Senior Cost Containment Manager
About the Role
We are seeking a Senior Cost Containment Manager to play a critical role in driving effective medical cost management strategies across complex workers' compensation claims. In this position, you will partner closely with Claims Managers, TPAs, and internal stakeholders to analyze, negotiate, and resolve high‑exposure medical bills while ensuring accuracy, compliance, and cost efficiency.
This role offers the opportunity to make a meaningful impact-both on individual claim outcomes and on broader organizational cost containment practices. If you enjoy problem‑solving, negotiation, and collaborating in a fast‑paced environment, this is an opportunity to apply your expertise at a strategic level.
Key Responsibilities
- Manage and resolve complex workers' compensation medical bills, including high‑exposure and challenging claims
- Lead prospective negotiations for large medical procedures and conduct retrospective audits of hospitalization and facility charges
- Analyze detailed medical billing data and translate findings into actionable recommendations for claims teams
- Serve as a trusted advisor to Claims Managers by supporting reserve strategies and developing plans of action for complex cases
- Partner with TPAs and medical bill review vendors to ensure accuracy, compliance, and optimal cost outcomes
- Conduct TPA audits, identify process improvement opportunities, and support best‑practice development
- Contribute to training and education initiatives for claims and operational teams
- Collaborate cross‑functionally to help shape enterprise‑wide cost containment strategies
Required Qualifications
- 3+ years of workers' compensation bill review or related cost containment experience
- Strong knowledge of medical billing, bill review processes, and cost containment strategies
- Proven negotiation and analytical skills
- Excellent written and verbal communication skills, with the ability to explain technical information to non‑medical audiences
- Ability to manage multiple priorities in a fast‑paced environment while maintaining attention to detail
- Proficiency in Microsoft Office (Word, Excel, Outlook)
- Must be authorized to work in the U.S. without current or future sponsorship requirements
Preferred Qualifications
- Experience negotiating large medical bills, including catastrophic claims and rehabilitation services
- Familiarity with TPA operations and medical bill review vendor management
- Experience conducting audits and delivering training to claims or operational teams
- Background in evaluating medical bill review programs and identifying cost‑saving opportunities
- Experience supporting reserve analysis through medical cost projections
FAQs
Congratulations, we understand that taking the time to apply is a big step. When you apply, your details go directly to the consultant who is sourcing talent. Due to demand, we may not get back to all applicants that have applied. However, we always keep your CV and details on file so when we see similar roles or see skillsets that drive growth in organisations, we will always reach out to discuss opportunities.
Yes. Even if this role isn’t a perfect match, applying allows us to understand your expertise and ambitions, ensuring you're on our radar for the right opportunity when it arises.
We also work in several ways, firstly we advertise our roles available on our site, however, often due to confidentiality we may not post all. We also work with clients who are more focused on skills and understanding what is required to future-proof their business.
That's why we recommend registering your CV so you can be considered for roles that have yet to be created.
Yes, we help with CV and interview preparation. From customised support on how to optimise your CV to interview preparation and compensation negotiations, we advocate for you throughout your next career move.