a single service. Its goal is to help clients manage risk effectively, protect assets, and pursue value through diverse investments, including clean energy.

Company size
10,001+
Company stage
IPO
Headquarters
Itasca, IL
Founded
1927

Recently Posted Jobs

Explore more opportunities at Arthur J. Gallagher & Co.

See more jobs