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Clinical Product Manager - Managed Care

Clinical Product Manager - Managed Care

AmTrust Financial ServicesPlantsville, CT, US
15 hours ago
Job type
  • Full-time
Job description

Clinical Product Manager

The Clinical Product Manager (CPM) shapes and optimizes ancillary healthcare services in workers' compensation, overseeing processes and vendors managing : DME, PT / OT, diagnostics / imaging, transportation / translation, home health, IME / peer review and other supporting vendors related to managed care medical spend. This cross-functional role blends strategy, clinical insight, and operational execution to improve outcomes, reduce costs, and enhance experiences for injured workers, adjusters, and clinical teams. Collaboration with vendors, stakeholders, and leadership is essential to drive measurable improvements and ensure program integrity.

AmTrust is looking for a critical thinker who can bring structure and innovation to our workers' compensation managed care programs. In this role, you will own vendor performance and process management in a broad variety of areas making sure the right partners are in place, performance stays strong, and programs deliver real value for injured workers and the carrier's work comp line of business.

Responsibilities

  • Lead vendor strategy from selection to onboarding, aligning partnerships with clinical and financial goals.
  • Build strong relationships with both vendors and internal teams; serve as the go-to for performance, compliance, and problem-solving, while leading key objectives related to each ancillary service.
  • Monitor and improve outcomes by developing and tracking key metrics, addressing gaps, while driving continuous improvement.
  • Launch programs and pilots to assess ideas, streamline workflows, and enhance care delivery when appropriate.
  • Keep operations running smoothly through clear processes, smart technology integration, and initiative driven issue resolution.
  • Expert ability to work with data to drive outcomes, by developing reporting requirements in detail and ability to self-identify data needs.
  • Lead deep-dive analyses of contracts, data, and business processes to identify risks, inefficiencies, and opportunities for improvement.
  • Protect financial integrity and outcomes by identifying billing issues, optimizing processes, and ensuring cost-effective solutions for transactions and the claim as a whole.
  • Champion / Audit compliance and quality- ensuring all services meet regulatory standards and clinical best practices across all states.
  • Educate and communicatetrain teams, share updates, and align stakeholders on priorities.

Qualifications

Required :

  • Bachelor's in Healthcare, Business, Analytics, or related field
  • 5+ years in healthcare analytics or clinical operations
  • 2+ years in Workers Compensation and associated ancillary services
  • Proven vendor management and workflow optimization experience
  • Proficiency with contracts, financial modeling, and business case development
  • Advanced Excel and analytical skills
  • Strong PowerPoint skills; Visio a plus
  • Excellent communication, both with AmTrust leadership and external parties
  • Preferred :

  • Master's degree or advanced learning degree
  • Familiarity with SQL / or advanced reporting and manipulation
  • Experience with multi-disciplinary healthcare vendors in the Workers' Compensation line of business.
  • Knowledge of workers' comp regulations, billing codes, and audit processes
  • Experience in vendor management of healthcare services
  • Strengths & Competencies :

  • Big-picture thinking with execution skills
  • Data-driven storytelling
  • Contract and process expertise
  • Executive-level communication
  • Process improvement leadership
  • Financial acumen
  • Vendor accountability
  • Cross-functional collaboration
  • Industry and tech awareness
  • The expected salary range for this role is $92,000-$120,000. Please note that the salary information shown above is a general guideline only. Salaries are based upon a wide range of factors considered in making the compensation decision.

    What We Offer

    AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include : Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off.

    AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities.

    AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain and develop the best talent available.

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