The Clinical Pharmacist manages prescription drug claims utilization and educates physicians to optimize prescribing patterns and reduce benefit payouts. They serve as a liaison for medical policy development and support clinical initiatives such as NCQA and HEDIS measures.
Emergent Holdings
22 Remote Job Openings at Emergent Holdings
The Pharmacy Technician supports clinical and operational processes for Medicare Star measures by conducting outreach to providers and members to improve medication adherence. They are also responsible for maintaining call logs, managing customer service inquiries, and assisting professional staff with medication lists and data analysis.
Investigates complex commercial auto claims and exercises significant discretion in determining compensability and reserves. Mentors lower-level claim handlers and coordinates special projects to ensure efficient claim resolution.
Lead the development and design of the organization's business resilience program to minimize loss and restore critical functions during interruptions. Coordinate with IT and business units to create, test, and maintain recovery plans and conduct preparedness training.
Workers' Compensation Defense Attorney - St. Louis, MO
Emergent Holdings
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Full Time
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19 days ago
Emergent Holdings
Defend workers' compensation claims through hearings, depositions, and settlement negotiations. Represent the company before courts and administrative bodies while providing legal guidance and risk assessment.
Defense Attorney (Worker's Compensation) - Los Angeles, CA
Emergent Holdings
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Full Time
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a month ago
Emergent Holdings
Defend litigated Workers' Compensation claims before the WCAB, managing a full caseload from referral through trial or arbitration. Responsibilities include conducting investigations, attending depositions, negotiating settlements, and drafting legal briefs.
Provide legal assistance to attorneys through case preparation, legal research, and the drafting of complex documents. Responsibilities include interviewing witnesses, managing workers' compensation files, and assisting with court hearings.
Manage and settle moderately difficult workers' compensation claims by investigating compensability and establishing financial reserves. Coordinate return-to-work efforts, manage medical billing, and negotiate settlements with attorneys or injured parties.
Director, Pharmacy Quality - Medicare Part D Star
Emergent Holdings
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Full Time
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a month ago
Emergent Holdings
The Director is responsible for designing and executing a multi-year strategy to improve medication adherence rates and achieve Medicare Part D Star measure performance goals. This includes overseeing a multidisciplinary team and managing external vendor contracts and service-level agreements.
Defense Attorney (Workers’ Compensation) – IL
Emergent Holdings
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Full Time
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a month ago
Emergent Holdings
Defend litigated Workers' Compensation claims before hearing locations and administrative bodies in Illinois. Provide legal advice, conduct research, and handle negotiations and settlements on behalf of the company.
The Expert Analyst identifies and analyzes healthcare data to support quality improvement initiatives and Stars performance. This role involves developing complex reports, conducting trend analysis, and presenting actionable insights to executive leadership.
Insurance Premium Audit Consultant II - Field Travel (Remote)
Emergent Holdings
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Full Time
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a month ago
Emergent Holdings
Perform virtual and field premium audits for Workers' Compensation and General Liability policies to determine accurate exposure and premiums. Review financial records and interview policyholders to ensure correct classification and policy endorsement.
Manage the day-to-day operations and workflow of the actuarial unit while leading and developing actuarial staff. Perform advanced actuarial analyses for pricing, reserving, and capital management to provide strategic recommendations to senior management.
Infrastructure Engineer II- RHEL- Azure
Emergent Holdings
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Full Time
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2 months ago
Emergent Holdings
Responsible for the operation, maintenance, and security of highly available computing platforms, servers, and networks. This includes deploying new technologies, managing middleware, and providing 24x7 on-call support for infrastructure reliability.
Lead Software Engineer (ECM Specialization)
Emergent Holdings
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Full Time
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2 months ago
Emergent Holdings
Leads the design, development, and support of Enterprise Content Management (ECM) solutions and workflow automation within an Agile/DevOps environment. Provides technical leadership to integrate content services with cloud platforms and enterprise applications while ensuring security and scalability.
Responsible for the operation, maintenance, and security of computing platforms, servers, and networks to ensure high availability. This includes deploying new technologies, managing middleware, and leading disaster recovery planning and exercises.
Senior Loss Control Consultant (Field) - Omaha/Lincoln Nebraska
Emergent Holdings
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Full Time
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3 months ago
Emergent Holdings
The consultant is responsible for evaluating physical premises and work practices to identify hazardous conditions and provide safety training to policyholders. They also collaborate with underwriting and business development teams to manage risk selection and develop effective loss control strategies.
Workers' Comp Claim Representative III - CA
Emergent Holdings
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Full Time
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3 months ago
Emergent Holdings
Investigate and determine the compensability of complex workers' compensation claims while managing reserves and negotiating settlements. Facilitate return-to-work programs, manage medical bills, and mentor lower-level staff to ensure compliance with state legislation.
Workers' Comp Claim Representative II - CA
Emergent Holdings
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Full Time
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3 months ago
Emergent Holdings
The role involves investigating workers' compensation claims to determine compensability and causal relationships while managing medical bills and return-to-work efforts. The representative negotiates settlements, establishes financial reserves, and maintains compliance with state legislation and internal performance standards.
The Actuarial Analyst II supports core actuarial functions including pricing, reserving, reinsurance analysis, and forecasting. They are also responsible for managing rate filings, financial data call reporting, and providing analytical support for business strategy.
Workers’ Compensation Defense Attorney – Kansas City, MO
Emergent Holdings
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Full Time
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4 months ago
Emergent Holdings
This role involves defending litigated Workers’ Compensation claims primarily in the Kansas City area, requiring research, investigations, attending depositions, and consulting with various parties. The attorney will also participate in negotiations, including settlements, and provide leadership on major company projects as needed.
The Infrastructure Engineer I is responsible for the operations of secure and highly available computing platforms, servers, and networks, including installation, maintenance, and continuous improvement of the operating environment. This role also involves deploying new technologies, troubleshooting user-reported problems, and supporting development environments.
