workers' compensation case manager

ForzaCare

<div><p><b>ABOUT US:</b></p><p>
Founded in 2022, <b>ForzaCare</b> is a purpose-driven organization that helps injured individuals recover faster and return to work safely through coordinated, clinically appropriate care. Our name reflects our mission - Forza means &quot;strength,&quot; representing the power of our team, and <i>Care</i> reflects our compassion for those we serve.
</p><p><b>ForzaCare is proud to be part of Ethos Risk Services,</b> a leading national provider of investigative and risk mitigation solutions. Together, we're expanding our reach and strengthening our ability to deliver exceptional service across the workers' compensation industry. Learn more about ForzaCare and Ethos partnership here.</p><p><b><br>
JOB SUMMARY:</b></p><p>
As a <b>Field Medical Case Manager </b>at ForzaCare, you'll help injured workers navigate their recovery and return to work. You'll act as the central point of coordination, connecting the injured worker, medical providers, employers, and insurance carriers to ensure timely, transparent, and effective care management.
</p><p><b>This role is ideal for licensed nurses or certified rehabilitation counselors</b>.<b> While prior experience in workers' compensation is strongly preferred, those who have it will find their background especially valuable in this role.</b></p><p><b><br>
KEY RESPONSIBILITIES:</b></p><ul><li>
Coordinate care between medical providers, employers, insurance carriers, and injured workers.</li><li>
Attend appointments with the injured workers, which may include visiting employers and injured workers at their place of employment.</li><li>
Develop, document, and monitor individualized recovery goals and return-to-work plans.</li><li>
Provide consistent communication and detailed progress reports to clients and stakeholders.</li><li>
Ensure all case management work meets or exceeds customer and compliance requirements.</li><li>
Build and maintain strong relationships with clients, providers, and internal team members.</li></ul><p><b><br>
QUALIFICATIONS:</b></p><p><b>
Education &amp; Licensure:</b></p><ul><li>
Active Registered Nurse (RN) or Certified Rehabilitation Counselor (CRC) license with associated college degree is required.</li><li>
Additional certifications such as CCM<b>,</b> CIRS, or other case management credentials are preferred.</li><li>
Must comply with all state-specific licensure and certification requirements.</li><li><b>
Prior experience in workers' compensation case management is strongly preferred.</b></li><li>
Valid driver's license, reliable transportation, and auto insurance with ability to travel to appointments.</li></ul><p><b>
Skills &amp; Attributes:</b></p><p>
At ForzaCare, we look for professionals who embody our values and thrive in a collaborative, purpose-driven environment:</p><ul><li><b>
Motivated</b> &ndash;You take pride in exceeding goals and continuously improving.</li><li><b>
Organized</b> &ndash; You can manage a fast-paced workload and multiple priorities with ease.</li><li><b>
Collaborative</b> &ndash; You communicate clearly and work well with diverse teams and stakeholders.</li><li><b>
Committed</b> &ndash; You uphold ForzaCare's mission to deliver high-quality, compassionate care and comply with all safety, ethical, and professional standards.</li></ul><p><i><br>
ForzaCare is an equal opportunity employer that does not discriminate on the basis of religious creed, sex, national origin, race, veteran status, disability, age, marital status, color or sexual orientation or any other characteristic.</i></p></div>

Medical Case Manager - Workers' Compensation

Enlyte

<div>Company Overview:
<div>
At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our industry-leading solutions and services. Whether you're supporting a Fortune 500 client or a local business, developing cutting-edge technology, or providing clinical services you'll work alongside dedicated professionals who share your commitment to excellence and make a meaningful impact. Join us in fueling our mission to protect dreams and restore lives, while building your career in an environment that values collaboration, innovation, and personal growth.</div><div></div><div><b><br>
Be part of a team that makes a real difference.</b></div>
Job Description:
<div><b>
This is a full-time, hybrid position. The candidate must be located in the
</b><br>
<b>Glendale, CA</b><b> </b><b>area due to regular local travel for in-person patient appointments.</b></div><div></div><div><b><br>
Perks: </b>Full and comprehensive benefits program, 24 days of paid vacation/holidays in your first year plus sick days, home office equipment including laptop and desktop monitor, mileage and travel reimbursement, Employee Assistance and Referral Program, and hands-on workers&rsquo; compensation case management training.</div><div></div><div><br>
Join our compassionate team and help make a positive difference in an injured person&rsquo;s life. As a Field Case Manager, you will work closely with treating physicians/providers, employers, customers, legal representatives, and the injured/disabled person to create and implement a treatment plan that returns the injured/disabled person back to work appropriately, ensure appropriate and cost-effective healthcare services, achievement of maximum medical recovery and return to an optimal level of work and functioning. In this role, you will:</div><ul><li>
Demonstrate knowledge, skills, and competency in the application of case management standards of practice.
</li><li>Use advanced knowledge of types of injury, medications, comorbidities, treatment options, treatment alternatives, and knowledge of job duties to advise on a treatment plan.</li><li>
Interview disabled persons to assess overall recovery, including whether injuries or conditions are occupational or non-occupational.</li><li>
Collaborate with treating physicians/providers and utilize available resources to help create and implement treatment plans tailored to an individual patient.</li><li>
Work with employers and physicians to modify job duties where practical to facilitate early return to work.</li><li>
Evaluate and modify case goals based on injured/disabled person&rsquo;s improvement and treatment effectiveness.</li><li>
Independently manage workload, including prioritizing cases and deciding how best to manage cases effectively.
</li><li>Complete other duties, such as attend injured worker&rsquo;s appointments when appropriate, prepare status updates for submittal to customers, and other duties as assigned.</li></ul>
Qualifications:
<ul><li><b>Education:</b> Associates Degree or Bachelor&rsquo;s Degree in Nursing or related field.</li><li><b>
Experience:</b> 2+ years clinical practice preferred. Workers&rsquo; compensation-related experience preferred.</li><li><b>
Skills:</b> Ability to advocate recommendations effectively with physicians/providers, employers, and customers. Ability to work independently. Knowledge of basic computer skills including Excel, Word, and Outlook Email. Proficient grammar, sentence structure, and written communication skills.</li><li><b>
Certifications, Licenses, Registrations:
</b><ul><li>Active Registered Nurse (RN) license required. Must be in good standing.</li><li>
URAC-recognized certification in case management (CCM, CDMS, CRC, CRRN or COHN, COHN-S, RN-BC, ACM, CMAC, CMC).
</li></ul></li><li><b>Travel: </b>Must have reliable transportation and be able to travel to and attend in-person appointments with injured workers in assigned geography.</li><li><b>
Internet:</b> Must have reliable internet.</li><li><b>
Transportation: </b>Must have reliable transportation and be able to travel to and attend in-person appointments with injured workers in assigned geography.</li></ul>
Benefits:
<div>
We&rsquo;re committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&amp;D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living. Benefits eligibility may differ depending on full-time or part-time status. Compensation depends on the applicable US geographic market. The expected base pay for this position ranges from $95,000 - $100,000 annually. In addition to the base salary, you will be eligible to participate in our productivity-based bonus program. Your total compensation, including base pay and potential bonus, will be based on a number of factors including skills, experience, education, and performance metrics.</div><div><br>
</div><p><i>The Company is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.</i>
</p><div>#LI-AV1</div><div>
Registered Nurse (RN), Nursing, Home Care Registered Nurse, Emergency Room Registered Nurse, Clinical Nurse, Nurse Case Manager, Field Case Manager, Medical Nurse Case Manager, Workers&rsquo; Compensation Nurse Case Manager, Critical Care Registered Nurse, Advanced Practice Registered Nurse (APRN), Nurse Practitioner, Case Management, Case Manager, Home Healthcare, Clinical Case Management, Hospital Case Management, Occupational Health, Patient Care, Utilization Management, Acute Care, Orthopedics, Rehabilitation, Rehab, CCM, Certified Case Manager, CDMS, Certified Disability Management Specialist, CRC, Certified Rehab Certificate, CRRN, Certified Rehab Registered Nurse, COHN, Certified Occupational Health Nurse, CMC, Cardiac Medicine Certification, CMAC, Case Management Administrator Certification, ACM, Accredited Case Manager, MSW, Masters in Social Work, URAC, Vocational Case Manager</div></div>

Medical Field Case Manager

<div>Company Overview:
<div>
At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our industry-leading solutions and services. Whether you're supporting a Fortune 500 client or a local business, developing cutting-edge technology, or providing clinical services you'll work alongside dedicated professionals who share your commitment to excellence and make a meaningful impact. Join us in fueling our mission to protect dreams and restore lives, while building your career in an environment that values collaboration, innovation, and personal growth.</div><div></div><div><b><br>
Be part of a team that makes a real difference.</b></div>
Job Description:
<div><b>
This is a full-time, hybrid position. The candidate must be located in th</b><b>e Albuquerque, New Mexico </b><b>area due to regular local travel for in-person patient appointments.</b></div><div><b>
Bilingual (English/Spanish) Required.</b></div><div></div><div><b><br>
Perks: </b>Full and comprehensive benefits program, 24 days of paid vacation/holidays in your first year plus sick days, home office equipment including laptop and desktop monitor, mileage and travel reimbursement, Employee Assistance and Referral Program, and hands-on workers&rsquo; compensation case management training.</div><div></div><div><br>
Join our compassionate team and help make a positive difference in an injured person&rsquo;s life. As a Field Case Manager, you will work closely with treating physicians/providers, employers, customers, legal representatives, and the injured/disabled person to create and implement a treatment plan that returns the injured/disabled person back to work appropriately, ensure appropriate and cost-effective healthcare services, achievement of maximum medical recovery and return to an optimal level of work and functioning. In this role, you will:</div><ul><li>
Demonstrate knowledge, skills, and competency in the application of case management standards of practice.
</li><li>Use advanced knowledge of types of injury, medications, comorbidities, treatment options, treatment alternatives, and knowledge of job duties to advise on a treatment plan.</li><li>
Interview disabled persons to assess overall recovery, including whether injuries or conditions are occupational or non-occupational.</li><li>
Collaborate with treating physicians/providers and utilize available resources to help create and implement treatment plans tailored to an individual patient.</li><li>
Work with employers and physicians to modify job duties where practical to facilitate early return to work.</li><li>
Evaluate and modify case goals based on injured/disabled person&rsquo;s improvement and treatment effectiveness.</li><li>
Independently manage workload, including prioritizing cases and deciding how best to manage cases effectively.
</li><li>Complete other duties, such as attend injured worker&rsquo;s appointments when appropriate, prepare status updates for submittal to customers, and other duties as assigned.</li></ul>
Qualifications:
<ul><li><b>Education:</b> Associates Degree or Bachelor&rsquo;s Degree in Nursing or related field.</li><li><b>
Experience:</b> 2+ years clinical practice preferred. Workers&rsquo; compensation-related experience preferred.</li><li><b>
Skills:</b> Ability to advocate recommendations effectively with physicians/providers, employers, and customers. Ability to work independently. Knowledge of basic computer skills including Excel, Word, and Outlook Email. Proficient grammar, sentence structure, and written communication skills.</li><li><b>
Certifications, Licenses, Registrations:
</b><ul><li>Active Registered Nurse (RN) license required. Must be in good standing.</li><li>
URAC-recognized certification in case management (CCM, CDMS, CRC, CRRN or COHN, COHN-S, RN-BC, ACM, CMAC, CMC) preferred.</li></ul></li><li><b>
Travel: </b>Must have reliable transportation and be able to travel to and attend in-person appointments with injured workers in assigned geography.</li><li><b>
Internet:</b> Must have reliable internet.</li></ul>
Benefits:
<div>
We&rsquo;re committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&amp;D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living. Benefits eligibility may differ depending on full-time or part-time status. Compensation depends on the applicable US geographic market. The expected base pay for this position ranges from $73,000 - $83,000 annually. In addition to the base salary, you will be eligible to participate in our productivity-based bonus program. Your total compensation, including base pay and potential bonus, will be based on a number of factors including skills, experience, education, and performance metrics.</div><div><br>
</div><p><i>The Company is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.</i>
</p><p>#LI-AC1</p><div></div><div><br>
Registered Nurse (RN), Nursing, Home Care Registered Nurse, Emergency Room Registered Nurse, Clinical Nurse, Nurse Case Manager, Field Case Manager, Medical Nurse Case Manager, Workers&rsquo; Compensation Nurse Case Manager, Critical Care Registered Nurse, Advanced Practice Registered Nurse (APRN), Nurse Practitioner, Case Management, Case Manager, Home Healthcare, Clinical Case Management, Hospital Case Management, Occupational Health, Patient Care, Utilization Management, Acute Care, Orthopedics, Rehabilitation, Rehab, CCM, Certified Case Manager, CDMS, Certified Disability Management Specialist, CRC, Certified Rehab Certificate, CRRN, Certified Rehab Registered Nurse, COHN, Certified Occupational Health Nurse, CMC, Cardiac Medicine Certification, CMAC, Case Management Administrator Certification, ACM, Accredited Case Manager, MSW, Masters in Social Work, URAC, Vocational Case Manager</div></div>

Bilingual Field Case Manager

<div>Company Overview:
<div>
At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our industry-leading solutions and services. Whether you're supporting a Fortune 500 client or a local business, developing cutting-edge technology, or providing clinical services you'll work alongside dedicated professionals who share your commitment to excellence and make a meaningful impact. Join us in fueling our mission to protect dreams and restore lives, while building your career in an environment that values collaboration, innovation, and personal growth.</div><div></div><div><b><br>
Be part of a team that makes a real difference.</b></div>
Job Description:
<div><b>
This is a full-time, hybrid position. The candidate must be located in the
</b><br>
<b>Baltimore, MD</b><b> </b><b>area due to regular local travel for in-person patient appointments.</b></div><div></div><div><b><br>
Perks: </b>Full and comprehensive benefits program, 24 days of paid vacation/holidays in your first year plus sick days, home office equipment including laptop and desktop monitor, mileage and travel reimbursement, Employee Assistance and Referral Program, and hands-on workers&rsquo; compensation case management training.</div><div></div><div><br>
Join our compassionate team and help make a positive difference in an injured person&rsquo;s life. As a Field Case Manager, you will work closely with treating physicians/providers, employers, customers, legal representatives, and the injured/disabled person to create and implement a treatment plan that returns the injured/disabled person back to work appropriately, ensure appropriate and cost-effective healthcare services, achievement of maximum medical recovery and return to an optimal level of work and functioning. In this role, you will:</div><ul><li>
Demonstrate knowledge, skills, and competency in the application of case management standards of practice.
</li><li>Use advanced knowledge of types of injury, medications, comorbidities, treatment options, treatment alternatives, and knowledge of job duties to advise on a treatment plan.</li><li>
Interview disabled persons to assess overall recovery, including whether injuries or conditions are occupational or non-occupational.</li><li>
Collaborate with treating physicians/providers and utilize available resources to help create and implement treatment plans tailored to an individual patient.</li><li>
Work with employers and physicians to modify job duties where practical to facilitate early return to work.</li><li>
Evaluate and modify case goals based on injured/disabled person&rsquo;s improvement and treatment effectiveness.</li><li>
Independently manage workload, including prioritizing cases and deciding how best to manage cases effectively.
</li><li>Complete other duties, such as attend injured worker&rsquo;s appointments when appropriate, prepare status updates for submittal to customers, and other duties as assigned.</li></ul>
Qualifications:
<ul><li><b>Education:</b> Associates Degree or Bachelor&rsquo;s Degree in Nursing or related field.</li><li><b>
Experience:</b> 2+ years clinical practice preferred. Workers&rsquo; compensation-related experience preferred.</li><li><b>
Skills:</b> Ability to advocate recommendations effectively with physicians/providers, employers, and customers. Ability to work independently. Knowledge of basic computer skills including Excel, Word, and Outlook Email. Proficient grammar, sentence structure, and written communication skills.</li><li><b>
Certifications, Licenses, Registrations:
</b><ul><li>Active Registered Nurse (RN) license required. Must be in good standing.</li><li>
URAC-recognized certification in case management (CCM, CDMS, CRC, CRRN or COHN, COHN-S, RN-BC, ACM, CMAC, CMC) preferred.</li></ul></li><li><b>
Travel: </b>Must have reliable transportation and be able to travel to and attend in-person appointments with injured workers in assigned geography.</li><li><b>
Internet:</b> Must have reliable internet.</li></ul>
Benefits:
<div>
We&rsquo;re committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&amp;D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living. Benefits eligibility may differ depending on full-time or part-time status. Compensation depends on the applicable US geographic market. The expected base pay for this position ranges from $79,000 - $90,000 annually. In addition to the base salary, you will be eligible to participate in our productivity-based bonus program. Your total compensation, including base pay and potential bonus, will be based on a number of factors including skills, experience, education, and performance metrics.</div><div><br>
</div><p><i>The Company is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.</i>
</p><div>#LI-AC1</div><div>
Registered Nurse (RN), Nursing, Home Care Registered Nurse, Emergency Room Registered Nurse, Clinical Nurse, Nurse Case Manager, Field Case Manager, Medical Nurse Case Manager, Workers&rsquo; Compensation Nurse Case Manager, Critical Care Registered Nurse, Advanced Practice Registered Nurse (APRN), Nurse Practitioner, Case Management, Case Manager, Home Healthcare, Clinical Case Management, Hospital Case Management, Occupational Health, Patient Care, Utilization Management, Acute Care, Orthopedics, Rehabilitation, Rehab, CCM, Certified Case Manager, CDMS, Certified Disability Management Specialist, CRC, Certified Rehab Certificate, CRRN, Certified Rehab Registered Nurse, COHN, Certified Occupational Health Nurse, CMC, Cardiac Medicine Certification, CMAC, Case Management Administrator Certification, ACM, Accredited Case Manager, MSW, Masters in Social Work, URAC, Vocational Case Manager</div></div>

<div>Company Overview:
<div>
At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our industry-leading solutions and services. Whether you're supporting a Fortune 500 client or a local business, developing cutting-edge technology, or providing clinical services you'll work alongside dedicated professionals who share your commitment to excellence and make a meaningful impact. Join us in fueling our mission to protect dreams and restore lives, while building your career in an environment that values collaboration, innovation, and personal growth.</div><div></div><div><b><br>
Be part of a team that makes a real difference.</b></div>
Job Description:
<div><b>
This is a full-time, hybrid position. The candidate must be located in the
</b><br>
<b>Lubbock, TX</b><b> </b><b>area due to regular local travel for in-person patient appointments.</b></div><div><b>
Bilingual (English/Spanish) Required.</b></div><div></div><div><b><br>
Perks: </b>Full and comprehensive benefits program, 24 days of paid vacation/holidays in your first year plus sick days, home office equipment including laptop and desktop monitor, mileage and travel reimbursement, Employee Assistance and Referral Program, and hands-on workers&rsquo; compensation case management training.</div><div></div><div><br>
Join our compassionate team and help make a positive difference in an injured person&rsquo;s life. As a Field Case Manager, you will work closely with treating physicians/providers, employers, customers, legal representatives, and the injured/disabled person to create and implement a treatment plan that returns the injured/disabled person back to work appropriately, ensure appropriate and cost-effective healthcare services, achievement of maximum medical recovery and return to an optimal level of work and functioning. In this role, you will:</div><ul><li>
Demonstrate knowledge, skills, and competency in the application of case management standards of practice.
</li><li>Use advanced knowledge of types of injury, medications, comorbidities, treatment options, treatment alternatives, and knowledge of job duties to advise on a treatment plan.</li><li>
Interview disabled persons to assess overall recovery, including whether injuries or conditions are occupational or non-occupational.</li><li>
Collaborate with treating physicians/providers and utilize available resources to help create and implement treatment plans tailored to an individual patient.</li><li>
Work with employers and physicians to modify job duties where practical to facilitate early return to work.</li><li>
Evaluate and modify case goals based on injured/disabled person&rsquo;s improvement and treatment effectiveness.</li><li>
Independently manage workload, including prioritizing cases and deciding how best to manage cases effectively.
</li><li>Complete other duties, such as attend injured worker&rsquo;s appointments when appropriate, prepare status updates for submittal to customers, and other duties as assigned.</li></ul>
Qualifications:
<ul><li><b>Education:</b> Associates Degree or Bachelor&rsquo;s Degree in Nursing or related field.</li><li><b>
Experience:</b> 2+ years clinical practice preferred. Workers&rsquo; compensation-related experience preferred.</li><li><b>
Skills:</b> Ability to advocate recommendations effectively with physicians/providers, employers, and customers. Ability to work independently. Knowledge of basic computer skills including Excel, Word, and Outlook Email. Proficient grammar, sentence structure, and written communication skills.</li><li><b>
Certifications, Licenses, Registrations:
</b><ul><li>Active Registered Nurse (RN) license required. Must be in good standing.</li><li>
URAC-recognized certification in case management (CCM, CDMS, CRC, CRRN or COHN, COHN-S, RN-BC, ACM, CMAC, CMC) preferred.</li></ul></li><li><b>
Travel: </b>Must have reliable transportation and be able to travel to and attend in-person appointments with injured workers in assigned geography.</li><li><b>
Internet:</b> Must have reliable internet.</li></ul>
Benefits:
<div>
We&rsquo;re committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&amp;D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living. Benefits eligibility may differ depending on full-time or part-time status. Compensation depends on the applicable US geographic market. The expected base pay for this position ranges from $68,000 - $75,000 annually. In addition to the base salary, you will be eligible to participate in our productivity-based bonus program. Your total compensation, including base pay and potential bonus, will be based on a number of factors including skills, experience, education, and performance metrics.</div><div><br>
</div><p><i>The Company is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.</i>
</p><div>#LI-AC1</div><div>
Registered Nurse (RN), Nursing, Home Care Registered Nurse, Emergency Room Registered Nurse, Clinical Nurse, Nurse Case Manager, Field Case Manager, Medical Nurse Case Manager, Workers&rsquo; Compensation Nurse Case Manager, Critical Care Registered Nurse, Advanced Practice Registered Nurse (APRN), Nurse Practitioner, Case Management, Case Manager, Home Healthcare, Clinical Case Management, Hospital Case Management, Occupational Health, Patient Care, Utilization Management, Acute Care, Orthopedics, Rehabilitation, Rehab, CCM, Certified Case Manager, CDMS, Certified Disability Management Specialist, CRC, Certified Rehab Certificate, CRRN, Certified Rehab Registered Nurse, COHN, Certified Occupational Health Nurse, CMC, Cardiac Medicine Certification, CMAC, Case Management Administrator Certification, ACM, Accredited Case Manager, MSW, Masters in Social Work, URAC, Vocational Case Manager</div></div>

CorVel Corporation

<div><p>The WC Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel.</p>
<p>
This is a remote position.</p>
<p><b>
ESSENTIAL FUNCTIONS &amp; RESPONSIBILITIES:</b></p>
<ul>
<li>Receives Workers&rsquo; Compensation claim, confirms policy coverage and acknowledgement of the claim</li>
<li>Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies</li>
<li>Establishes reserves and authorizes payments within reserving authority limits</li>
<li>Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim</li>
<li>Coordinates early return-to-work efforts with the appropriate parties</li>
<li>Manages subrogation and litigation of claim as it applies</li>
<li>Manages potential claim recoveries of all types</li>
<li>Reports claims to the excess carrier when applicable</li>
<li>Communicates claim status with the customer and claimant</li>
<li>Adheres to client and carrier guidelines and participates in claims review as needed</li>
<li>Develops and maintains professional customer relationships</li>
<li>Complies with rules and regulations of applicable state</li>
<li>Complies with all safety rules and regulations during working hours in conjunction with the Injury and Illness Prevention Program (&ldquo;IIPP&rdquo;)</li>
<li>Additional duties as assigned</li></ul><br>
<p></p>
<p><b>
KNOWLEDGE &amp; SKILLS:</b></p>
<ul>
<li>Excellent written and verbal communication skills</li>
<li>Ability to assist team members to develop knowledge and understanding of claims practice</li>
<li>Ability to identify, analyze and solve problems</li>
<li>Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets</li>
<li>Strong interpersonal, time management and organizational skills</li>
<li>Ability to work both independently and within a team environment</li>
<li>Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers&rsquo; Compensation</li></ul><br>
<p></p>
<p><b>
EDUCATION &amp; EXPERIENCE:</b></p>
<ul>
<li>Bachelor's degree or a combination of education and related experience</li>
<li>Minimum of 3 years&rsquo; industry experience and claim handling</li>
<li>Self-Insured Certificate preferred</li>
<li>State Certification or license as an experienced claims adjuster</li>
<li>Current license or certification in Workers&rsquo; Compensation must be maintained throughout employment with CorVel</li></ul><br>
<p></p>
<p><b>
PAY RANGE:</b></p>
<p>
CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.</p>
<p>
For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.</p>
<p>
Pay Range: $29.35 - $47.28 per hour</p>
<p>
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management</p>
<p>
In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.</p><br>
<p></p>
<p><b>
ABOUT CORVEL:</b></p>
<p>
CorVel, a certified Great Place to Work&reg; Company, is a national provider of industry-leading risk management solutions for the workers&rsquo; compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).</p>
<p>
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.</p>
<p><b>
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.</b></p>
<p>
#LI-Remote</p></div>

CA Senior WC Claims Specialist

CA Senior Claims Specialist

Search 10000+ Workers' compensation case manager jobs near you this May. New roles added regularly across leading industries. Apply today.

10000 workers' compensation case manager jobs Near Me

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CA Senior WC Claims Specialist

CA Senior Claims Specialist