Nurse Navigator

IntroductionAt Gallagher, we help clients face risk with confidence because we believe that when businesses are protected, they're free to grow, lead, and innovate. You'll be backed by our digital ecosystem: a client-centric suite of consulting tools making it easier for you to meet your clients where they want to be met. Advanced data and analytics providing a comprehensive overview of the risk landscape is at your fingertips. Here, you're not just improving clients' risk profiles, you're building trust. You'll find a culture grounded in teamwork, guided by integrity, and fueled by a shared commitment to do the right thing. We value curiosity, celebrate new ideas, and empower you to take ownership of your career while making a meaningful impact for the businesses we serve. If you're ready to bring your unique perspective to a place where your work truly matters; think of Gallagher.OverviewWe are looking to add a Nurse Navigator to our growing team in Phoenix, AZ supporting our Kairos Division! As a nurse navigator, your role will be to guide and support our members in understanding their benefits and how best to utilize them. You will serve as a clinical concierge, providing healthcare navigation, proactive outreach, and assistance with claim resolution and prior authorization. Additionally, you will offer disease management and education, acting as a liaison between healthcare professionals, vendors, and other departments or teams. Your goal will be to ensure that our members receive the best possible care and support throughout their healthcare journey.How you'll make an impactEnsures effective use of services and manages costs, helping control expenses and ensure fair practicesReview and analyze claims to understand resources that may be needed for resolutionAct as a liaison among referral sources, physicians, and members to facilitate cost-effective healthcare solutions and enhance communicationCollects and analyze data on health outcomes and program participation to assess and improve wellness initiatives, leading to better health outcomes and satisfactionIdentifies member for referral opportunities to integrate with other services, promoting comprehensive careCollaborate with healthcare professionals, vendors, and departments to integrate health and wellness initiativesUtilize understanding of case management, insurance plans, and regulations to ensure compliance and effective service deliveryConnect individuals with healthcare providers and community resources to address specific health needs, improving individual and community health outcomesSkills for success:Strong communication: ability to effectively communicate and present to groups and individualsCritical thinking and problem-solving: assess health needs, identify risk factors, and develop appropriate interventionsOrganizational and time management: manage multiple tasks and prioritize workload effectivelyFlexibility and adaptability: ability to adjust approach and strategies based on the needs of individuals and groupsCollaboration and partnership: work effectively with other healthcare professionals, groups, and community organizations to deliver comprehensive wellness servicesProfessionalism and ethical conduct: adhere to ethical and legal standards in healthcare practice and maintain confidentialityContinued learning and adaptability: willingness to learn and adapt to new software systems and technological advancementsAbout YouRequired:Associate's degree from an accredited school of nursingMinimum of 3 years clinical experience in an acute care settingActive Registered Nursing license within the state of practicePreferred:BSN3+ year utilization management/case management experience in an insurance (non-hospital) setting3+ years claims review experience including familiarity of reimbursement methodologyPre- and post-pay claims review and healthcare data experience preferredExperience in quality improvement related activitiesBehaviors:Demonstrates adequate knowledge of managed care with emphasis on use of criteria , guidelines and national standards of practiceDemonstrates good written and oral communications, organizational and leadership skillsComputer literateDemonstrates good time management skillsSelf starterAbility to travel locally to client sites 1-3x per month within Arizona#LI-LB3#LI-HybridCompensation and benefitsWe offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits.Below are the minimum core benefits you'll get, depending on your job level these benefits may improve:Medical/dental/vision plans, which start from day one!Life and accident insurance401(K) and Roth optionsTax-advantaged accounts (HSA, FSA)Educational expense reimbursementPaid parental leaveOther benefits include:Digital mental health services (Talkspace)Flexible work hours (availability varies by office and job function)Training programsGallagher Thrive program - elevating your health through challenges, workshops and digital fitness programs for your overall wellbeingCharitable matching gift programAnd more...The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process.We value inclusion and diversityClick Here to review our U.S. Eligibility RequirementsInclusion and diversity (I&D) is a core part of our business, and it's embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work.Gallagher embraces our employees' diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest.Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as "protected characteristics") by applicable federal, state, or local laws.Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.