Senior Case Manager jobs at Central Health Plan of California - 146 jobs

FUNCTION OF THE JOB: The Workers' Compensation Senior Telephonic Nurse Case Manager is responsible for evaluating and expediting appropriate, cost-effective medical treatment of injured employees with the goal of optimum medical improvement. The Senior TCM is responsible for disability management, including proactive early return to work coordination. Close collaboration with the claims and medical team to achieve individual case and department goals is a critical component of the position. This is a full-time remote position. KNOWLEDGE AND SKILLS: Excellent verbal and written communication skills. This position will involve continuous personal, telephonic, and written contact. Strong interpersonal and relationship building skills. Knowledge of traumatic injuries and the resultant disabilities and medical complications. Knowledge of Workers' Compensation Acts and working knowledge of the medical providers in the assigned territory. Knowledge and expertise in use of medical treatment guidelines and disability duration guidelines. Experience using Microsoft Office products and ability to learn other technology tools. Strong time management, critical thinking, and organizational skills with the ability to work independently to manage priorities and meet deadlines. Model exceptional customer experience skills. MAJOR DUTIES/RESPONSIBILITIES OF THE JOB: Complete timely initial assessment report, case management plan, and establish disability duration timeframes. Throughout the life of an assignment review, analyze and critically assess medical records compared to evidence-based treatment guidelines; communicate findings and recommendations to the adjuster as part of the development of a medical action plan. Active participation with claims team to review, establish, and execute action plan. Develop and maintain action plan for early return to work (RTW) based on disability duration guidelines. Work collaboratively with all stakeholders to effectively manage recovery and return to work process. Meet productivity requirements. Effectively manage inventory based on guidelines. Assist with training and development of team members and broader workers' compensation team including preparation and presentation of updates on relevant medical topics. Assist Nurse Manager and leadership team as needed with triage and projects. EDUCATION AND EXPERIENCE: Registered Nurse (RN) license in good standing required and willingness to obtain additional licenses as needed. BSN preferred. Certified Case Manager (CCM) certification, CDMS and/or CRRN preferred. Compact license preferred. 7-10 years of experience in Workers' Compensation Case Management preferred. Proficiency with MS Office products. The pay range for the role is $65,900 to $111,900. The specific offer will depend on an applicant's skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program. Chubb offers a comprehensive benefits package, more details on which can be found on our careers website. The disclosed pay range estimate may be adjusted for the applicable geographic differential for the location in which the position is filled.

Charles Taylor is a highly successful global provider of professional services to the insurance industry. We are seeking an experienced Workers Compensation Field Case Manager to join our team in the Cincinnati-North Dayton-Columbus, OH area. This is a remote, contracted role. Job Summary The Field Case Manager is responsible for assisting our clients injured workers with case management and return to work services. Essential Duties and Responsibilities Provide field case management services for our clients injured workers, including onsite attendance at doctor's appointments Perform case assessments and develop action plans to support recovery and timely return to work Coordinate timely access to needed medical services and maintain proactive communications Cultivate excellent relationships with all parties (AE's, IWs, providers, clients) Provide written reports on case status and updates (post, physician visit/weekly/monthly) and submits timely monthly billing to billing specialist. Contracted CM Requirements Prior Field Case Management - workers' compensation experience preferred Active Registered nurse (R.N. License and possess the ability to be licensed as a registered nurse in multiple states without restrictions) Understanding and working knowledge of ODG Guidelines Seasoned professional nurse with clinical nursing experience and at least 2-years case management experience with injured workers Understanding of case management processes Excellent interpersonal communication skills - both oral and written Professional certifications such as: CDMS, CRRN, COHN, or CCM are a plus Values At Charles Taylor, our values define our identity, principles and conduct. This person will demonstrate and champion Charles Taylor Values by ensuring Agility, Integrity, Care, Accountability and Collaboration. AAP/EEO Statement Here at Charles Taylor we are proud to be an Inclusive Employer. We provide an environment of mutual respect with zero tolerance to discrimination of any kind regardless of age, disability, gender identity, marital/ family status, race, religion, sex, or sexual orientation. Our external partnerships and the dedicated work we do in promoting a transparent and fair recruitment and selection process all contribute to the successful, inclusive, and diverse culture and environment which we are proud to be a part of at Charles Taylor.

Charles Taylor is a highly successful global provider of professional services to the insurance industry. We are seeking an experienced Workers Compensation Field Case Manager to join our team in the Cincinnati-North Dayton-Columbus, OH area. This is a remote, contracted role. Job Summary The Field Case Manager is responsible for assisting our clients injured workers with case management and return to work services. Essential Duties and Responsibilities * Provide field case management services for our clients injured workers, including onsite attendance at doctor's appointments * Perform case assessments and develop action plans to support recovery and timely return to work * Coordinate timely access to needed medical services and maintain proactive communications * Cultivate excellent relationships with all parties (AE's, IWs, providers, clients) * Provide written reports on case status and updates (post, physician visit/weekly/monthly) and submits timely monthly billing to billing specialist. Contracted CM Requirements * Prior Field Case Management - workers' compensation experience preferred * Active Registered nurse (R.N. License and possess the ability to be licensed as a registered nurse in multiple states without restrictions) * Understanding and working knowledge of ODG Guidelines * Seasoned professional nurse with clinical nursing experience and at least 2-years case management experience with injured workers * Understanding of case management processes * Excellent interpersonal communication skills - both oral and written * Professional certifications such as: CDMS, CRRN, COHN, or CCM are a plus Values At Charles Taylor, our values define our identity, principles and conduct. This person will demonstrate and champion Charles Taylor Values by ensuring Agility, Integrity, Care, Accountability and Collaboration. AAP/EEO Statement Here at Charles Taylor we are proud to be an Inclusive Employer. We provide an environment of mutual respect with zero tolerance to discrimination of any kind regardless of age, disability, gender identity, marital/ family status, race, religion, sex, or sexual orientation. Our external partnerships and the dedicated work we do in promoting a transparent and fair recruitment and selection process all contribute to the successful, inclusive, and diverse culture and environment which we are proud to be a part of at Charles Taylor.

Why Saybrus? We strive to help employees lead fulfilling professional lives. Excellence is expected and rewarded. We believe in straightforward communication and encourage employees to share opinions and ideas. Our salaries, incentive awards and comprehensive benefits provide a highly competitive total reward package based on individual and company performance. Many of our employees work from their homes, while others are based in our Hartford, CT headquarters. Job Summary Case Managers provide new permanent product business support to key business partners. They must independently manage cases by creatively resolving issues, negotiating underwriting offers (where applicable) while leveraging contacts and resources to ensure a desired outcome. Candidates must possess a strong knowledge of the life insurance process and be able to troubleshoot problems causing cycle time delays. Responsibilities also include timely communications, assistance in gathering outstanding requirements and overall superior customer service. Case Managers are expected to utilize strong communication skills (verbal and written) to ensure cases move through the new business process in a timely manner. Case managers must work well in a team environment. This role has a direct correlation to the success of the account.Job Description Duties and Responsibilities Negotiate underwriting offers with the underwriting teams of our Product Partners as appropriate to provide best opportunity for placement. Review and assess requirements, as needed. Manage the necessary components for the new business process, identifying cases that need special handling. Manage daily workload with emphasis on time management and quality standards. Proactively follow up and provide communication to support advisor/distributor satisfaction; Ensure cases progress from submission to placement in a timely/efficient manner with superior service. Ensure policy issuance within required timeline. Use expertise in Life insurance process, terminology, technology to support and enhance daily operations. Accept ownership and suggest innovative solutions to meet branch/client needs while undertaking new and different requests. Explore opportunities to add value. Ensure delivery requirements and payments for issued contracts are received in a timely manner. Serve as a single point of contact to customers. Receive and resolve complex and/or sensitive customer service inquiries, complaints and problems with quality, accuracy, and in a timely manner. Proactively resolve any issues and inquiries. Provide continuous scheduled telephone coverage as business needs dictate. May be responsible for employee training and mentoring. Perform other duties as assigned Knowledge, Skills and Abilities Minimum 5 years of experience with knowledge of the life insurance process for permanent products, including key impairments. Working knowledge of desktop applications such as Outlook, Word and Excel. Knowledge of Smart Office and Salesforce.com a plus. Critical thinking skills with the ability to identify and troubleshoot problems, and comfort with cases involving a high degree of complexity. Excellent verbal and written communication skills; clear and effective. Excellent interpersonal and relationship building skills to interact with internal and external clients. Discretion while handling confidential matters (e.g., medical records). Ability to work independently in a fast-paced, multi-faceted environment while focusing on critical deliverables. Comfortable in a team environment and supportive of corporate change. 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.

AMERISAFE is seeking a detail-oriented, productivity driven professional to add to our Illinois based Workers Compensation Claims Team. In this position, you will conduct on-site and in-person investigations, determine compensability, establish reserves, document decision making, issue benefit payments, and make notifications to the State administrative authority. You will work with injured workers, employers, medical and legal professionals to ensure the appropriate benefits are provided to injured workers under the appropriate Workers' Compensation Laws. In addition to the benefits listed on our careers page, other benefits of this position include: Salaried position based on location and experience ($50,000 to $95,000) Auto reimbursement program Reimbursement for cell phone and internet Target Case Load of 60 claims Upon an offer and acceptance of employment with AMERISAFE, you will be required to complete our pre-employment screening, which includes a criminal background check, a 10-panel drug test and, if applicable, a review of your motor vehicle report. A 10-panel drug test includes amphetamine/methamphetamine, barbiturates, benzodiazepines, cocaine metabolite (BZE), marijuana metabolite (THCA), methadone, methaqualone, codeine/morphine, phencyclidine, propoxyphene. Qualifications Claims experience highly preferred. Bachelor's degree or related professional business experience acceptable. State license to handle Workers' Compensation claims if required. Professional written and verbal communication skills required. World class customer service attitude required. Ability to learn and use proprietary software and Microsoft Office products is necessary. The ability to be self-directed. This is a remote position. Valid driver's license, acceptable driving record and acceptable vehicle required. Frequent travel within a designated territory required, but rarely is overnight travel required.

AMERISAFE is seeking a detail-oriented, productivity driven professional to add to our Illinois based Workers Compensation Claims Team. In this position, you will conduct on-site and in-person investigations, determine compensability, establish reserves, document decision making, issue benefit payments, and make notifications to the State administrative authority. You will work with injured workers, employers, medical and legal professionals to ensure the appropriate benefits are provided to injured workers under the appropriate Workers' Compensation Laws. In addition to the benefits listed on our careers page, other benefits of this position include: * Salaried position based on location and experience ($50,000 to $95,000) * Auto reimbursement program * Reimbursement for cell phone and internet * Target Case Load of 60 claims Upon an offer and acceptance of employment with AMERISAFE, you will be required to complete our pre-employment screening, which includes a criminal background check, a 10-panel drug test and, if applicable, a review of your motor vehicle report. A 10-panel drug test includes amphetamine/methamphetamine, barbiturates, benzodiazepines, cocaine metabolite (BZE), marijuana metabolite (THCA), methadone, methaqualone, codeine/morphine, phencyclidine, propoxyphene. Qualifications * Claims experience highly preferred. * Bachelor's degree or related professional business experience acceptable. * State license to handle Workers' Compensation claims if required. * Professional written and verbal communication skills required. * World class customer service attitude required. * Ability to learn and use proprietary software and Microsoft Office products is necessary. * The ability to be self-directed. This is a remote position. * Valid driver's license, acceptable driving record and acceptable vehicle required. * Frequent travel within a designated territory required, but rarely is overnight travel required.

This position is a hybrid of remote from home and field work. The candidate will need to reside in and travel throughout the North Sound region (Snohomish, Skagit, Whatcom, San Juan and Island counties). Who we are Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration. Our commitment is to: * Strive to apply an equity lens to all our work. * Reduce health disparities. * Create an equitable work environment. About the Role This position works under the general direction of the Supervisor of Care Management and is responsible for the plan's regional field care management and coordination programs and processes. The Regional Field Case Manager will provide care management services for CHPW members with short term, long term, stable, unstable, and predictable course of illness. The Regional Field Case Manager resides within the assigned region to effectively coordinate care between members, providers and community resources. This role also provides care management services for CHPW members with highly complex medical/behavioral and social conditions where advocacy and coordination are required. This role represents CHPW in the community to provide education on care management programs and provide in-person support for members. The Regional Field Case Manager coordinates with internal and external partners to support members, providers and initiatives in the assigned region. To be successful in this role, you: * Possess a Bachelor's degree in nursing or a master's degree in social work and/or a related behavior health field (required). * Have a current, unrestricted license in the state of Washington as a registered nurse (RN) (required) OR * Have a current, unrestricted license in the State of Washington as a Social Worker (LSWAA, LSWAIC) (required) OR * Current, unrestricted license in the State of Washington as a Mental health Counselor (LMHC), Mental Health Professional (LMHP), or Marriage and Family Therapist (LMFT) (required) * Have a minimum of one (1) year case management experience; home health or discharge planning experience; or a combination of education and experience which provides an equivalent background required OR * Have a minimum of one (1) year in an acute care, facility-based medical or behavioral health experience and/or outpatient psychiatric and substance abuse disorder treatment experience, required; or equivalent combination of education and experience and/or working with children and families. * Have experience with those who have disabilities and knowledge of Child and Families Services. * Have a minimum three (3) years of clinical experience and/or outpatient setting (required). * Have a valid state issued drivers' license. Preferred * Have a case management certification. * Are bilingual. * Have experience in managed care (Medicaid/HCA). * Have previous experience in using Care Management software applications. * Have knowledge of, and experience with, community resources. * Experience in care management workflow systems Essential functions and Roles and Responsibilities: * Engages with members, providers and agencies in the assigned region to support field care management services. * Provides face-to-face visits to members where telephonic care management is a barrier, to foster effective participation in the care management program. * Identify and partner with emergency response services or other programs in a community that support members who are high utilizers of medical/behavioral health services. Field case management can include meeting members in acute care, emergency room, adult family home, Inpatient behavioral health facilities, shelters, community health centers, members home or member preferred location. * Assesses, evaluates, plans, implements, and documents the care of members within the organizations' clinical database system in accordance with organizational policies and procedures. * Implements the plan of care through direct member care, coordination, and delegation of the activities of the health care team. Promotes continuity of care by accurately and completely communicating to health care team the status of members for whom care is provided. * Evaluates members' progress towards goals, identify potential barriers, assists members in navigating the healthcare system and expected outcomes in collaboration with member and the interdisciplinary care team. * Works within the multi-interdisciplinary care team that collaborates with providers, members, caregivers, contracted vendors, community resources, and health plan partners to assess the member's health status, identify care needs and ensure access to appropriate services to achieve positive health outcomes. * Advocates on behalf of members and facilitates coordination of resources required to help members reach optimum functional levels and autonomy within the constraints of their disease conditions. * Represents CHPW Care Management Department in the community to provide education on care management programs and collaborate with providers and community partners. Leads regional based projects as assigned * Participates in external care conferences and other d/c planning activities that may be needed to prevent a readmission as needed. * Participates in clinical case review with internal interdisciplinary team at Care Management Rounds. * Employees are expected to report to work as scheduled, participate in all assigned meetings, and meet established performance and accountability standards. * Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion. * This position requires traveling on behalf of the Company and working in the field at least 50% of the time. It is essential that a current driver's license, proof of insurance and an acceptable driving record are maintained. Knowledge, Skills, and Abilities: * Knowledge of regulatory and certification requirements and their impact on the organization such as CMS, HCA, HEDIS, CAHPS, and NCQA. * Knowledge of and experience with community and other resources * Analytical skills and the ability to interpret, evaluate and formulate action plans based upon data * Organizational, time management, and project management skills * Ability to handle multiple priorities * Ability to multi-task and deal with complex assignments on a frequent basis * Proficiency and experience with Microsoft Office products * Written and verbal communication skills; able to communicate with and collaborate effectively with internal departments, physicians and allied health care providers * Ability to work independently * Perform all functions of the job with accuracy, attention to detail and within established timeframes. * Ability to maintain confidentiality Note: If you think you do not qualify, please reconsider. Studies have shown that women and people of color are less likely to apply to jobs unless they feel they meet every qualification. However, everyone brings different strengths to the table for a job, and people can be successful in a role in a variety of ways. If you are excited about this job but your experience doesn't perfectly check every box in the , we encourage you to apply anyway. As part of our hiring process, the following criteria must be met: * Complete and successfully pass a criminal background check Criminal History: includes review of criminal convictions and probation. CHPW does not automatically or categorically exclude persons with a criminal background from employment. The applicant's criminal history will be reviewed on a case-by-case basis considering the risk to the business, members, and/employees. * Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency * Vaccination requirement (CHPW offers a process for medical or religious exemptions) * Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation. Compensation and Benefits: The position is FLSA Exempt and is not eligible for overtime and has a 10% annual incentive target based on company, department, and individual performance goals. The base pay actually offered will take into account internal equity and also may vary depending on the candidate's job-related knowledge, skills, and experience among other factors. CHPW offers the following benefits for Full and Part-time employees and their dependents: * Medical, Prescription, Dental, and Vision * Telehealth app * Flexible Spending Accounts, Health Savings Accounts * Basic Life AD&D, Short and Long-Term Disability * Voluntary Life, Critical Care, and Long-Term Care Insurance * 401(k) Retirement and generous employer match * Employee Assistance Program and Mental Fitness app * Financial Coaching, Identity Theft Protection * Time off including PTO accrual starting at 17 days per year * 40 hours Community Service volunteer time * 10 standard holidays, 2 floating holidays * Compassion time off, jury duty Sensory/Physical/Mental Requirements: Sensory*: * Speaking, hearing, near vision, far vision, depth perception, peripheral vision, touch, smell, and balance. Physical*: * Extended periods of sitting, computer use, talking, and possibly standing * Simple grasp, firm grasp, fine manipulation, pinch, finger dexterity, supination/pronation, wrist flexion Mental: * Must have the ability to learn and prioritize multiple tasks within the scope and guidelines of the position and its applicable licensure requirements, many requiring extremely complex cognitive capabilities. Must be able to manage conflict, communicate effectively and meet time-sensitive deadlines. Work Environment: Office environment Employees who frequently work in front of computer monitors are at risk for environmental exposure to low-grade radiation. * Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation. * The above is intended to describe the general content of and the requirements for satisfactory performance in this position. It is not to be construed as an exhaustive statement of the duties, responsibilities, or requirements of this position. Job descriptions may be updated or changed to reflect business needs.

Why Saybrus? We strive to help employees lead fulfilling professional lives. Excellence is expected and rewarded. We believe in straightforward communication and encourage employees to share opinions and ideas. Our salaries, incentive awards and comprehensive benefits provide a highly competitive total reward package based on individual and company performance. Many of our employees work from their homes, while others are based in our Hartford, CT headquarters. Job Summary Saybrus Partners is looking for a self-motivated individual for the role of Case Manager, a critical role in the success of Saybrus' life insurance distribution strategy. Case Managers provide new business support to key business partners. They must independently manage cases by creatively resolving issues, negotiating underwriting offers (where applicable) while leveraging contacts and resources to ensure a desired outcome. Candidates must possess a strong knowledge of the life insurance process and be able to troubleshoot problems causing cycle time delays. Responsibilities also include timely communications, assistance in gathering outstanding requirements and overall superior customer service. Case Managers are expected to utilize strong communication skills (verbal and written) to ensure cases move through the new business process in a timely manner. Case managers must work well in a team environment. This role has a direct correlation to the success of the account.Job Description Principal Duties and Responsibilities Proactively follow up and provide communication to support advisor/distributor satisfaction and understanding; ensure cases progress from submission to placement in a timely/efficient manner with superior service. Manage daily workload with emphasis on time management and quality standards. Review and assess requirements, as needed. Serve as a single point of contact to customers. Receive and resolve complex and/or sensitive customer service inquiries, complaints and problems with quality, accuracy, and in a timely manner. Proactively resolve any issues and inquiries. Manage the necessary components for the new business process, identifying cases that need special handling. Accept ownership and suggest innovative solutions to meet branch/client needs while undertaking new and different requests. Explore opportunities to add value. Use expertise in life insurance process, terminology, technology to support and enhance daily operations. Negotiate underwriting offers with the underwriting teams of our Product Partners as appropriate to provide best opportunity for placement. Provide continuous scheduled telephone coverage as business needs dictate. May be responsible for employee training and mentoring. Perform other duties as assigned Knowledge, Skills and Abilities Knowledge of the life insurance process (permanent and term products), including key impairments Working knowledge of desktop applications such as Outlook, Word and Excel. Knowledge of Smart Office and Salesforce.com a plus. Critical thinking skills with the ability to identify and troubleshoot problems, and comfort with cases involving a high degree of complexity. Excellent verbal and written communication skills; clear and effective Excellent interpersonal and relationship building skills to interact with internal and external clients Discretion while handling confidential matters (e.g., medical records) Ability to work independently in a fast-paced, multi-faceted environment while focusing on critical deliverables Comfortable in a team environment and supportive of corporate change

🚨 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.

An ECM Coordinator supports department staff with administrative tasks related to a member's medical condition(s), department case work, communication with internal and external stakeholders, and manage audits. This role will engage with members to offer support and resources related to their medical condition(s) through Allied Care. ESSENTIAL FUNCTIONS Facilitate reviews, referrals, and outreach for referral-based proprietary strategies as well as engaging with members across Medical Management products Document all engagement accurately and concisely within the Microsoft Customer Relationship Management (CRM) system Manage escalated and time sensitive case management questions received from members, broker relationships, and internal and external Allied stakeholders Collaborate with strategic vendor partners to provide supportive services and support to members Lead and facilitate claims auditing in conjunction with ECM Coordinators. Complete department auditing related to daily tasks to ensure accuracy and identify escalations Identify impactful scenarios through appropriate closing summaries in timely fashion. Share impactful scenarios with the department's leadership team to deliver to internal departments, such as Sales, Operations, and Executive leadership Identifying escalations for department leadership team, as appropriate Other duties as assigned EDUCATION Bachelor's Degree or equivalent work experience, required EXPERIENCE AND SKILLS At least 3-5 years of administrative support experience required. Focus on patient-provider engagement, needs assessments, coordination of care, and or patient treatment adherence within the healthcare or social service industry preferred Understanding of intermittent medical terminology such as CPT, HCPC, and diagnostic codes Understanding of basic benefit plan design terminology such as deductible, out-of-pocket, prescription drugs, physical medicine services, etc. Strong verbal and written communication skills Strong analytical and problem-solving skills COMPETENCIES Communication Customer Focus Accountability Functional/Technical Job Skills PHYSICAL DEMANDS This is a standard desk role - long periods of sitting and working on a computer are required. WORK ENVIROMENT Remote Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive. The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life & Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend. Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time. All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process. It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role. Protect Yourself from Hiring Scams Important Notice About Our Hiring Process To keep your experience safe and transparent, please note: All interviews are conducted via video. No job offer will ever be made without a video interview with Human Resources and/or the Hiring Manager. If someone contacts you claiming to represent us and offers a position without a video interview, it is not legitimate. We never ask for payment or personal financial information during the hiring process. For your security, please verify all job opportunities through our official careers page: Current Career Opportunities at Allied Benefit Systems Your security matters to us-thank you for helping us maintain a fair and trustworthy process!

🚨 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 ******************************************************** .

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 *********************************************************

This position is a hybrid of remote from home and field work. The candidate will need to reside in and travel throughout the North Sound region (Snohomish, Skagit, Whatcom, San Juan and Island counties). Who we are Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration. Our commitment is to: * Strive to apply an equity lens to all our work. * Reduce health disparities. * Create an equitable work environment. About the Role This position works under the general direction of the Supervisor of Care Management and is responsible for the plan's regional field care management and coordination programs and processes. The Regional Field Case Manager will provide care management services for CHPW members with short term, long term, stable, unstable, and predictable course of illness. The Regional Field Case Manager resides within the assigned region to effectively coordinate care between members, providers and community resources. This role also provides care management services for CHPW members with highly complex medical/behavioral and social conditions where advocacy and coordination are required. This role represents CHPW in the community to provide education on care management programs and provide in-person support for members. The Regional Field Case Manager coordinates with internal and external partners to support members, providers and initiatives in the assigned region. To be successful in this role, you: * Possess a Bachelor's degree in nursing or a master's degree in social work and/or a related behavior health field (required). * Have a current, unrestricted license in the state of Washington as a registered nurse (RN) (required) OR * Have a current, unrestricted license in the State of Washington as a Social Worker (LSWAA, LSWAIC) (required) OR * Current, unrestricted license in the State of Washington as a Mental health Counselor (LMHC), Mental Health Professional (LMHP), or Marriage and Family Therapist (LMFT) (required) * Have a minimum of one (1) year case management experience; home health or discharge planning experience; or a combination of education and experience which provides an equivalent background required OR * Have a minimum of one (1) year in an acute care, facility-based medical or behavioral health experience and/or outpatient psychiatric and substance abuse disorder treatment experience, required; or equivalent combination of education and experience and/or working with children and families. * Have experience with those who have disabilities and knowledge of Child and Families Services. * Have a minimum three (3) years of clinical experience and/or outpatient setting (required). * Have a valid state issued drivers' license. Preferred * Have a case management certification. * Are bilingual. * Have experience in managed care (Medicaid/HCA). * Have previous experience in using Care Management software applications. * Have knowledge of, and experience with, community resources. * Experience in care management workflow systems Essential functions and Roles and Responsibilities: * Engages with members, providers and agencies in the assigned region to support field care management services. * Provides face-to-face visits to members where telephonic care management is a barrier, to foster effective participation in the care management program. * Identify and partner with emergency response services or other programs in a community that support members who are high utilizers of medical/behavioral health services. Field case management can include meeting members in acute care, emergency room, adult family home, Inpatient behavioral health facilities, shelters, community health centers, members home or member preferred location. * Assesses, evaluates, plans, implements, and documents the care of members within the organizations' clinical database system in accordance with organizational policies and procedures. * Implements the plan of care through direct member care, coordination, and delegation of the activities of the health care team. Promotes continuity of care by accurately and completely communicating to health care team the status of members for whom care is provided. * Evaluates members' progress towards goals, identify potential barriers, assists members in navigating the healthcare system and expected outcomes in collaboration with member and the interdisciplinary care team. * Works within the multi-interdisciplinary care team that collaborates with providers, members, caregivers, contracted vendors, community resources, and health plan partners to assess the member's health status, identify care needs and ensure access to appropriate services to achieve positive health outcomes. * Advocates on behalf of members and facilitates coordination of resources required to help members reach optimum functional levels and autonomy within the constraints of their disease conditions. * Represents CHPW Care Management Department in the community to provide education on care management programs and collaborate with providers and community partners. Leads regional based projects as assigned * Participates in external care conferences and other d/c planning activities that may be needed to prevent a readmission as needed. * Participates in clinical case review with internal interdisciplinary team at Care Management Rounds. * Employees are expected to report to work as scheduled, participate in all assigned meetings, and meet established performance and accountability standards. * Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion. * This position requires traveling on behalf of the Company and working in the field at least 50% of the time. It is essential that a current driver's license, proof of insurance and an acceptable driving record are maintained. Knowledge, Skills, and Abilities: * Knowledge of regulatory and certification requirements and their impact on the organization such as CMS, HCA, HEDIS, CAHPS, and NCQA. * Knowledge of and experience with community and other resources * Analytical skills and the ability to interpret, evaluate and formulate action plans based upon data * Organizational, time management, and project management skills * Ability to handle multiple priorities * Ability to multi-task and deal with complex assignments on a frequent basis * Proficiency and experience with Microsoft Office products * Written and verbal communication skills; able to communicate with and collaborate effectively with internal departments, physicians and allied health care providers * Ability to work independently * Perform all functions of the job with accuracy, attention to detail and within established timeframes. * Ability to maintain confidentiality Note: If you think you do not qualify, please reconsider. Studies have shown that women and people of color are less likely to apply to jobs unless they feel they meet every qualification. However, everyone brings different strengths to the table for a job, and people can be successful in a role in a variety of ways. If you are excited about this job but your experience doesn't perfectly check every box in the , we encourage you to apply anyway. As part of our hiring process, the following criteria must be met: * Complete and successfully pass a criminal background check Criminal History: includes review of criminal convictions and probation. CHPW does not automatically or categorically exclude persons with a criminal background from employment. The applicant's criminal history will be reviewed on a case-by-case basis considering the risk to the business, members, and/employees. * Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency * Vaccination requirement (CHPW offers a process for medical or religious exemptions) * Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation. Compensation and Benefits: The position is FLSA Exempt and is not eligible for overtime and has a 10% annual incentive target based on company, department, and individual performance goals. The base pay actually offered will take into account internal equity and also may vary depending on the candidate's job-related knowledge, skills, and experience among other factors. CHPW offers the following benefits for Full and Part-time employees and their dependents: * Medical, Prescription, Dental, and Vision * Telehealth app * Flexible Spending Accounts, Health Savings Accounts * Basic Life AD&D, Short and Long-Term Disability * Voluntary Life, Critical Care, and Long-Term Care Insurance * 401(k) Retirement and generous employer match * Employee Assistance Program and Mental Fitness app * Financial Coaching, Identity Theft Protection * Time off including PTO accrual starting at 17 days per year * 40 hours Community Service volunteer time * 10 standard holidays, 2 floating holidays * Compassion time off, jury duty Sensory/Physical/Mental Requirements: Sensory*: * Speaking, hearing, near vision, far vision, depth perception, peripheral vision, touch, smell, and balance. Physical*: * Extended periods of sitting, computer use, talking, and possibly standing * Simple grasp, firm grasp, fine manipulation, pinch, finger dexterity, supination/pronation, wrist flexion Mental: * Must have the ability to learn and prioritize multiple tasks within the scope and guidelines of the position and its applicable licensure requirements, many requiring extremely complex cognitive capabilities. Must be able to manage conflict, communicate effectively and meet time-sensitive deadlines. Work Environment: Office environment Employees who frequently work in front of computer monitors are at risk for environmental exposure to low-grade radiation. * Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation. * The above is intended to describe the general content of and the requirements for satisfactory performance in this position. It is not to be construed as an exhaustive statement of the duties, responsibilities, or requirements of this position. Job descriptions may be updated or changed to reflect business needs.

This position is a hybrid of remote from home and field work. The candidate will need to reside in and travel throughout the North Sound region (Snohomish, Skagit, Whatcom, San Juan and Island counties). Who we are Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration. Our commitment is to: * Strive to apply an equity lens to all our work. * Reduce health disparities. * Create an equitable work environment. About the Role This position works under the general direction of the Supervisor of Care Management and is responsible for the plan's regional field care management and coordination programs and processes. The Regional Field Case Manager will provide care management services for CHPW members with short term, long term, stable, unstable, and predictable course of illness. The Regional Field Case Manager resides within the assigned region to effectively coordinate care between members, providers and community resources. This role also provides care management services for CHPW members with highly complex medical/behavioral and social conditions where advocacy and coordination are required. This role represents CHPW in the community to provide education on care management programs and provide in-person support for members. The Regional Field Case Manager coordinates with internal and external partners to support members, providers and initiatives in the assigned region. To be successful in this role, you: * Possess a Bachelor's degree in nursing or a master's degree in social work and/or a related behavior health field (required). * Have a current, unrestricted license in the state of Washington as a registered nurse (RN) (required) OR * Have a current, unrestricted license in the State of Washington as a Social Worker (LSWAA, LSWAIC) (required) OR * Current, unrestricted license in the State of Washington as a Mental health Counselor (LMHC), Mental Health Professional (LMHP), or Marriage and Family Therapist (LMFT) (required) * Have a minimum of one (1) year case management experience; home health or discharge planning experience; or a combination of education and experience which provides an equivalent background required OR * Have a minimum of one (1) year in an acute care, facility-based medical or behavioral health experience and/or outpatient psychiatric and substance abuse disorder treatment experience, required; or equivalent combination of education and experience and/or working with children and families. * Have experience with those who have disabilities and knowledge of Child and Families Services. * Have a minimum three (3) years of clinical experience and/or outpatient setting (required). * Have a valid state issued drivers' license. Preferred * Have a case management certification. * Are bilingual. * Have experience in managed care (Medicaid/HCA). * Have previous experience in using Care Management software applications. * Have knowledge of, and experience with, community resources. * Experience in care management workflow systems Essential functions and Roles and Responsibilities: * Engages with members, providers and agencies in the assigned region to support field care management services. * Provides face-to-face visits to members where telephonic care management is a barrier, to foster effective participation in the care management program. * Identify and partner with emergency response services or other programs in a community that support members who are high utilizers of medical/behavioral health services. Field case management can include meeting members in acute care, emergency room, adult family home, Inpatient behavioral health facilities, shelters, community health centers, members home or member preferred location. * Assesses, evaluates, plans, implements, and documents the care of members within the organizations' clinical database system in accordance with organizational policies and procedures. * Implements the plan of care through direct member care, coordination, and delegation of the activities of the health care team. Promotes continuity of care by accurately and completely communicating to health care team the status of members for whom care is provided. * Evaluates members' progress towards goals, identify potential barriers, assists members in navigating the healthcare system and expected outcomes in collaboration with member and the interdisciplinary care team. * Works within the multi-interdisciplinary care team that collaborates with providers, members, caregivers, contracted vendors, community resources, and health plan partners to assess the member's health status, identify care needs and ensure access to appropriate services to achieve positive health outcomes. * Advocates on behalf of members and facilitates coordination of resources required to help members reach optimum functional levels and autonomy within the constraints of their disease conditions. * Represents CHPW Care Management Department in the community to provide education on care management programs and collaborate with providers and community partners. Leads regional based projects as assigned * Participates in external care conferences and other d/c planning activities that may be needed to prevent a readmission as needed. * Participates in clinical case review with internal interdisciplinary team at Care Management Rounds. * Employees are expected to report to work as scheduled, participate in all assigned meetings, and meet established performance and accountability standards. * Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion. * This position requires traveling on behalf of the Company and working in the field at least 50% of the time. It is essential that a current driver's license, proof of insurance and an acceptable driving record are maintained. Knowledge, Skills, and Abilities: * Knowledge of regulatory and certification requirements and their impact on the organization such as CMS, HCA, HEDIS, CAHPS, and NCQA. * Knowledge of and experience with community and other resources * Analytical skills and the ability to interpret, evaluate and formulate action plans based upon data * Organizational, time management, and project management skills * Ability to handle multiple priorities * Ability to multi-task and deal with complex assignments on a frequent basis * Proficiency and experience with Microsoft Office products * Written and verbal communication skills; able to communicate with and collaborate effectively with internal departments, physicians and allied health care providers * Ability to work independently * Perform all functions of the job with accuracy, attention to detail and within established timeframes. * Ability to maintain confidentiality Note: If you think you do not qualify, please reconsider. Studies have shown that women and people of color are less likely to apply to jobs unless they feel they meet every qualification. However, everyone brings different strengths to the table for a job, and people can be successful in a role in a variety of ways. If you are excited about this job but your experience doesn't perfectly check every box in the , we encourage you to apply anyway. As part of our hiring process, the following criteria must be met: * Complete and successfully pass a criminal background check Criminal History: includes review of criminal convictions and probation. CHPW does not automatically or categorically exclude persons with a criminal background from employment. The applicant's criminal history will be reviewed on a case-by-case basis considering the risk to the business, members, and/employees. * Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency * Vaccination requirement (CHPW offers a process for medical or religious exemptions) * Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation. Compensation and Benefits: The position is FLSA Exempt and is not eligible for overtime and has a 10% annual incentive target based on company, department, and individual performance goals. The base pay actually offered will take into account internal equity and also may vary depending on the candidate's job-related knowledge, skills, and experience among other factors. CHPW offers the following benefits for Full and Part-time employees and their dependents: * Medical, Prescription, Dental, and Vision * Telehealth app * Flexible Spending Accounts, Health Savings Accounts * Basic Life AD&D, Short and Long-Term Disability * Voluntary Life, Critical Care, and Long-Term Care Insurance * 401(k) Retirement and generous employer match * Employee Assistance Program and Mental Fitness app * Financial Coaching, Identity Theft Protection * Time off including PTO accrual starting at 17 days per year * 40 hours Community Service volunteer time * 10 standard holidays, 2 floating holidays * Compassion time off, jury duty Sensory/Physical/Mental Requirements: Sensory*: * Speaking, hearing, near vision, far vision, depth perception, peripheral vision, touch, smell, and balance. Physical*: * Extended periods of sitting, computer use, talking, and possibly standing * Simple grasp, firm grasp, fine manipulation, pinch, finger dexterity, supination/pronation, wrist flexion Mental: * Must have the ability to learn and prioritize multiple tasks within the scope and guidelines of the position and its applicable licensure requirements, many requiring extremely complex cognitive capabilities. Must be able to manage conflict, communicate effectively and meet time-sensitive deadlines. Work Environment: Office environment Employees who frequently work in front of computer monitors are at risk for environmental exposure to low-grade radiation. * Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation. * The above is intended to describe the general content of and the requirements for satisfactory performance in this position. It is not to be construed as an exhaustive statement of the duties, responsibilities, or requirements of this position. Job descriptions may be updated or changed to reflect business needs.

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.

✨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

About Us: Allcare Homecare is committed to providing exceptional care and support to individuals in need. We believe in empowering lives through compassion, dedication, and community-driven service. Our team is dedicated to ensuring the highest quality of care for those we serve, and we are looking for a motivated and empathetic Case Coordinator to join our mission. Position Summary: The Case Coordinator is responsible for managing and coordinating care plans, communicating with service providers, and ensuring the well-being of the individuals under our care. This role involves collaboration with medical professionals, families, and internal teams to create and maintain detailed care plans that meet the specific needs of each person served. Key Responsibilities: Develop, implement, and monitor care plans for individuals served, ensuring all medical, social, and emotional needs are addressed. Coordinate with healthcare providers, social workers, and other stakeholders to facilitate comprehensive care. Maintain accurate and up-to-date records, including medical information, service schedules, and care documentation. Communicate regularly with families and guardians to provide updates and address concerns. Ensure compliance with state and federal regulations, as well as company policies. Conduct routine assessments and adjust care plans as necessary based on changes in condition or needs. Support the onboarding and training of staff members as it pertains to care delivery. Participate in audits, quality assurance measures, and continuous improvement initiatives. Qualifications: Bachelor's degree in Social Work, Healthcare Administration, or a related field preferred. (perfered not needed) 2+ years of experience in case management, healthcare, or social services. Strong understanding of care planning, medical terminology, and state regulations. Excellent communication, organizational, and problem-solving skills. Ability to work both independently and collaboratively in a team environment. Proficiency in Microsoft Office Suite and care management software (e.g., Axis Care). Requirements CPR FIRST AID Live Scan NEG TB TEST WITHIN LAST TWO YEAR