Case Manager jobs at Acuity Insurance - 797 jobs

At Allstate, great things happen when our people work together to protect families and their belongings from life's uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers' evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection. Privacy, Compliance & Technology Counsel We are seeking a creative, high-energy attorney with strong experience in privacy and technology who is interested in working at the intersection of law, business, technology, data, and consumers. Our team within the Allstate Law and Regulation department is growing to help the business thrive amid an evolving regulatory landscape and rapidly advancing technologies, including artificial intelligence, cloud computing, and data platforms. This attorney will provide real-time, business-focused privacy counsel across a broad range of businesses, technology-enabled products and services, emerging technologies, and complex compliance matters. The role will serve as a trusted subject matter expert and key business partner, bringing strong business acumen and hands-on experience advising on privacy issues related to AI, cloud environments, and data platforms. In addition to privacy, this role supports matters across the enterprise relating to artificial intelligence, technology, transactions, cybersecurity, commercial, risk management, and data management. This attorney will bring a collaborative, cross-functional approach to achieving effective business outcomes. Key Responsibilities Deep understanding of GLBA, FCRA, GDPR, CCPA and similar state laws with capability to conduct complex research and determine applicable and pertinent laws, statutes, regulations, rules, and other legal authorities Proactively counsel the enterprise privacy program to ensure compliance with existing laws and regulations and implementation of new requirements, including emerging requirements relating to AI Anticipate legal concerns and provide creative problem solving in a dynamic business environment Conduct risk-return analyses on key issues, looking at issues from a holistic perspective, recognizing overall impact to the enterprise; make strategic recommendations based on risk analyses Advise business partners on emerging business issues, legal subjects and risk management Play a key role in executing strategy, action planning, and communication with business partners, business units, and other areas of Law & Regulation Play a key role on complex projects, collaborating between legal teams within Law & Regulation and with business clients, as appropriate Understand the dynamics of working within a highly regulated environment including the interactions between business partners, technology, compliance, risk, government relations and other legal teams, as well as the interactions between laws of different jurisdictions Assist in building a culture of constructive debate and conversations with a virtual team multiple across locations Education & Experience Juris Doctorate and active bar membership in good standing 7+ years legal experience in a law firm or an in-house legal department for a mid- to large-sized company focusing on emerging technologies Strong experience in the following areas: privacy, data, and technology; developing and implementing compliance strategies; and advising on commercial operations. Experience in insurance regulation or other highly regulated industries Key Competencies & Functional Skills Strong focus on collaboration, strategic business partnerships and guidance Excellent verbal and written communication skills. Solid project management skills, including the ability to prioritize and deliver across multiple workstreams. Proficient in Microsoft Office and other relevant legal or business technology tools. Strong analytical and critical thinking abilities. Demonstrated discretion and professionalism in handling sensitive and confidential information. High business acumen, including the ability to assess and communicate legal risk in a commercial context and contribute to the development of business cases and return-on-investment evaluations. Remote Work & Travel Expectations This is a remote role with travel expectations. While candidates may be located anywhere in the U.S., travel will primarily be to Chicago/Northbrook, IL, with occasional travel to Dallas, TX; Charlotte, NC; Scottsdale, AZ; or other sites as needed due to team collaboration and business travel considerations. Supervisory Responsibilities This role does not have supervisory responsibilities Skills Artificial Intelligence (AI) Business Partnerships Business Transactions Collaboration Cybersecurity Data Privacy Emerging Technologies Innovative Technologies Legal Risk Planning Privacy Compliance Privacy Laws Problem Solving Regulatory Compliance Risk AnalysisStrategy Development Team Collaboration Compensation Compensation offered for this role is $140,000.00 - $193,000.00 annually and is based on experience and qualifications. The candidate(s) offered this position will be required to submit to a background investigation. Joining our team isn't just a job - it's an opportunity. One that takes your skills and pushes them to the next level. One that encourages you to challenge the status quo. One where you can shape the future of protection while supporting causes that mean the most to you. Joining our team means being part of something bigger - a winning team making a meaningful impact. Allstate generally does not sponsor individuals for employment-based visas for this position. Effective July 1, 2014, under Indiana House Enrolled Act (HEA) 1242, it is against public policy of the State of Indiana and a discriminatory practice for an employer to discriminate against a prospective employee on the basis of status as a veteran by refusing to employ an applicant on the basis that they are a veteran of the armed forces of the United States, a member of the Indiana National Guard or a member of a reserve component. For jobs in San Francisco, please click here for information regarding the San Francisco Fair Chance Ordinance. For jobs in Los Angeles, please click here for information regarding the Los Angeles Fair Chance Initiative for Hiring Ordinance. To view the “EEO Know Your Rights” poster click here. This poster provides information concerning the laws and procedures for filing complaints of violations of the laws with the Office of Federal Contract Compliance Programs. To view the FMLA poster, click here. This poster summarizing the major provisions of the Family and Medical Leave Act (FMLA) and telling employees how to file a complaint. It is the Company's policy to employ the best qualified individuals available for all jobs. Therefore, any discriminatory action taken on account of an employee's ancestry, age, color, disability, genetic information, gender, gender identity, gender expression, sexual and reproductive health decision, marital status, medical condition, military or veteran status, national origin, race (include traits historically associated with race, including, but not limited to, hair texture and protective hairstyles), religion (including religious dress), sex, or sexual orientation that adversely affects an employee's terms or conditions of employment is prohibited. This policy applies to all aspects of the employment relationship, including, but not limited to, hiring, training, salary administration, promotion, job assignment, benefits, discipline, and separation of employment. #J-18808-Ljbffr

As an Audit Attorney, you'll provide strategic oversight of outsourced legal counsel to help the organization effectively manage the needs of Sentry's policyholders. What You'll Do As an Audit Attorney, you will: Develop standards and technical operating procedures to ensure quality, consistency, and control of litigated files. Set guidelines for outside counsel use, relationships with counsel, expected behavior, and costs associated with counsel. Monitor adherence to guidelines and take appropriate action when counsel does not follow guidelines consistent with Sentry policy and philosophy. Monitor legal costs of outside counsel and make recommendations for improved service/cost as appropriate. Provide recommendations of counsel to claim staff as requested on the selection of independent legal counsel to handle claims as appropriate. What it Takes Juris Doctor Degree or equivalent work experience. Minimum of 5 years related work experience. Wide breadth of knowledge and experience in defense and/or insurance claims. Strong analytical, communication, and presentation skills. Ability to work with various groups and develop partnerships, teamwork, and good working relationships with all levels of external and internal business partners. What You'll Receive At Sentry, your total rewards go beyond competitive compensation. Below are some benefits and perks that you'll receive. Sentry is happy to offer flexibility through a scheduled Hybrid work model. Monday and Friday work from home if you choose to, Tuesday through Thursday you'll work in office. As a Sentry associate, you will have an in-office workspace and materials for your home office. In addition to the laptop, you will receive prior to your start, Sentry will provide equipment for your home office. Meal Subsidy available for associates who report to an office. 401(K) plan with a dollar-for-dollar match on your first eight percent, plus immediate vesting to help strengthen your financial future. Continue your education and career development through Sentry University (SentryU) and utilize our Tuition Reimbursement program. Generous Paid-Time Off plan for you to enjoy time out of the office as well as Volunteer-Time off. Group Medical, Dental, Vision, Life insurance, Parental leave, and our Health and Wellness benefits to encourage a healthy lifestyle. Well-being and Employee Assistance programs. Sentry Foundation gift matching program to encourage charitable giving. About Sentry We take great pride in making Forbes' list of America's Best Midsize Employers. A lot of different factors go into that honor, many of which contribute to your job satisfaction. Our bright future is built on a long track record of success. We got our start in 1904 and have been helping businesses succeed and protect their futures ever since. Because of the trust placed in us, we're one of the largest and financially strongest mutual insurance companies in the United States. We're rated A+ by A.M. Best, the industry's leading rating authority. Our headquarters is in Stevens Point, Wisconsin, with offices located throughout the United States. From sales to claims, and information technology to marketing, we enjoy a rewarding and challenging work environment with opportunities for ongoing professional development and growth. Get ready to own your future at Sentry. Opportunities await! Joe Larsen ...@sentry.com Equal Employment Opportunity Sentry is an Equal Opportunity Employer. It is our policy that there be no discrimination in employment based on race, color, national origin, religion, sex, disability, age, marital status, or sexual orientation.

A leading health care organization located in Minneapolis is seeking an Associate General Counsel to oversee M&A legal functions. The ideal candidate should have a Juris Doctorate, at least 3 years of transactional experience, and strong skills in negotiation and stakeholder management. This position offers a competitive salary range of $132,200 to $226,600 annually along with a comprehensive benefits package. #J-18808-Ljbffr

🚨 Now Hiring: RN Case Manager - San Jose, CA Region 🚨 💻 Work from home + local field travel 💰 Salary: $51,283- $93,781 annually 🎉 Quarterly Bonus Opportunities 📚 Free CEUs for licenses & certificates 💳 License & Certification Reimbursement We're looking for an RN with a passion for case management to join our team! ✨ RN degree required ✨ National Certification preferred (CCM, CRC, COHN, CRRC) ✨ Workers' Comp Case Management experience a plus ✅ Your Impact: You'll provide effective case management services in a cost‑effective manner, delivering medical case management consistent with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines. You'll support patients/employees receiving benefits under insurance lines including Workers' Compensation, Group Health, Liability, Disability, and Care Management. This is your chance to grow your career, earn great rewards, and enjoy true work-life balance. 👉 Apply today and make an impact in the San Jose community! Responsibilities Reviews case records and reports, collects and analyzes data, evaluates injured worker/disabled individual's medical status, identifies needs and obstacles to medical case resolution and RTW by providing proactive case management services. Render opinions regarding case costs, treatment plan, outcome and problem areas, and makes recommendations to facilitate case management goals to include RTW. Demonstrates ability to meet administrative requirements, including productivity, time management and QA standards, with a minimum of supervisory intervention. May perform job site evaluations/summaries to facilitate case management process. Facilitates timely return to work date by establishing a professional working relationship with the injured worker/disabled individual, physician, and employer. Coordinate RTW with injured worker, employer and physicians. Maintains contact and communicates with claims adjusters to apprise them of case activity, case direction or secure authorization for services. Maintains contact with all parties involved on case, necessary for case management the injured worker/disabled individual. May obtain records from the branch claims office. May review files for claims adjusters and supervisors for appropriate referral for case management services. May meet with employers to review active files. Makes referrals for Peer reviews and IME's by obtaining and delivering medical records and diagnostic films, notifying injured worker/disabled individual and conferring with physicians. Utilizes clinical expertise and medical resources to interpret medical records and test results and provides assessment accordingly. May spend approximately 70% of their work time traveling to homes, health care providers, job sites and various offices as required facilitating RTW and resolution of cases. Meets monthly production requirements and quality assessment (QA) requirements to ensure a quality product. Reviews cases with supervisor monthly to evaluate files and obtain directions. Upholds the Crawford and Company Code of Business Conduct at all times. Demonstrates excellent customer service, and respect for customers, co-workers, and management. Independently approaches problem solving by appropriate use of research and resources. May perform other related duties as assigned. Qualifications Associate's degree or relevant course work/certification in Nursing is required; BSN Degree is preferred. Minimum of 1-3 years diverse clinical experience and one of the below: Certification as a case manager from the URAC-approved list of certifications (preferred); A registered nurse (RN) license. Must be compliant with state requirements regarding national certifications. General working knowledge of case management practices and ability to quickly learn and apply workers compensation/case management products and services. Excellent oral and written communications skills to effectively facilitate return-to-work solutions within a matrix organization and ensure timely, quality documentation. Excellent analytical and customer service skills to facilitate the resolution of case management problems. Basic computer skills including working knowledge of Microsoft Office products. Demonstrated ability to establish collaborative working relationships with claims adjusters, employers, patients, attorneys and all levels of employees. Demonstrated ability to gather and analyze data and establish plans to improve trends, processes, and outcomes. Excellent organizational skills as evidenced by proven ability to handle multiple tasks simultaneously. Demonstrated leadership ability with a basic understanding of supervisory and management principles. Active RN home state licensure in good standing without restrictions with the State Board of Nursing. Must meet specific requirements to provide medical case management services. Minimum of 1 National Certification (CCM, CDMS, CRRN, and COHN) is preferred. If not attained, must plan to take certification exam within proceeding 36 months. National certification must be obtained in order to reach Senior Medical Case Management status. Travel may entail approximately 70% of work time. Must maintain a valid driver's license in state of residence. #LI-RG1

🚨 Now Hiring: RN Case Manager - Sacramento, CA Region 🚨 💻 Work from home + local field travel 💰 Salary: $52,309 - $95,657 annually 🎉 Quarterly Bonus Opportunities 📚 Free CEUs for licenses & certificates 💳 License & Certification Reimbursement We're looking for an RN with a passion for case management to join our team! ✨ RN degree required ✨ National Certification preferred (CCM, CRC, COHN, CRRC) ✨ Workers' Comp Case Management experience a plus ✅ Your Impact: You'll provide effective case management services in a cost‑effective manner, delivering medical case management consistent with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines. You'll support patients/employees receiving benefits under insurance lines including Workers' Compensation, Group Health, Liability, Disability, and Care Management. This is your chance to grow your career, earn great rewards, and enjoy true work-life balance. 👉 Apply today and make an impact in the Sacramento community! Associate's degree or relevant course work/certification in Nursing is required; BSN Degree is preferred. Minimum of 1-3 years diverse clinical experience and one of the below: Certification as a case manager from the URAC-approved list of certifications (preferred); A registered nurse (RN) license. Must be compliant with state requirements regarding national certifications. General working knowledge of case management practices and ability to quickly learn and apply workers compensation/case management products and services. Excellent oral and written communications skills to effectively facilitate return-to-work solutions within a matrix organization and ensure timely, quality documentation. Excellent analytical and customer service skills to facilitate the resolution of case management problems. Basic computer skills including working knowledge of Microsoft Office products and Lotus Notes. Demonstrated ability to establish collaborative working relationships with claims adjusters, employers, patients, attorneys and all levels of employees. Demonstrated ability to gather and analyze data and establish plans to improve trends, processes, and outcomes. Excellent organizational skills as evidenced by proven ability to handle multiple tasks simultaneously. Demonstrated leadership ability with a basic understanding of supervisory and management principles. Active RN home state licensure in good standing without restrictions with the State Board of Nursing. Must meet specific requirements to provide medical case management services. Minimum of 1 National Certification (CCM, CDMS, CRRN, and COHN) is preferred. If not attained, must plan to take certification exam within proceeding 36 months. National certification must be obtained in order to reach Senior Medical Case Management status. Travel may entail approximately 70% of work time. Must maintain a valid driver's license in state of residence. #LI-RG1 Reviews case records and reports, collects and analyzes data, evaluates injured worker/disabled individual's medical status, identifies needs and obstacles to medical case resolution and RTW by providing proactive case management services. Render opinions regarding case costs, treatment plan, outcome and problem areas, and makes recommendations to facilitate case management goals to include RTW. Demonstrates ability to meet administrative requirements, including productivity, time management and QA standards, with a minimum of supervisory intervention. May perform job site evaluations/summaries to facilitate case management process. Facilitates timely return to work date by establishing a professional working relationship with the injured worker/disabled individual, physician, and employer. Coordinate RTW with injured worker, employer and physicians. Maintains contact and communicates with claims adjusters to apprise them of case activity, case direction or secure authorization for services. Maintains contact with all parties involved on case, necessary for case management the injured worker/disabled individual. May obtain records from the branch claims office. May review files for claims adjusters and supervisors for appropriate referral for case management services. May meet with employers to review active files. Makes referrals for Peer reviews and IME's by obtaining and delivering medical records and diagnostic films, notifying injured worker/disabled individual and conferring with physicians. Utilizes clinical expertise and medical resources to interpret medical records and test results and provides assessment accordingly. May spend approximately 70% of their work time traveling to homes, health care providers, job sites and various offices as required facilitating RTW and resolution of cases. Meets monthly production requirements and quality assessment (QA) requirements to ensure a quality product. Reviews cases with supervisor monthly to evaluate files and obtain directions. Upholds the Crawford and Company Code of Business Conduct at all times. Demonstrates excellent customer service, and respect for customers, co-workers, and management. Independently approaches problem solving by appropriate use of research and resources. May perform other related duties as assigned.

🚨 Now Hiring: RN Case Manager - Oklahoma City, OK Region 🚨 💻 Work from home + local field travel 💰 Salary: Competitive & commensurate with experience 🎉 Quarterly Bonus Opportunities 📚 Free CEUs for licenses & certificates 💳 License & Certification Reimbursement We're looking for an RN with a passion for case management to join our team! ✨ RN degree required ✨ National Certification preferred (CCM, CRC, COHN, CRRC) ✨ Workers' Comp Case Management experience a plus 📍 Location Requirement Candidates must be based in Oklahoma City or cities along the corridor up to Tulsa (including Edmond, Norman, Moore, Stillwater, and surrounding areas) ✅ Your Impact: You'll provide effective case management services in a cost‑effective manner, delivering medical case management consistent with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines. You'll support patients/employees receiving benefits under insurance lines including Workers' Compensation, Group Health, Liability, Disability, and Care Management. This is your chance to grow your career, earn great rewards, and enjoy true work-life balance. 👉 Apply today and make an impact in the Oklahoma City community! Associate's degree or relevant course work/certification in Nursing is required; BSN Degree is preferred. Minimum of 1-3 years diverse clinical experience and one of the below: Certification as a case manager from the URAC-approved list of certifications (preferred); A registered nurse (RN) license. Must be compliant with state requirements regarding national certifications. General working knowledge of case management practices and ability to quickly learn and apply workers compensation/case management products and services. Excellent oral and written communications skills to effectively facilitate return-to-work solutions within a matrix organization and ensure timely, quality documentation. Excellent analytical and customer service skills to facilitate the resolution of case management problems. Basic computer skills including working knowledge of Microsoft Office products and Lotus Notes. Demonstrated ability to establish collaborative working relationships with claims adjusters, employers, patients, attorneys and all levels of employees. Demonstrated ability to gather and analyze data and establish plans to improve trends, processes, and outcomes. Excellent organizational skills as evidenced by proven ability to handle multiple tasks simultaneously. Demonstrated leadership ability with a basic understanding of supervisory and management principles. Based on federal, state, or local law, this position may require you to be fully vaccinated for COVID-19. Active RN home state licensure in good standing without restrictions with the State Board of Nursing. Must meet specific requirements to provide medical case management services. Minimum of 1 National Certification (CCM, CDMS, CRRN, and COHN) is preferred. If not attained, must plan to take certification exam within proceeding 36 months. National certification must be obtained in order to reach Senior Medical Case Management status. Travel may entail approximately 70% of work time. Must maintain a valid driver's license in state of residence. #LI-RG1 Reviews case records and reports, collects and analyzes data, evaluates injured worker/disabled individual's medical status, identifies needs and obstacles to medical case resolution and RTW by providing proactive case management services. Render opinions regarding case costs, treatment plan, outcome and problem areas, and makes recommendations to facilitate case management goals to include RTW. Demonstrates ability to meet administrative requirements, including productivity, time management and QA standards, with a minimum of supervisory intervention. May perform job site evaluations/summaries to facilitate case management process. Facilitates timely return to work date by establishing a professional working relationship with the injured worker/disabled individual, physician, and employer. Coordinate RTW with injured worker, employer and physicians. Maintains contact and communicates with claims adjusters to apprise them of case activity, case direction or secure authorization for services. Maintains contact with all parties involved on case, necessary for case management the injured worker/disabled individual. May obtain records from the branch claims office. May review files for claims adjusters and supervisors for appropriate referral for case management services. May meet with employers to review active files. Makes referrals for Peer reviews and IME's by obtaining and delivering medical records and diagnostic films, notifying injured worker/disabled individual and conferring with physicians. Utilizes clinical expertise and medical resources to interpret medical records and test results and provides assessment accordingly. May spend approximately 70% of their work time traveling to homes, health care providers, job sites and various offices as required facilitating RTW and resolution of cases. Meets monthly production requirements and quality assessment (QA) requirements to ensure a quality product. Reviews cases with supervisor monthly to evaluate files and obtain directions. Upholds the Crawford and Company Code of Business Conduct at all times. Demonstrates excellent customer service, and respect for customers, co-workers, and management. Independently approaches problem solving by appropriate use of research and resources. May perform other related duties as assigned.

Now Hiring: RN Case Manager - Oklahoma City, OK Region Work from home + local field travel Salary: Competitive & commensurate with experience Quarterly Bonus Opportunities Free CEUs for licenses & certificates License & Certification Reimbursement We're looking for an RN with a passion for case management to join our team! RN degree required National Certification preferred (CCM, CRC, COHN, CRRC) Workers' Comp Case Management experience a plus Location Requirement Candidates must be based in Oklahoma City or cities along the corridor up to Tulsa (including Edmond, Norman, Moore, Stillwater, and surrounding areas) Your Impact: You'll provide effective case management services in a cost‑effective manner, delivering medical case management consistent with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines. You'll support patients/employees receiving benefits under insurance lines including Workers' Compensation, Group Health, Liability, Disability, and Care Management. This is your chance to grow your career, earn great rewards, and enjoy true work-life balance. Apply today and make an impact in the Oklahoma City community!

🚨 Now Hiring: RN Sr Case Manager - San Antonio, TX Region 🚨 💻 Work from home + local field travel 💰 Salary: Competitive & commensurate with experience 🎉 Quarterly Bonus Opportunities 📚 Free CEUs for licenses & certificates 💳 License & Certification Reimbursement We're looking for an RN with a passion for case management to join our team! ✨ RN degree required ✨ National Certification preferred (CCM, CRC, COHN, CRRC) ✨ Workers' Comp Case Management experience a plus ✅ Your Impact: You'll provide effective case management services in a cost‑effective manner, delivering medical case management consistent with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines. You'll support patients/employees receiving benefits under insurance lines including Workers' Compensation, Group Health, Liability, Disability, and Care Management. This is your chance to grow your career, earn great rewards, and enjoy true work-life balance. 👉 Apply today and make an impact in the San Antonio community! Bachelor's Degree in a health-related field is preferred. Associates or diploma in nursing also accepted. Three years of Workers' Compensation case management with ability to independently coordinate a diverse caseload ranging in moderate to high complexity. Demonstrated ability to handle complex assignments and ability to work independently is required. Effective oral and written communication skills are required. Thorough understanding of jurisdictional WC statutes. Advanced knowledge to exert positive influence in all areas of case management. Advanced communications and interpersonal skills in order to conduct training, provide mentorship, and assist supervisor in general areas as assigned. Highly skilled at promoting all managed care products and services internally and externally. Active RN home state licensure in good standing without restrictions with the State Board of Nursing. Minimum of 1 nationally recognized Certification from the URAC list of approved certifications. Must be able to travel as required. Individuals who conduct initial clinical review possess an active, professional license or certification: To practice as a health professional in a state or territory of the U.S.; and With a scope of practice that is relevant to the clinical area(s) addressed in the initial clinical review. Must maintain a valid driver's license in state of residence. #LI-RG1 May assist supervisor/manager in review of reports, staff development. Reviews case records and reports, collects and analyzes data, evaluates client's medical and vocational status and defines needs and problems in order to provide proactive case management services. Demonstrates ability to meet or surpass administrative requirements, including productivity, time management, quality assessment (QA) standards with a minimum of supervisory intervention. Facilitates a timely return to work date by establishing a professional working relationship with the injured worker/disabled individual, physician and employer. Coordinates return to work with injured worker/disabled individual, employer and physicians. May recommend and facilitate completion of peer reviews and IME's by obtaining and delivering medical records and diagnostic films notifying patients. Manages cases of various product lines of at least 3-4 areas of service (W/C, Health, STD, LTD, Auto, Liability, TPA, Catastrophic, Life Care Planning). Specifically, the case manager should be experienced in catastrophic cases plus 2-3 additional types listed above. Renders opinions regarding case cost, treatment plan, outcome, and problem areas and makes recommendations to facilitate rehabilitation case management goals to include RTW. May review files for claims adjusters and supervisors. May perform job site evaluations/summaries. Prepares monthly written evaluation reports denoting case activity, progress and recommendations in accordance with state regulations and company standards. May obtain referrals from branch claims office or assist in fielding phone calls for management as needed. Maintains contact and communicates with insurance adjusters to apprise them of case activity, case direction or receive authorization for services. Maintains contact with all parties involved on case, necessary for rehabilitation of the client. May spend approximately 70% of work time traveling to homes, health care providers, job sites, and various offices as required to facilitate return to work and resolution of cases. May meet with employers to review active files. Reviews cases with supervisor monthly to evaluate file and obtain direction. Upholds the Crawford and Company Code of Business Conduct at all times. Demonstrates excellent customer service, and respect for customers, co-workers, and management. Independently approaches problem resolution by appropriate use of research and resources. May perform other related duties as assigned.

🚨 Now Hiring: RN Sr Case Manager - Los Angeles, CA Region 🚨 💻 Work from home + local field travel 💰 Salary: $55,450 - $101,393 annually 🎉 Quarterly Bonus Opportunities 📚 Free CEUs for licenses & certificates 💳 License & Certification Reimbursement We're looking for an RN with a passion for case management to join our team! ✨ RN degree required ✨ National Certification preferred (CCM, CRC, COHN, CRRC) ✨ Workers' Comp Case Management experience a plus 📍 Location Requirement Candidates must be based in one of these California areas: San Fernando, Van Nuys, Santa Clarita, Granada Hills, Panorama, or Valencia. ✅ Your Impact: You'll provide effective case management services in a cost‑effective manner, delivering medical case management consistent with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines. You'll support patients/employees receiving benefits under insurance lines including Workers' Compensation, Group Health, Liability, Disability, and Care Management. This is your chance to grow your career, earn great rewards, and enjoy true work-life balance. 👉 Apply today and make an impact in the Los Angeles community! Bachelor's Degree in a health-related field is preferred. Associates or diploma in nursing also accepted. Three years of Workers' Compensation case management with ability to independently coordinate a diverse caseload ranging in moderate to high complexity. Demonstrated ability to handle complex assignments and ability to work independently is required. Effective oral and written communication skills are required. Thorough understanding of jurisdictional WC statutes. Advanced knowledge to exert positive influence in all areas of case management. Advanced communications and interpersonal skills in order to conduct training, provide mentorship, and assist supervisor in general areas as assigned. Highly skilled at promoting all managed care products and services internally and externally. Active RN home state licensure in good standing without restrictions with the State Board of Nursing. Minimum of 1 nationally recognized Certification from the URAC list of approved certifications. Must be able to travel as required. Individuals who conduct initial clinical review possess an active, professional license or certification: To practice as a health professional in a state or territory of the U.S.; and With a scope of practice that is relevant to the clinical area(s) addressed in the initial clinical review. Must maintain a valid driver's license in state of residence. #LI-RG1 May assist supervisor/manager in review of reports, staff development. Reviews case records and reports, collects and analyzes data, evaluates client's medical and vocational status and defines needs and problems in order to provide proactive case management services. Demonstrates ability to meet or surpass administrative requirements, including productivity, time management, quality assessment (QA) standards with a minimum of supervisory intervention. Facilitates a timely return to work date by establishing a professional working relationship with the client, physician and employer. Coordinates return to work with patient, employer and physicians. May recommend and facilitate completion of peer reviews and IME's by obtaining and delivering medical records and diagnostic films notifying patients. Manages cases of various product lines of at least 3-4 areas of service (W/C, Health, STD, LTD, Auto, Liability, TPA, Catastrophic, Life Care Planning). Specifically, the case manager should be experienced in catastrophic cases plus 2-3 additional types listed above. Renders opinions regarding case cost, treatment plan, outcome, and problem areas and makes recommendations to facilitate rehabilitation goals and RTW. May review files for claims adjusters and supervisors. May perform job site evaluations/summaries. Prepares monthly written evaluation reports denoting case activity, progress and recommendations in accordance with state regulations and company standards. May obtain referrals from branch claims office or assist in fielding phone calls for management as needed. Maintains contact and communicates with insurance adjusters to apprise them of case activity, case direction or receive authorization for services. Maintains contact with all parties involved on case, necessary for rehabilitation of the client. May spend approximately 70% of work time traveling to homes, health care providers, job sites, and various offices as required to facilitate return to work and resolution of cases. May meet with employers to review active files. Reviews cases with supervisor monthly to evaluate file and obtain direction. Upholds the Crawford Code of Business Conduct at all times. Demonstrates excellent customer service, and respect for customers, co-workers, and management. Independently approaches problem resolution by appropriate use of research and resources. May perform other related duties as assigned.

**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 170 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 provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. **Salary Range** $85,600.00 - $141,200.00 **Target Openings** 2 **What Is the Opportunity?** Under moderate supervision, provide office based 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. Responsible for helping to ensure injured parties receive appropriate treatment directly related to the compensable injury or assist claim handlers in managing medical treatment to an appropriate resolution. **What Will You Do?** + Contact customer, medical provider 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. Evaluate and update treatment and return to work plans within established protocols throughout the life of the claim. + Coordinate with medical providers to ensure the injured employee is actively participating in a viable treatment plan. + Evaluate medical treatment requests to ensure that they are reasonable and necessary based upon jurisdictional guidelines. + Engage specialty resources as needed to achieve optimal resolution (Dial-a-doc, physician advisor, peer reviews, MCU). + Partner with Claim Professional to provide medical information and disability status necessary to create an overall strategy to achieve an optimal outcome. + Utilize internal Claim Platform Systems to manage all claim activities on a timely basis. + Utilize Preferred Provider Network per jurisdictional guidelines. + Partner with Claim Professional to provide input on medical treatment and recovery time to assist in evaluating appropriate claim reserves. + Submit accurate billing documentation on all activities as outlined in established guidelines. + Customer Engagement. + Participate in Telephonic and/or onsite File Reviews. + Respond to inquiries - oral and written. + Keep injured worker apprised of claim status. + In-person medical case management may be required to support Concierge locations, where a Nurse Case Manager meets with injured employees face to face following office visits at a provider's medical facility. + In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) and/or certifications may be required to comply with state and Travelers requirements. Generally, License(s) are required to be obtained within three months. + Perform other duties as assigned. **What Will Our Ideal Candidate Have?** + Disability case management experience. + Prior clinical experience. + Familiarity with URAC standards. + Analytical Thinking: Identifies current or future problems or opportunities; analyzes, synthesizes and compares information to understand issues; identifies cause/effect relationships; and explores alternative solutions that support sound decision-making. + Communication: Expresses, summarizes and records thoughts clearly and concisely orally and in writing by applying proper content, format, sentence structure, grammar, language and terminology. + Ability to effectively present file resolution to internal and/or external stakeholders. + Negotiation: Intermediate ability to understand alternatives, influence stakeholders and reach a fair agreement through discussion and compromise. + General Insurance Contract Knowledge: Ability to understand policies and contracts, as they apply to policy conditions. + Principles of Investigation: Intermediate investigative skills. + Follows a logical sequence of inquiry with a goal of securing information about the work accident, resulting injury, anticipated treatment, job duties and any material factors that may impact recovery and return to work. + Value Determination: Basic ability to determine liability and assigns a dollar value based on damages claimed and estimates, sets and readjusts reserves. + Legal Knowledge: Basic knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry. + Medical knowledge: Thorough knowledge of the nature and extent of injuries, periods of disability, and treatment needed. + WC Technical: intermediate ability to demonstrate understanding of WC Products and ability to apply available resources and technology to manage treatment plans and assist with claim resolution. + Demonstrate a clear understanding and ability to work within jurisdictional parameters within their assigned state. + Customer Service: Advanced ability to build and maintain productive relationships with our insureds and deliver results with optimal outcomes. + Teamwork: Advanced ability to work together in situations when actions are interdependent and a team is mutually responsible to produce a result. + Planning & Organizing: Advanced ability to establish a plan/course of action and contingencies for self or others to meet current or future goals. + Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Clinical Research Counselor (CRC), or Certified Rehab Registered Nurse (CRRN). **What is a Must Have?** + Registered Nurse; Licensed Practical Nurse or Licensed Vocational Nurse. **What Is in It for You?** + **Health Insurance** : Employees and their eligible family members - including spouses, domestic partners, and children - 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, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers. + **Paid Time Off:** Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. + **Wellness Program:** The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs. + **Volunteer Encouragement:** We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice. **Employment Practices** Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email (*******************) so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit ******************************************************** .

🚨 Now Hiring: RN Case Manager - Indianapolis, IN Region 🚨 💻 Work from home + local field travel 💰 Salary: Competitive & commensurate with experience 🎉 Quarterly Bonus Opportunities 📚 Free CEUs for licenses & certificates 💳 License & Certification Reimbursement We're looking for an RN with a passion for case management to join our team! ✨ RN degree required ✨ National Certification preferred (CCM, CRC, COHN, CRRC) ✨ Workers' Comp Case Management experience a plus ✅ Your Impact: You'll provide effective case management services in a cost‑effective manner, delivering medical case management consistent with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines. You'll support patients/employees receiving benefits under insurance lines including Workers' Compensation, Group Health, Liability, Disability, and Care Management. This is your chance to grow your career, earn great rewards, and enjoy true work-life balance. 👉 Apply today and make an impact in the Indianapolis community! Associate's degree or relevant course work/certification in Nursing is required; BSN Degree is preferred. Minimum of 1-3 years diverse clinical experience and one of the below: Certification as a case manager from the URAC-approved list of certifications (preferred); A registered nurse (RN) license. Must be compliant with state requirements regarding national certifications. General working knowledge of case management practices and ability to quickly learn and apply workers compensation/case management products and services. Excellent oral and written communications skills to effectively facilitate return-to-work solutions within a matrix organization and ensure timely, quality documentation. Excellent analytical and customer service skills to facilitate the resolution of case management problems. Basic computer skills including working knowledge of Microsoft Office products and Lotus Notes. Demonstrated ability to establish collaborative working relationships with claims adjusters, employers, patients, attorneys and all levels of employees. Demonstrated ability to gather and analyze data and establish plans to improve trends, processes, and outcomes. Excellent organizational skills as evidenced by proven ability to handle multiple tasks simultaneously. Demonstrated leadership ability with a basic understanding of supervisory and management principles. Active RN home state licensure in good standing without restrictions with the State Board of Nursing. Must meet specific requirements to provide medical case management services. Minimum of 1 National Certification (CCM, CDMS, CRRN, and COHN) is preferred. If not attained, must plan to take certification exam within proceeding 36 months. National certification must be obtained in order to reach Senior Medical Case Management status. Travel may entail approximately 70% of work time. Must maintain a valid driver's license in state of residence. #LI-RG1 Reviews case records and reports, collects and analyzes data, evaluates injured worker/disabled individual's medical status, identifies needs and obstacles to medical case resolution and RTW by providing proactive case management services. Render opinions regarding case costs, treatment plan, outcome and problem areas, and makes recommendations to facilitate case management goals to include RTW. Demonstrates ability to meet administrative requirements, including productivity, time management and QA standards, with a minimum of supervisory intervention. May perform job site evaluations/summaries to facilitate case management process. Facilitates timely return to work date by establishing a professional working relationship with the injured worker/disabled individual, physician, and employer. Coordinate RTW with injured worker, employer and physicians. Maintains contact and communicates with claims adjusters to apprise them of case activity, case direction or secure authorization for services. Maintains contact with all parties involved on case, necessary for case management the injured worker/disabled individual. May obtain records from the branch claims office. May review files for claims adjusters and supervisors for appropriate referral for case management services. May meet with employers to review active files. Makes referrals for Peer reviews and IME's by obtaining and delivering medical records and diagnostic films, notifying injured worker/disabled individual and conferring with physicians. Utilizes clinical expertise and medical resources to interpret medical records and test results and provides assessment accordingly. May spend approximately 70% of their work time traveling to homes, health care providers, job sites and various offices as required facilitating RTW and resolution of cases. Meets monthly production requirements and quality assessment (QA) requirements to ensure a quality product. Reviews cases with supervisor monthly to evaluate files and obtain directions. Upholds the Crawford and Company Code of Business Conduct at all times. Demonstrates excellent customer service, and respect for customers, co-workers, and management. Independently approaches problem solving by appropriate use of research and resources. May perform other related duties as assigned.

Now Hiring: RN Case Manager - Indianapolis, IN Region Work from home + local field travel Salary: Competitive & commensurate with experience Quarterly Bonus Opportunities Free CEUs for licenses & certificates License & Certification Reimbursement We're looking for an RN with a passion for case management to join our team! RN degree required National Certification preferred (CCM, CRC, COHN, CRRC) Workers' Comp Case Management experience a plus Your Impact: You'll provide effective case management services in a cost‑effective manner, delivering medical case management consistent with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines. You'll support patients/employees receiving benefits under insurance lines including Workers' Compensation, Group Health, Liability, Disability, and Care Management. This is your chance to grow your career, earn great rewards, and enjoy true work-life balance. Apply today and make an impact in the Indianapolis community!

🚨 Now Hiring: RN Case Manager - Orlando, FL Region 🚨 💻 Work from home + local field travel 💰 Salary: Competitive & commensurate with experience 🎉 Quarterly Bonus Opportunities 📚 Free CEUs for licenses & certificates 💳 License & Certification Reimbursement We're looking for an RN with a passion for case management to join our team! ✨ RN degree required ✨ National Certification preferred (CCM, CRC, COHN, CRRC) ✨ Workers' Comp Case Management experience a plus ✅ Your Impact: You'll provide effective case management services in a cost‑effective manner, delivering medical case management consistent with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines. You'll support patients/employees receiving benefits under insurance lines including Workers' Compensation, Group Health, Liability, Disability, and Care Management. This is your chance to grow your career, earn great rewards, and enjoy true work-life balance. 👉 Apply today and make an impact in the Orlando community! Associate's degree or relevant course work/certification in Nursing is required; BSN Degree is preferred. Minimum of 1-3 years diverse clinical experience and one of the below: Certification as a case manager from the URAC-approved list of certifications (preferred); A registered nurse (RN) license. Must be compliant with state requirements regarding national certifications. General working knowledge of case management practices and ability to quickly learn and apply workers compensation/case management products and services. Excellent oral and written communications skills to effectively facilitate return-to-work solutions within a matrix organization and ensure timely, quality documentation. Excellent analytical and customer service skills to facilitate the resolution of case management problems. Basic computer skills including working knowledge of Microsoft Office products and Lotus Notes. Demonstrated ability to establish collaborative working relationships with claims adjusters, employers, patients, attorneys and all levels of employees. Demonstrated ability to gather and analyze data and establish plans to improve trends, processes, and outcomes. Excellent organizational skills as evidenced by proven ability to handle multiple tasks simultaneously. Demonstrated leadership ability with a basic understanding of supervisory and management principles. Active RN home state licensure in good standing without restrictions with the State Board of Nursing. Must meet specific requirements to provide medical case management services. Minimum of 1 National Certification (CCM, CDMS, CRRN, and COHN) is preferred. If not attained, must plan to take certification exam within proceeding 36 months. National certification must be obtained in order to reach Senior Medical Case Management status. Travel may entail approximately 70% of work time. Must maintain a valid driver's license in state of residence. #LI-RG1 Reviews case records and reports, collects and analyzes data, evaluates injured worker/disabled individual's medical status, identifies needs and obstacles to medical case resolution and RTW by providing proactive case management services. Render opinions regarding case costs, treatment plan, outcome and problem areas, and makes recommendations to facilitate case management goals to include RTW. Demonstrates ability to meet administrative requirements, including productivity, time management and QA standards, with a minimum of supervisory intervention. May perform job site evaluations/summaries to facilitate case management process. Facilitates timely return to work date by establishing a professional working relationship with the injured worker/disabled individual, physician, and employer. Coordinate RTW with injured worker, employer and physicians. Maintains contact and communicates with claims adjusters to apprise them of case activity, case direction or secure authorization for services. Maintains contact with all parties involved on case, necessary for case management the injured worker/disabled individual. May obtain records from the branch claims office. May review files for claims adjusters and supervisors for appropriate referral for case management services. May meet with employers to review active files. Makes referrals for Peer reviews and IME's by obtaining and delivering medical records and diagnostic films, notifying injured worker/disabled individual and conferring with physicians. Utilizes clinical expertise and medical resources to interpret medical records and test results and provides assessment accordingly. May spend approximately 70% of their work time traveling to homes, health care providers, job sites and various offices as required facilitating RTW and resolution of cases. Meets monthly production requirements and quality assessment (QA) requirements to ensure a quality product. Reviews cases with supervisor monthly to evaluate files and obtain directions. Upholds the Crawford and Company Code of Business Conduct at all times. Demonstrates excellent customer service, and respect for customers, co-workers, and management. Independently approaches problem solving by appropriate use of research and resources. May perform other related duties as assigned.

🚨 Now Hiring: RN Case Manager - Atlanta, GA Region 🚨 💻 Work from home + local field travel 💰 Salary: Competitive & commensurate with experience 🎉 Quarterly Bonus Opportunities 📚 Free CEUs for licenses & certificates 💳 License & Certification Reimbursement We're looking for an RN with a passion for case management to join our team! ✨ RN degree required ✨ National Certification preferred (CCM, CRC, COHN, CRRC) ✨ Workers' Comp Case Management experience a plus ✅ Your Impact: You'll provide effective case management services in a cost‑effective manner, delivering medical case management consistent with URAC standards, CMSA Standards of Practice, and Broadspire QA Guidelines. You'll support patients/employees receiving benefits under insurance lines including Workers' Compensation, Group Health, Liability, Disability, and Care Management. This is your chance to grow your career, earn great rewards, and enjoy true work-life balance. 👉 Apply today and make an impact in the Atlanta community! Associate's degree or relevant course work/certification in Nursing is required; BSN Degree is preferred. Minimum of 1-3 years diverse clinical experience and one of the below: Certification as a case manager from the URAC-approved list of certifications (preferred); A registered nurse (RN) license. Must be compliant with state requirements regarding national certifications. General working knowledge of case management practices and ability to quickly learn and apply workers compensation/case management products and services. Excellent oral and written communications skills to effectively facilitate return-to-work solutions within a matrix organization and ensure timely, quality documentation. Excellent analytical and customer service skills to facilitate the resolution of case management problems. Basic computer skills including working knowledge of Microsoft Office products and Lotus Notes. Demonstrated ability to establish collaborative working relationships with claims adjusters, employers, patients, attorneys and all levels of employees. Demonstrated ability to gather and analyze data and establish plans to improve trends, processes, and outcomes. Excellent organizational skills as evidenced by proven ability to handle multiple tasks simultaneously. Demonstrated leadership ability with a basic understanding of supervisory and management principles. Active RN home state licensure in good standing without restrictions with the State Board of Nursing. Must meet specific requirements to provide medical case management services. Minimum of 1 National Certification (CCM, CDMS, CRRN, and COHN) is preferred. If not attained, must plan to take certification exam within proceeding 36 months. National certification must be obtained in order to reach Senior Medical Case Management status. Travel may entail approximately 70% of work time. Must maintain a valid driver's license in state of residence. #LI-RG1 Reviews case records and reports, collects and analyzes data, evaluates injured worker/disabled individual's medical status, identifies needs and obstacles to medical case resolution and RTW by providing proactive case management services. Render opinions regarding case costs, treatment plan, outcome and problem areas, and makes recommendations to facilitate case management goals to include RTW. Demonstrates ability to meet administrative requirements, including productivity, time management and QA standards, with a minimum of supervisory intervention. May perform job site evaluations/summaries to facilitate case management process. Facilitates timely return to work date by establishing a professional working relationship with the injured worker/disabled individual, physician, and employer. Coordinate RTW with injured worker, employer and physicians. Maintains contact and communicates with claims adjusters to apprise them of case activity, case direction or secure authorization for services. Maintains contact with all parties involved on case, necessary for case management the injured worker/disabled individual. May obtain records from the branch claims office. May review files for claims adjusters and supervisors for appropriate referral for case management services. May meet with employers to review active files. Makes referrals for Peer reviews and IME's by obtaining and delivering medical records and diagnostic films, notifying injured worker/disabled individual and conferring with physicians. Utilizes clinical expertise and medical resources to interpret medical records and test results and provides assessment accordingly. May spend approximately 70% of their work time traveling to homes, health care providers, job sites and various offices as required facilitating RTW and resolution of cases. Meets monthly production requirements and quality assessment (QA) requirements to ensure a quality product. Reviews cases with supervisor monthly to evaluate files and obtain directions. Upholds the Crawford and Company Code of Business Conduct at all times. Demonstrates excellent customer service, and respect for customers, co-workers, and management. Independently approaches problem solving by appropriate use of research and resources. May perform other related duties as assigned.

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 170 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 provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. Salary Range $85,600.00 - $141,200.00 Target Openings 2 What Is the Opportunity? Under moderate supervision, provide office based 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. Responsible for helping to ensure injured parties receive appropriate treatment directly related to the compensable injury or assist claim handlers in managing medical treatment to an appropriate resolution. What Will You Do? * Contact customer, medical provider 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. Evaluate and update treatment and return to work plans within established protocols throughout the life of the claim. * Coordinate with medical providers to ensure the injured employee is actively participating in a viable treatment plan. * Evaluate medical treatment requests to ensure that they are reasonable and necessary based upon jurisdictional guidelines. * Engage specialty resources as needed to achieve optimal resolution (Dial-a-doc, physician advisor, peer reviews, MCU). * Partner with Claim Professional to provide medical information and disability status necessary to create an overall strategy to achieve an optimal outcome. * Utilize internal Claim Platform Systems to manage all claim activities on a timely basis. * Utilize Preferred Provider Network per jurisdictional guidelines. * Partner with Claim Professional to provide input on medical treatment and recovery time to assist in evaluating appropriate claim reserves. * Submit accurate billing documentation on all activities as outlined in established guidelines. * Customer Engagement. * Participate in Telephonic and/or onsite File Reviews. * Respond to inquiries - oral and written. * Keep injured worker apprised of claim status. * In-person medical case management may be required to support Concierge locations, where a Nurse Case Manager meets with injured employees face to face following office visits at a provider's medical facility. * In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) and/or certifications may be required to comply with state and Travelers requirements. Generally, License(s) are required to be obtained within three months. * Perform other duties as assigned. What Will Our Ideal Candidate Have? * Disability case management experience. * Prior clinical experience. * Familiarity with URAC standards. * Analytical Thinking: Identifies current or future problems or opportunities; analyzes, synthesizes and compares information to understand issues; identifies cause/effect relationships; and explores alternative solutions that support sound decision-making. * Communication: Expresses, summarizes and records thoughts clearly and concisely orally and in writing by applying proper content, format, sentence structure, grammar, language and terminology. * Ability to effectively present file resolution to internal and/or external stakeholders. * Negotiation: Intermediate ability to understand alternatives, influence stakeholders and reach a fair agreement through discussion and compromise. * General Insurance Contract Knowledge: Ability to understand policies and contracts, as they apply to policy conditions. * Principles of Investigation: Intermediate investigative skills. * Follows a logical sequence of inquiry with a goal of securing information about the work accident, resulting injury, anticipated treatment, job duties and any material factors that may impact recovery and return to work. * Value Determination: Basic ability to determine liability and assigns a dollar value based on damages claimed and estimates, sets and readjusts reserves. * Legal Knowledge: Basic knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry. * Medical knowledge: Thorough knowledge of the nature and extent of injuries, periods of disability, and treatment needed. * WC Technical: intermediate ability to demonstrate understanding of WC Products and ability to apply available resources and technology to manage treatment plans and assist with claim resolution. * Demonstrate a clear understanding and ability to work within jurisdictional parameters within their assigned state. * Customer Service: Advanced ability to build and maintain productive relationships with our insureds and deliver results with optimal outcomes. * Teamwork: Advanced ability to work together in situations when actions are interdependent and a team is mutually responsible to produce a result. * Planning & Organizing: Advanced ability to establish a plan/course of action and contingencies for self or others to meet current or future goals. * Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Clinical Research Counselor (CRC), or Certified Rehab Registered Nurse (CRRN). What is a Must Have? * Registered Nurse; Licensed Practical Nurse or Licensed Vocational Nurse. What Is in It for You? * Health Insurance: Employees and their eligible family members - including spouses, domestic partners, and children - 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, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers. * Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. * Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs. * Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice. Employment Practices Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit *********************************************************

Our Company Explore how you can contribute at AmeriLife. For over 50 years, AmeriLife has been a leader in the development, marketing and distribution of annuity, life and health insurance solutions for those planning for and living in retirement. Associates get satisfaction from knowing they provide agents, marketers and carrier partners the support needed to succeed in a rapidly evolving industry. Job Summary We are seeking an experienced Medical Case Manager with a background in high-net-worth cases to join our team. This role involves assessing medical records for new business applications and working closely with clients, advisors, carrier medical underwriters, case managers, and internal teams to deliver customized underwriting solutions. The ideal candidate will bring a minimum of 5 years of experience in medical underwriting within a carrier environment, with a demonstrated track record of handling high-net-worth clients and complex cases. Job Description Key Responsibilities: Risk Assessment: Review and evaluate medical information, history, and lifestyle factors to assess risk accurately for new business applications, ensuring alignment with company guidelines and risk appetite. High Net-Worth Client Underwriting: Apply expertise in high-net-worth client underwriting, providing tailored assessments and recommendations for sophisticated cases with large policy values. Collaboration with Advisors and Agents: Work closely with sales agents, brokers, and advisors to discuss underwriting decisions, alternative solutions, and provide education on medical underwriting considerations. Decision-Making: Make informed, independent underwriting decisions, backed by solid analysis and within authorized limits; escalate complex cases as necessary. Documentation and Compliance: Maintain accurate records of underwriting decisions, ensuring full compliance with company policies, procedures, and regulatory requirements. Continuous Improvement: Stay updated on industry trends, medical advancements, and changes in underwriting guidelines, and contribute insights for policy updates and risk management strategies. Qualifications: Experience: Minimum of 5 years in medical underwriting, ideally within a life insurance carrier environment, with demonstrated expertise in new business underwriting for high-net-worth clients. Medical Knowledge: Strong understanding of medical terminology, conditions, and risk factors, with the ability to apply this knowledge to high-stakes underwriting cases. Analytical Skills: Strong analytical skills, with the ability to evaluate complex medical and financial information effectively. Communication Skills: Excellent verbal and written communication skills, with the ability to explain underwriting decisions to both technical and non-technical stakeholders. Attention to Detail: High degree of accuracy and attention to detail in assessing risk and documenting decisions. Compliance Knowledge: Familiarity with industry regulations, compliance standards, and underwriting best practices. Equal Employment Opportunity Statement We are an Equal Opportunity Employer and value diversity at all levels of the organization. All employment decisions are made without regard to race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), sexual orientation, gender identity or expression, age, national origin, ancestry, disability, genetic information, marital status, veteran or military status, or any other protected characteristic under applicable federal, state, or local law. We are committed to providing an inclusive, equitable, and respectful workplace where all employees can thrive. Americans with Disabilities Act (ADA) Statement We are committed to full compliance with the Americans with Disabilities Act (ADA) and all applicable state and local disability laws. Reasonable accommodations are available to qualified applicants and employees with disabilities throughout the application and employment process. Requests for accommodation will be handled confidentially. If you require assistance or accommodation during the application process, please contact us at ****************. Pay Transparency Statement We are committed to pay transparency and equity, in accordance with applicable federal, state, and local laws. Compensation for this role will be determined based on skills, qualifications, experience, and market factors. Where required by law, the pay range for this position will be disclosed in the job posting or provided upon request. Additional compensation information, such as benefits, bonuses, and commissions, will be provided as required by law. We do not discriminate or retaliate against employees or applicants for inquiring about, discussing, or disclosing their pay or the pay of another employee or applicant, as protected under applicable law. Pay ranges are available upon request. Background Screening Statement Employment offers are contingent upon the successful completion of a background screening, which may include employment verification, education verification, criminal history check, and other job-related inquiries, as permitted by law. All screenings are conducted in accordance with applicable federal, state, and local laws, and information collected will be kept confidential. If any adverse decision is made based on the results, applicants will be notified and given an opportunity to respond.

Reporting to the Case Management Supervisor and/or their designee, the Non-Medical Case Manager is responsible for providing Non-Medical Case Management Services, that include EFA and Co-Morbidity Services and monitoring Ryan White eligibility. Contacts and interactions vary and may involve multiple constituencies such as direct interaction with THC's executive management, community organizers, the general public, THC's patients, physicians, colleagues, assigned staff, vendors, contractors and consultants for the purpose of providing and exchanging information. Example of Essential Job Functions Manages a caseload of patients Ensures all intake assessments are completed and assessments are reviewed semi-annually Ability to assess clients for needs related to treatment education, risk reduction and prevention. Responsible for all new patients are properly oriented to the unit (i.e. understand rules, policies, procedures, sign consent/release of information forms) Responsible for developing, implementing and evaluating individualized patient care plans Establishes long and short term goals for the patient which are S-M-A-R-T(Smart, Measurable, Achievable, Realistic, Timely) Ensure the patients are linked to care management and staff adhere to appropriate lines of communication that promote team based and patient centered care Ensure that advance preparations for patients are coordinated for providers and with patients. Participates in patient centered interdisciplinary care conferences and meetings as required. Acts as a liaison between patients, their families and healthcare providers Improve patients' quality of life through collaboration and follow up care Ensure customer service standards are continuously demonstrated. Facilitate collaboration between community health education resources and the patients Assist patients with creating, monitoring and documentation of self-management goals and follow up with patients regarding set goals, identify for needs assessment. Effectively tracks outcomes of care on an individual and aggregate basis regarding the patients Gathers and documents attempts to gather program eligibility information. Assist with navigation in patients' use of health center services Participates in professional development opportunities and attends staff/team meetings as deemed necessary Documents in medical record per policy and standards Provides in-service training, and on-the-job training to new staff within the scope of service Maintains information in a confidential manner in compliance with HIPAA and confidentiality policies and procedures. Performs other duties as assigned. Travel is required Minimum Education, Training and Experience Required AA Degree Required Bachelor's Level Degree preferred One year Case Management experience preferred

This is an RN position that specifically requires experience in STI, PrEP/PEP clinical care with an interest in supporting programmatic STI, PrEP/PEP services. Reporting to the Case Manager Supervisor and/or their designee, the Medical Case Manager is responsible for providing daily care coordination, case management, and direct patient care. This position works with HIV/AIDS and Hepatitis-C infected individuals. The incumbent will work as part of an interdisciplinary care team including, but not limited to, coordinating patient services such non- medical case management, mental health and substance abuse treatment and integration of primary medical and specialty care. This position provides health education for patients with an emphasis on medication adherence and treatment compliance. This position works as part of the Integrated Behavioral Health Case Management team. Contacts and interactions vary and may involve multiple constituencies such as direct interaction with THC's executive management, community organizers, the general public, THC's patients, physicians, colleagues, assigned staff, vendors, contractors and consultants for the purpose of providing and exchanging information. Example of Essential Job Functions Manages a caseload of patients Ensures all intake assessments are completed Ability to assess clients for needs related to treatment education, risk reduction and prevention. Responsible for All new patients and employees are properly oriented to the unit (i.e. understand rules, policies, procedures, sign consent/release of information forms) Responsible for developing, implementing and evaluating individualized patient care plans Establishes long and short term goals for the patient which are S-M-A-R-T(Smart, Measurable, Achievable, Realistic, Timely) Educates patients regarding the disease process and medications, methods for improving medication compliance, available community resources and other pertinent information. Ensure the patients are linked to care management and staff adhere to appropriate lines of communication regarding the work being done with patients Directs and monitors team members in implementing patient's care plan. Maintains extensive knowledge regarding the current standards of HIV/AIDS care and case management processes. Ensure quality care is delivered in an efficient and effective manner. Ensure customer service standards are continuously demonstrated. Engaging patients and their care givers in understanding and setting self-management plans in a culturally and linguistically appropriate manner. Facilitates and coordinates services to develop patient-centered, individualized, integrated patient care plans, including self-management and outcomes goals. Collaborate with various health care providers across the care continuum to ensure that patients are effectively managed and that health care needs are met. Ensure that advance preparations for patients are coordinated for providers and with patients. Participates in patient centered interdisciplinary care conferences and meetings as required. Responsible for care in collaboration with the patient's physician, the patient and/or family representative, and other members of the professional staff Acts as a liaison between patients, their families and healthcare providers Providing clinical expertise for assigned patient population Reassessing all treatment plans according to policy and as needed Improve patients' quality of life through collaboration and follow up care Facilitate collaboration between community health education resources and the patients Assist patients with creating, monitoring and documentation of self-management goals and follow up with patients regarding set goals Communicates to other team members regarding the status of patients' social and mental health needs Monitor patients' use of health center services and the adequateness and effectiveness of the services utilized, including patient flow Develops and maintains policies and procedures as required Participates in professional development opportunities and attends staff/team meetings as deemed necessary Documents in medical record per policy and standards Maintains accurate and up-to-date records in a timely manner Provides in-service training, and on-the-job training to new staff within the scope of service Assist with audits and quality issues Provide services in clinic within the scope of services of license as directed by Supervisory staff. Facilitates referrals to specialty care and support services Follows up on all medical care related referrals and documents all contact and outcome in the medical record. Interacts with providers, including specialists, to ensure comprehensive care for the patients Disseminates information and educates the provider community and patients regarding the latest treatment protocols in HIV/AIDS management. Collaborates with ASOs and other community services in the Eligible Metropolitan Area (EMA), including specialty care providers, as necessary to ensure appropriate access to services and follow-up on the results to such referrals Effectively tracks outcomes of care on an individual and aggregate basis regarding the patients Monitors patients acuity level in an ongoing fashion to ensure transition to reduced intensity of services when patient is no longer an acuity level that necessitates medical case management. Communicates with all team members about changes to level of services Maintains information in a confidential manner in compliance with HIPAA and confidentiality policies and procedures. Participation in required Ryan White staff meetings Clinical coverage for direct patient care when needed Performs other duties as assigned within the scope of license. Required Knowledge, Skills and Abilities Knowledge of FQHC operations, operating principles, guidelines and bylaws. Excellent leadership, customer service, organizational and presentation skills as well as the ability to effectively communicate THC's vision, and motivate others to achieve it organizationally, departmentally, and personally/professionally. Ability to communicate effectively (verbally and in writing). Ability to plan and organize work initiatives to successfully accomplish center/organizational goals and objectives. Ability to multi-task, prioritize and delegate as appropriate. Strong analytical, problem solving and interpersonal skills. Ability to identify, develop and implement short/long-term strategic goals and objectives. Ability to develop and maintain customer relationships; influence, build credibility and trust. Ability to think critically as well as apply critical thinking skills. Ability to: ensure and advocate for quality healthcare and services; and, lead and manage a diverse staff. Must have demonstrated knowledge of HIV/AIDS services in Maryland, along with an interest and ability to expand knowledge through training. Knowledge of the federal 340B program and its requirements. Licenses and Certifications RN License

✨Join a group of passionate advocates on our mission to improve the lives of youth! Rite of Passage Team is hiring for a Medical Case Manager at Southern California Treatment Program in Costa Mesa, CA ✨ Rite of Passage's Southern California Treatment Program is located in a thriving community known for its cultural diversity, sunny weather, and proximity to world-class educational institutions, that allows our team members to enjoy an inspiring and supportive environment where they can make a meaningful impact while growing both personally and professionally. Pay: Rate starting at $23.00 per hour; $1000.00 Sign-On Bonus for Full-Time Clinical position paid out at 3 and 6 Months! Perks and Benefits: Medical, Dental, Vision, company paid Life Insurance, eligibility for a 403(b) match of up to 6% after 1 year of employment, Paid Time Off that begins accruing on the first day, and more! See complete list here: ATCS Benefits & Perks What you will do: You will be responsible for coordinating medication management services, scheduling monthly/quarterly psychiatry appointments, coordinating care with all providers to ensure client's mental health stability and their successful transition back to the community. To be considered you must: Demonstrate empathy, patience, and respect, along with a genuine desire to work with troubled teens. ~ Successfully pass a criminal background check, drug screening, physical exam, and TB test. ~ Hold a current State Driver's License with an acceptable driving record for the past three years. ~ Retain one of the following combinations: Associates level degree in a related field with three years of experience, or Bachelor's level degree in a related field with two years of related experience in mental health service provision. Relevant experience includes, but not limiting to working with youth in mental health setting, treatment services, residential, schools, after-school programs, or coaching sports Information regarding Schedule/hours/shifts: Shifts: Monday - Friday 9:00 am - 6:00 pm Apply today and Make a Difference in the Lives of Youth! After 40 years of improving the lives of youth, we are looking for passionate advocates to continue the legacy of helping young people become successful adults. As a Medical Case Manager , you will have the unique opportunity to create a positive, safe and supportive environment for the youth we serve while building a career rich in growth opportunities and self-fulfillment. Follow us on Social! Instagram / Facebook / Linkedin / Tik Tok / YouTube