Managed Care Specialist

Gallagher•Rolling Meadows, IL

About The Position

At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it’s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people’s lives. It takes empathy, precision, and a strong sense of partnership—and that’s exactly what you’ll find here. We’re a team of fast-paced fixers, empathetic experts, and outcomes drivers — people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses and individuals move forward with confidence. Here, you’ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you’re here, you’re part of something bigger. You’re part of a team that shows up, stands together, and leads with purpose.

Requirements

Bachelor’s degree.
3 years of direct insurance industry experience.
General knowledge of the workers' compensation managed care industry.
Excellent written and oral communication skills.
Strong organizational skills with the ability to: Prioritize workload. Manage multiple tasks simultaneously.
Ability to travel up to 20%.
Ability to work under pressure with minimal guidance.
Must be a team player.

Nice To Haves

Proficiency in computer applications, including: risxfacs.com. Microsoft Outlook, Excel, Word, PowerPoint, and Access.
Familiarity with Access or enterprise database programs is a plus.

Responsibilities

Maintain various programs, including: Oversight of medical bill processes (eBill interfaces and bill review). PPO/Specialty Networks. Pharmacy processes. Case management processes (UR/TCM/FCM, eInvoice, nurse note, and Electronic Referral). Customer service/litigation issues. Vendor security and other related programs.
Sustain continuous communication with managed care vendors to ensure service program expectations are identified and maintained.
Manage questions/issues from internal and external users related to: Managed care programs (e.g., scanning, medical bill review, case management, pharmacy). Managed care processes (e.g., eBill, eInvoice, auto referral). Managed care interfaces.
Resolve and troubleshoot service issues through appropriate channels.
Develop and enhance existing managed care workers' compensation programs.
Direct vendor activity, including: Authorization of fee applications. Assessing the impact on clients' funding mechanisms.
Participate in client and/or vendor meetings.
Exercise decision-making authority on: Client fees and credits of significant value. Allocation of fines and penalties (approve/deny as necessary).
Serve as a communications liaison between managed care vendors and servicing branches.
Demonstrate managed care expertise by independently directing vendor activities that directly impact client expenditures and company revenue.
Develop and direct client-specific initiatives, including: Customization of claim intake, scanning, and bill review services.
Identify and implement workflows and processes to streamline operations and improve efficiencies.

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