Why join the Novacore team? Because your next stellar chapter starts here — and we’re building something bold and meaningful. At Novacore, we’re not your average insurance company. We’re a team of driven professionals passionate about redefining the specialty insurance experience for our agents, carrier partners — and for each other. We specialize in tailored solutions for niche industries, powered by advanced analytics, modern technology and a culture of innovation. Backed by strong leadership and strategic growth initiatives, Novacore is poised to scale and lead in the specialty insurance market. But at our core, we believe it’s not just what we do — it’s how we do it and who we do it with. Recognized as a top workplace, Novacore is a place where ambition is supported, growth is continuous and culture matters. From day one, you’ll find mentorship, hands-on learning and clear paths for advancement. You’ll grow your skills, expand your expertise and become even more exceptional — because when you succeed, we all do. We offer: - A collaborative, results-driven environment - Competitive compensation and comprehensive benefits - Year-round social and community events - Ongoing mentorship and professional development - Endless opportunities for upward mobility So if you're ready to be part of something extraordinary — with a team that’s transforming commercial insurance — we want to meet you. Reinsurance Nurse Case ManagerOverview: Carbon Stop Loss Solutions is a leading managing general underwriter (MGU) in the field of employer stop loss and managed care insurance. Carbon’s team of experts are known as the industry leader in delivering best-in-class risk solutions to effectively lower healthcare costs. Carbon’s offerings support clients and brokers in a rapidly changing healthcare market with best-in-class service, underwriting, claims support and effective cost containment strategies. Carbon Stop Loss Solutions makes up Novacore’s Healthcare Segment. The Reinsurance Nurse Case Manager is a registered nurse who can assist Novacore’s Claim and Underwriting Departments in managing risk and mitigating claims exposure. **We are open to candidates local to the Philadelphia-area Home Office or fully remote. Responsibilities: - Assist underwriters in the timely evaluation of clinical and claim data during the disclosure process to identify potential risk. - Work with Third-Party Administrators and producers as a medical resource for discussion and assistance with potential catastrophic claim management. - Assist Case Managers, either employed by Carbon’s TPAs, or with outside firms, with high dollar catastrophic claimants. - Evaluate claims reporting for potential exposure and reserve recommendations. - Clinical review and claims analysis to assess claim trends and possible group resources. - Maintain patient confidentiality in compliance with standards set forth by Carbon as well as HIPAA. - Work with the department manager in seeking and employing new business partners to promote health care resources and mitigate claims exposure. - Serve as a back-up for other department medical staff as needed. - Maintain licensure and certifications as indicated to promote personal professional advancement. Qualifications: - Registered Nurse active license required - BSN preferred. - CCM certification, preferred. - At least one year of acute care clinical experience. - UM or CM experience on either the payer or provider side. - Prior TPA, MGU or Stop loss carrier experience is highly preferable. - Prior experience analyzing health care claims and coding. - Prior experience working with catastrophic health care claims. - Experience with data entry and analysis of medical reporting. - Provide risk assessment and communicate the analysis succinctly in reporting. - Ability to conduct independent medical research as an adjunct to medical underwriting tasks. - Ability to meet tight time frames. - Strong organizational and time management skills. - Ability to work independently in a remote setting. - Ability to work with multiple offices and underwriters and prioritize time frames. - Proficient with MS Office software. Ability to communicate effectively and professionally both internally and with external clients.

Love + medicine is who we are, it's what we do, it's why people want to work here. If you’re looking for a job to love, apply today. Scheduled Weekly Hours: 40 Emplify Health by Gundersen is looking to add a Prior Authorization Specialist to our team! In this role you will work with hospital departments and insurance companies to obtain the necessary pre-certifications and authorizations for services ordered/scheduled from insurance. Attention to detail, strong communication, and computer and phone skills are important! In this role, You will: - Secure prior authorizations from insurance companies for all hospital and clinical scheduled procedures acting as a liaison between patients, physicians, and insurance providers. - Navigate complex insurance regulations and advocate for patients' needs - Process paperwork effectively and efficiently to ensure all documentation is completed - Maintain strong communication both verbally and written What's Available: - Full time, 1.0 FTE - 40 hours/week - Monday-Friday, hours between 7 am -5 pm, 8-hour shifts - Remote eligible after training in-person - Starting pay of $19.86/hour + more for experience! What You'll Need: - High School Diploma or equivalency - 1-2 years' experience in healthcare with insurance or prior authorization experience required - Excellent problem-solving abilities and strong attention to detail - Strong communication skills, both verbal and written - Coding experience and certifications is a plus! What You'll Get: - Support to grow in your career with access to our Career Development Center and Tuition Investment Program - Top-rated retirement plan and healthcare benefits - Departmental leadership that supports you as you do your best work. - Work/Life balance to love what you do and where you live Emplify Health is comprised of two of the Midwest’s most respected healthcare systems, Bellin Health and Gundersen Health System. Once neighbors, we are now partners, united in our mission to provide exceptional care to our communities. As a not-for-profit, patient-centered healthcare network, we have headquarters in Green Bay and La Crosse, Wisconsin. Our extensive network includes 11 hospitals and more than 100 clinics, serving 67 cities and rural communities across Wisconsin, Iowa, Minnesota and Michigan’s Upper Peninsula. With over 4,500 dedicated nurses and providers, we are committed to delivering primary, specialty and emergency care, along with innovative medical education programs. Join us in making a meaningful difference in the lives of our patients and communities. If you need assistance with any portion of the application or have questions about the position, please contact HR-Recruitment@gundersenhealth.org or call 608-775-0267. We inspire your best life by relentlessly caring, learning and innovating. This is our purpose. Together with our values — belonging, respect, excellence, accountability, teamwork and humility — our pillars set our foundation and our future. Equal Opportunity Employer

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Claims Manager PRIMARY PURPOSE: To manage the technical and operational functions within assigned office(s) including compliance with company standards and industry best practices; to ensure consistent delivery of quality services; to be responsible for staffing and training needs; and to be responsible for budget preparation and profit and loss management. Has direct responsibility for 25-49 colleagues. ESSENTIAL FUNCTIONS and RESPONSIBILITIES - Responsible for overall operational management for assigned locations/offices. - Establishes policy and procedure to assure compliance to best practices, claims management services standards, state regulations and client service requirements. - Establishes business plan with goal and objectives for the partnership and assigned locations/offices. - Monitors management reports relating to the partnership/office performance. - Assists with the coordination of sales and client service efforts. ADDITIONAL FUNCTIONS and RESPONSIBILITIES - Performs other duties as assigned. - Supports the organization's quality program(s). - Travels as required. SUPERVISORY RESPONSIBILITIES - Administers company personnel policies in all areas and follows company staffing standards and training recommendations. - Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions. - Provides support, guidance, leadership and motivation to promote maximum performance. QUALIFICATIONS Education & Licensing Baccalaureate degree from an accredited college or university preferred. Licenses as required. Experience Eight (8) years claims management experience including two (2) years supervisory experience or equivalent combination of experience and education. Skills & Knowledge - Excellent oral and written communication, including presentation skills - PC literate, including Microsoft Office products - Leadership/management/motivational skills - Analytical and interpretive skills - Strong organizational skills - Excellent interpersonal skills - Excellent negotiation skills - Ability to work in a team environment - Ability to meet or exceed Performance Competencies WORK ENVIRONMENT When applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines Physical: Computer keyboarding, travel as required Auditory/Visual: Hearing, vision and talking The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance W2 General Liability Adjuster PRIMARY PURPOSE: To investigate claims against insurance or other companies for personal, casualty, or property loss or damages; attempts to effect out-of-court settlement with claimant. ESSENTIAL FUNCTIONS and RESPONSIBILITIES - Examines claim forms and other records to determine insurance coverage. - Interviews, telephones, or corresponds with claimant and witnesses; consults police and hospital records; and inspects property damage to determine extent of company's liability, varying method of investigation according to type of insurance. - Prepares report of findings and negotiates settlement with claimant. - Recommends litigation by legal department when settlement cannot be negotiated. - Attends litigation hearings. - Revises case reserves in assigned claims files to cover probably costs. - Assists in preparing loss experience report to help determine profitability and calculates adequate future rates. ADDITIONAL FUNCTIONS and RESPONSIBILITIES - Performs other duties as assigned. - Supports the organizations quality program(s). QUALIFICATIONS Education & Licensing High School diploma or GED required. Experience Six (6) years of general office experience or equivalent combination of education and experience required. Claims industry experience preferred. Skills & Knowledge - Knowledge of professional liability claims - Ability to review information and ensure accuracy and applicable policy placement - Oral and written communication skills - PC literate, including Microsoft Office products - Attention to detail and accuracy - Ability to work in a team environment - Ability to meet or exceed Performance Competencies WORK ENVIRONMENT When applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines Physical: Computer keyboarding, travel as required Auditory/Visual: Hearing, vision and talking The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.