Senior Managed Care Manager at Great American Insurance Group in Woodland Hills, CA

Job description

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group’s member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 35 specialty property and casualty operations, there are always opportunities here to learn and grow. At Great American, we value and recognize the benefits derived when people with different backgrounds and experiences work together to achieve business results. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best. For over 50 years, Republic Indemnity has been a trusted partner for businesses across the western U.S., helping them effectively manage their workers' compensation costs. Our headquarters in Woodland Hills, California, along with an additional office in San Francisco, to serve a hub for our operations. We specialize in workers' compensation in California and other western states, along with capabilities to support multistate accounts across the US. Our Vision: Clear Paths to Success At Republic, we believe in creating clear pathways for everyone - whether it's a broker, policyholder, injured worker, or colleague. We're committed to helping people reach their goals and achieve success. 
This position is not eligible for employment visa sponsorship. Applicants must be authorized to work in the United States without the need for current or future sponsorship. Division Overview Republic Indemnity markets workers’ compensation insurance to a wide range of clients, primarily in California and the western United States. With a focus on strong results and exceptional service, we are committed to meeting the needs of our customers and delivering positive outcomes. Our employees play an important role in supporting that commitment and contributing to the success of the business. We offer ongoing opportunities to learn, grow, and build a rewarding career. Position Overview The Senior Managed Care Manager serves as a senior clinical resource to the claims organization, combining team leadership with hands-on expertise in managing complex workers’ compensation claims. This role oversees the coordination and evaluation of treatment plans to help ensure injured workers receive appropriate, effective, and cost-efficient care while guiding team members in applying clinical standards, regulatory requirements, and sound case-management practices. The position provides clinical direction for complex and catastrophic cases and partners with claims professionals, healthcare providers, and vendors to improve care coordination, claim outcomes, and medical-cost management. Great American’s culture is built on connection, shared learning, and strong relationships. This is a hybrid role that combines in-office and remote work. Employees are expected to maintain a meaningful on-site presence to support collaboration, relationship building, and business success. Fully remote work will be considered based on the candidates location. The standard office hours are 8:00 a.m. to 4:30 p.m. PT. Responsibilities Lead and oversee managed care activities to help ensure injured workers receive appropriate, effective, timely, and cost-efficient medical treatment. Provide clinical expertise on complex and catastrophic workers’ compensation claims, including hospitalization, transfers of care, traumatic brain injuries, and other severe conditions. Apply expertise in the California Medical Treatment Utilization Schedule (MTUS), ODG Guidelines, California formulary requirements, and applicable workers’ compensation medical treatment regulations. Review complex treatment plans, care facilities, and medical-cost projections to assess clinical appropriateness and alignment with applicable standards and guidelines. Guide staff in evaluating treatment requests for approval or referral t