Nurse Medical Case Manager - Workers' Compensation
Location: NC - Charlotte, VA - Richmond
Type: Hybrid
Time Type: Full Time
Posted: 3 Days Ago
Job Requisition ID: R-39653
Who Are We?
Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.
Job Category
Claim, Nurse - Medical Case Manager
Compensation Overview
The annual base salary range for this position is $81,000.00 - $133,700.00, determined by factors including the scope, complexity and location of the role; skills, education, training, credentials and experience of the candidate; and other conditions of employment.
What Is the Opportunity?
Under moderate supervision, provide telephonic medical case management with emphasis on early intervention, return to work planning, coordination of quality medical care on claims involving disability and medical treatment, as well as in-house medical reviews as applicable to claim handling laws and regulations.
What Will You Do?
- Contact customers, medical providers and injured parties on claims involving medical treatment and/or disability to coordinate appropriate medical care and return to work.
- Develop strategies to facilitate an injured employee's return to work and achieve maximum medical improvement.
- Coordinate with medical providers to ensure the injured employee is actively participating in a viable treatment plan.
- Evaluate medical treatment requests to ensure they are reasonable and necessary.
- Engage specialty resources as needed to achieve optimal resolution.
- Partner with Claim Professionals to provide medical information and disability status necessary to create an overall strategy.
- Utilize internal Claim Platform Systems to manage all claim activities on a timely basis.
- Submit accurate billing documentation on all activities as outlined in established guidelines.
- Participate in Telephonic and/or onsite File Reviews.
- Keep injured workers apprised of claim status.
- In-person medical case management may be required to support Concierge locations.
- Perform other duties as assigned.
What Will Our Ideal Candidate Have?
- Disability case management experience preferred.
- Prior clinical experience preferred.
- Analytical Thinking, Communication, Negotiation skills.
- General Insurance Contract Knowledge.
- Legal and Medical Knowledge.
- WC Technical knowledge.
- Customer Service and Teamwork skills.
- Planning & Organizing abilities.
- Certified Case Manager (CCM) or similar certifications preferred.
What is a Must Have?
- Registered Nurse; Licensed Practical Nurse or Licensed Vocational Nurse required.
What Is in It for You?
- Health Insurance : Employees and their eligible family members are eligible for coverage from the first day of employment.
- Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay.
- Paid Time Off: Start with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
- Wellness Program: Tools, discounts and resources to achieve wellness goals.
- Volunteer Encouragement: Matching Gift and Volunteer Rewards program.
Employment Practices
Travelers is an equal opportunity employer, committed to recruiting, retaining and developing diverse talent.
To learn more about our comprehensive benefit programs please visit here .
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