Vice President, Bill Review and Managed Care

Overview

This is a remote position located in California. Must be willing to travel up to 25% throughout the state. Keenan, a leading insurance brokerage and consulting firm, has built a strong reputation serving hospitals, public agencies, and California school districts. With deep expertise in employee benefits, workers’ compensation, loss control, financial services, and property and liability programs, Keenan is dedicated to delivering innovative solutions that protect organizations and empower the communities they serve. As part of Gallagher—a global leader in insurance, risk management, and consulting—you will join a collaborative, purpose-driven organization committed to helping clients and employees thrive. The Vice President role is a critical leadership position responsible for the strategic development, integration, and operational oversight of Keenan’s medical cost containment program. This role plays a pivotal part in differentiating the PRIME program in the marketplace by driving excellence across bill review, utilization review, and nurse case management functions. The Vice President will lead and support clinical teams, ensure compliance with Medical Provider Network (MPN) standards through strategic partnerships, and develop impactful training programs. Additionally, this leader will serve as a key technical expert, guiding case management teams and resolving complex medical and procedural issues to deliver high-quality, cost-effective outcomes for our clients. How you'll make an impact Oversee Bill Review and Managed Care operations, including financial performance and monthly reporting. Serve as primary liaison with key vendor partners (, Enlyte/Genex, Harbor Health, One Call) and collaborate to enhance program effectiveness. Analyze and maintain competitive intelligence, develop pricing strategies, and conduct annual reviews to ensure market competitiveness. Support business development efforts, including RFP responses, client proposals, presentations, and onboarding activities such as bill review comparisons. Partner with Account Executives to deliver client education, program implementation, and ongoing relationship support. Drive program innovation, branding, and differentiation while identifying opportunities to improve care management and cost containment outcomes. Review and resolve complex medical and procedural cases, providing subject matter expertise to internal teams. Develop and deliver training programs; ensure all departmental policies, procedures, and training materials remain current and compliant. Monitor vendor contracts and negotiate service agreements to optimize value and performance. Stay informed on industry trends, medical advancements, and best practices to continuously enhance program effectiveness. About You Required: Bachelors Degree with a minimum of 10 years experience in claims line of business required. A minimum 5 years experience in claims management positions required. Comprehensive knowledge of industry best practices and procedures. Preferred: 15 plus years claims experience highly preferred. Relevant industry designations preferred. Active California RN license preferred. Behaviors: Demonstrated verbal and written communications skills, negotiation skills and influence management skills. Proven analytical and quantitative skills. Strategic thinker; able to make prompt, intelligent decisions based upon detailed analysis of complex issues. Strong service orientation to internal and external customers. Excellent interpersonal skills. Experience completing high impact projects effectively and efficiently. Able to multitask and work independently. Knowledge of Microsoft Office Suite tools. Experience with RMIS systems and data mining. Compensation and benefits We 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 insurance 401(K) and Roth options Tax-advantaged accounts (HSA, FSA) Educational expense reimbursement Paid parental leave Other benefits include: 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 And 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.